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Health care affordability ranks first or second among issues voters want Congress to tackle in 2019, according to numerous polls following the 2018 midterm elections. While Democrats and Republicans have very different opinions on hot button issues such as the Affordable Care Act and Medicare for All, they unite when it comes to anger over pharmaceutical costs.President Donald Trump has a plan to cut prescription drug prices, Democrats of all stripes have campaigned on tackling this. Should we expect to see big changes this year? As a 25-year veteran of the drug-pricing battle on Capitol Hill, I’m skeptical anything ambitious will be coming. Even so, there’s new momentum for change. Here are my predictions for action on drug pricing in the new 116th Congress. (Ted Slafsky, 1/7)

Across the United States, about 1 of every 7 individuals in jail or prison has chronic hepatitis C. In some states, such as New Mexico, it’s closer to 1 in 3. With approximately 9 million people spending time in prison or jail over the course of a year, more than 1.2 million incarcerated individuals have chronic hepatitis C. Left untreated, this viral disease can cause serious and costly health problems, including cirrhosis, liver cancer, liver failure, and even death. Once a difficult-to-treat infection, chronic hepatitis C can now be cured by taking a regimen of daily pills for eight to 12 weeks that act directly against the virus. But there’s a hitch: This cure costs $25,000 or more per person. (Anne C. Spaulding and Jagpreet Chhatwal, 1/9)

For all the nasty partisan divisiveness in Washington, it’s often worth worrying more when both parties agree. A case in point is a potential left-right condominium on drug prices that should alarm Americans hoping a cure for cancer or Alzheimer’s arrives in their lifetime.Members of Congress are calling prescription drug prices a top target for 2019. A GOP Senate in most cases will check the ambitions of Democrats in the House, but pharmaceuticals may be the exception. GOP Senator Chuck Grassley appears eager to investigate drug companies from his new post running the Senate Finance Committee. President Trump is demanding better deals on drugs, and the risk is that this crowd comes to a consensus. (2/7)

Will 2019 be the year that lawmakers finally address prescription drug prices? Not if they follow distracting and counterproductive proposals like the one made by Democratic presidential primary candidate Sen. Elizabeth Warren (D-Mass.) last month to get the government into the drug manufacturing business. Warren's Affordable Drug Manufacturing Act would create an Office of Drug Manufacturing that would manufacture select generic drugs at a "fair price." (Terry Wilcox, 1/4)

In the U.S., medications are priced and sold by the pill, capsule or fluid ounce. A better approach would be to charge different prices for a medicine based on the disease for which it is prescribed. While the current drug-purchasing system is too complex to reform overnight, there is a simple change that could improve health outcomes and control spending: disease-specific rebates. Take a drug that wipes out malignant cells in lung cancer but is inconsistent in its ability to kill pancreatic cancer cells. In a world of “indication based” rebates, the manufacturer would pay the insurer or pharmacy benefit manager an agreed-upon amount each time the medication is used to treat a patient with pancreatic cancer. (Roger D. Klein, 1/8)

A recent commentary (“Supreme Court must right wrong striking down Md.'s drug price-gouging statute,” Jan. 4) provides a guide to why patients are still frustrated about the state of drug prices, but not as the author intended. When the writer of the op-ed — like the drafters of Maryland’s generic drug legislation — myopically focuses on the “the Martin Shkrelis of the pharmaceutical industry,” he loses sight of what is driving high costs for patients: expensive brand-name drugs. (Chester Davis, 1/8)

For more than four decades, well-meaning members of Congress of both parties have attempted to introduce competition into the prescription drug monopoly and for 40 years, they've been stymied and stone-walled by the powerful drug companies and their lobbyists. Minnesota Democratic Sen. Amy Klobuchar and Iowa Republican Sen. Charles Grassley have mounted another campaign with a proposal to prohibit pay-for-delay deals between drug companies that keep competitively priced general drugs and new medicines off the market. (1/9)