View: Let Medicare use its leverage to lower drug costs

The best strategy to push down such prices — the one endorsed by Clinton and one of her rivals for the Democratic presidential nomination, Bernie Sanders — is to give Medicare, which pays for 29 percent of all U.S. prescription drug purchases, the ability to negotiate prices with drugmakers.

That Medicare doesn’t already do this is Congress’s fault. In 2003, when lawmakers created the Medicare prescription drug benefit, they explicitly prohibited bargaining. Presumably, this was to maintain the support of drug companies, but it gives away great leverage that Medicare could use to keep drug prices in check.

See also: View: The danger of trying to manage U.S. drug prices

Along with this bargaining power, the government needs better information on drug effectiveness. Clinton endorses this, too. An authoritative body, similar to those in other countries, should compare various medicines for the same condition. The Patient Protection and Affordable Care Act (PPACA) created the Patient-Centered Outcomes Research Institute (PCORI) to address similar questions, but it is prohibited from considering the relative value of drugs.

Some medicines may be so unique and effective as to be worth buying at a high price. But both Medicare and private insurers need to know which ones they are.