【华盛顿讯】美国总统特朗普将于周五宣布，全美 50 个州将参与一项计划，在美国医疗补助计划（Medicaid）内部对部分药品实行最惠国定价，把选定药品的实际价格下调至其他部分国家的水平。
这套方案被命名为医疗补助 “慷慨模式（GENEROUS）”。特朗普政府声称，该计划将为医疗补助项目节省数十亿美元处方药开支。但相关协议内容并未对外公开，专家表示实际能够省下多少资金尚不明确。
距离 11 月中期选举越来越近，生活成本问题已经成为选民最关心的议题之一。周五即将公布的这项举措意在回应民众对药品负担过重的诉求。特朗普与多家制药企业达成协议，力求让美国部分药品价格不再大幅高于其他富裕国家。
去年，特朗普签署行政令，推出药品领域的 “最惠国政策”：美国采购药品将对标全球各国中的最低售价。
白宫今年 5 月估算，特朗普与药企达成的降价协议，把部分美国处方药价格下调至其他国家水平，未来十年有望节约 5290 亿美元。
医疗补助计划由联邦与各州共同出资，面向低收入群体。参保患者目前购买处方药，仅需支付几美元象征性自付费用。但药品降价，主要利好负责出资这套福利项目的各州财政。
由于特朗普政府和参与药企达成的协议细节几乎没有公开，外界很难独立核实官方宣称的节约规模，真实的成本效益仍是未知数。
罗伯特・伍德・约翰逊基金会高级政策顾问凯西・亨普斯特德接受美联社采访时表示，社会强烈要求政府提供更详尽的数据，用以佐证节约开支的说法；信息缺失也阻碍国会进一步立法。
“特朗普呼吁国会把这套最惠国相关安排写入法律，” 亨普斯特德说，“但这件事其实不太现实，因为没人清楚协议的具体条款究竟是什么。”
她还提到一个隐忧：本届政府任期有限，一旦政府换届，这些降价政策能否延续、药价会不会再度反弹，目前都存在变数。
不少声音希望更多普通民众可以享受到药价下调红利。
前共和党国会议员、制药改革联盟发言人 J・D・海沃思在一份声明中评价，周五即将发布的宣告代表 “实实在在的进步，但还远远不够”，数百万没有参加政府医保的美国人同样期盼更低的药价。
美国患者的药价高低受多重因素影响，包括药品市场竞争情况以及个人保险。大多数美国人通过单位投保、商业保险市场或者医疗补助、联邦医疗保险这类政府医保获得保障，保险帮患者承担了绝大部分药费。
Trump to announce all 50 states joining Medicaid drug pricing model
WASHINGTON --President Donald Trump is set to announce Friday that all 50 states will join in on a program set to providemost favored nation pricingto some drugs within the Medicaid program， bringing the net price of selected drugs down to prices paid in certain other countries．
The Trump administration claims that Medicaid will save billions on prescription drug costs as a result of the plan， dubbed the Medicaid “GENEROUS” model． Experts say the savings are unclear since the content of the deals isn＇t public．
Friday＇s announcement comes ascost-of-living issues are at the forefrontof voters’ concerns ahead of the midterm elections in November． In a way to address affordability concerns， Trump has cut deals with pharmaceutical companies so that the cost of some drugs in the U．S． would not be dramatically higher than in other affluent nations．
Last year， Trump signed an executive order instituting a “Most Favored Nations” policy， where the U．S． would commit to paying the same price for medications as the nation that pays the lowest price anywhere in the world．
The White Housein May estimatedthat Trump’sdeals with pharmaceutical companiesto lower some of their U．S． prescription drug prices to levels charged in other countries could save $529 billion over the next 10 years．
Patients in Medicaid， the state- and federally-funded program for people with low incomes， already pay a nominal co-payment of a few dollars to fill their prescriptions， but lower prices could help state budgets that fund the programs．
The true cost of the claimed savings is unclear since few details of the deals struck by the Trump administration and participating pharmaceutical companies have been made public， making it hard to independently verify the projected savings．
Kathy Hempstead， a senior policy advisor at the Robert Wood Johnson Foundation， told The Associated Press that there is significant pressure on the administration to provide more granular data to justify its cost-savings claims， and that the lack of information creates a barrier to legislative action．
“He is saying Congress should codify all of his MFN arrangements，＂ Hempstead said． “But it’s kind of unreasonable because it’s not clear what Congress would actually do． No one knows what is in these deals．”
She added that there is concern about whether the current administration’s tenure will affect the longevity of these price cuts and whether prices will revert once the administration leaves．
Some want to see more people benefit from lower drug pricing．
JD Hayworth， a former Republican congressman and spokesperson for the Pharmaceutical Reform Alliance， said in a statement that Friday＇s announcement reflects “meaningful progress， but that progress remains incomplete，＂ as millions of Americans not enrolled in government healthcare want lower drug prices．
Drug prices for patients in the U．S． can depend on a number of factors， including the competition a treatment faces and insurance coverage． Most people have coverage through work， the individual insurance market or government programs like Medicaid and Medicare， which shield them from much of the cost．
