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As U.S. President Donald Trump prepares to deliver a long-anticipated speech on Friday on curbing prescription drug costs, health industry insiders expect little in the way of policies that would hurt the drugmakers he once accused of "getting away with murder." The speech will address the high prices set by drugmakers, rising costs for consumers and barriers to negotiating lower prices for seniors in the government's Medicare program, senior White House officials told reporters. (Abutaleb, 5/10)

Officials said the plan would increase competition, create incentives for drugmakers to lower initial prices and slash federal rules that make it harder for private insurers to negotiate lower prices. The result would be lower pharmacy costs for patients — a key Trump campaign promise. (Perrone, 5/11)

Asked if the plan would include direct negotiations by Medicare, the official said, “No, we are talking about something different.” “We are not calling for Medicare negotiation in the way that Democrats have called for,” the official said later. “We clearly want to make important changes that will dramatically improve the way negotiation takes place inside the Medicare program.” (Pear, 5/10)

Democrats have been pressuring Trump ahead of his speech to renew his call for Medicare to negotiate drug prices, something that Trump touted on the campaign trail in 2016, in a break with Republican party orthodoxy. (Sullivan, 5/10)

Officials also said the policy changes could happen sooner than later. The “vast majority” of the proposals will be regulatory actions the “president can direct the administration to take.” In the plan, Trump will address a quartet of issues the administration has identified, the officials said. “The blueprint focuses on four major problems: high list prices set by drug manufacturers, rising out-of-pocket costs for consumers and patients, foreign governments free-riding off American innovation, and government rules preventing private plans from negotiating better deals for our seniors, especially for high-cost medications,” one official said. (Mershon, 5/11)

The president will also propose changes to government rules that his administration contends have allowed drugmakers and pharmacy benefit managers to game the system, the officials said. He will also try to make foreign governments pay more to buy drugs created through U.S. innovation and further seek to accelerate the use of generic drugs in place of higher-cost brand names, they said. Low-income seniors could get free generic drugs, doctors might see reduced incentives to select more expensive drugs if cheaper alternatives exist, and health plans could be required to share rebates with beneficiaries, as part of the proposals. (Armour, Radnofsky and Burton, 5/10)

Trump will also move to rein in what his administration has characterized as “foreign freeloaders” — or first-world countries that use government controls or negotiations to hold down their drug costs. “The U.S. taxpayer, through our publicly funded research efforts as well as through patients and consumers … are largely paying for the vast majority of the R&D that goes into the development of new biologics,” a senior administration official said, lamenting that foreign countries get to “free ride” off of U.S. investment in drug development. (Cancryn and Pittman, 5/10)

Food and Drug Administration Commissioner Scott Gottlieb kicked things off last year by expediting reviews of applications to bring new generic drugs to market. The agency has given priority to certain generic-drug applications that would fill gaps where there is little-to-no low-cost competition. The FDA approved a record-setting 1,027 new generic drugs last year. Trump’s fiscal 2019 budget request to Congress proposed speeding up generic drug approvals further. Currently, the first company to try and bring a generic to market gets six months to sell its drug before competitors drive down the price. If it has trouble making the cheaper drugs or getting approved, the process can drag out -- making consumers wait for the less expensive version. Trump’s proposal would allow the FDA to leapfrog the troubled application and move on to one ready to gain approval. (Edney, 5/10)

No one with a stake in drug prices — whether pharmaceutical companies, pharmacy benefit managers that negotiate on drug prices or health insurers — feels completely comfortable, given Trump's tendency to go off-script — including that time he accused drug companies of “getting away with murder.” But the administration has spent the past few weeks dropping clues about the policy directions it favors — including a slew of technical proposals that do little to threaten the pharmaceutical industry that would seem to be at greatest risk from any plan to lower drug prices. (Johnson, 5/10)

The near-term implications for biotechnology and pharmaceutical stocks remain murky on Wall Street. Cowen analysts said in a research note Thursday that they expect Trump’s speech will “be relatively benign, with more drastic proposals coming at a later date or not at all.” Wells Fargo & Co.’s David Maris, meanwhile, has cautioned that calls for lower prices and greater transparency have “never been louder." (Lipschultz, 5/10)

A coterie of the country’s most powerful and recognizable Democrats gathered Thursday to offer their early rebuttal to President Trump’s anticipated Friday address on drug prices. As one lawmaker put it, the group was “hopeful, but … not optimistic” that Trump would deliver on his early promises to lower prescription drug prices. What they want to see, however, is far broader than anything that top Trump administration officials have hinted at ahead of Trump’s Friday speech. (Mershon, 5/10)