Medicare actuaries indicate the ‘most-favored nations’ plan could limit patients’ access to medicine, though CMS’ Verma says she has confidence manufacturers won’t let that happen. Loss of access, combined with expected legal challenges, may make Democrats wary of embracing the Trump team’s last-minute rule, despite general agreement on the underlying policy idea. A Part D reference pricing policy is still in the works, CMS said.

Trump administration could also finalize international reference pricing plan, which could be riskier to industry as it's an area where Democrats and Trump have more alignment, but this proposal may be easier for industry to overturn in court than that rebate rule. A finalized rebate rule is under review by the Office of Management and Budget, but it is unclear if the coming proposal will have any teeth given the limitations imposed by the President’s summer executive order. 

The global COVID-19 crisis has presented a chance for industry to improve its reputation by highlighting the value of its R&D engines. Pharma executives and observers outline why they are optimistic about a chance to regain public trust.