Ronald Reagan's health advisory panel is urging him to repeal a regulation adopted over industry opposition in the Nixon administration to hold down prices paid for drugs under Medicare, Medicaid and other federal health care programs.
That recommendation is one of a number -- some reflectiing longtime goals of the pharmaceutical industry -- in a report given to the presidential transition team last week by Dr. William B. Walsh, chairman of the Health Policy Advisory Group (HPAG).
Walsh, president of Project Hope, an international medical education organization, listed the recommendations in an interview this week.
HPAG, whose 16 members included three present and former representatives of the industry, suggested that the Reagan administration:
Scuttle the so-called maximum allowable cost plan, which limits federal payments for any particular medicine prescribed under government programs, because, Walsh said, "everybody will charge the maximum, particularly to Medicare and Medicaid patients."
Often, the maximum the government pays is geared to the prices of unbranded or generic products, rather than to the prices of generally costlier brand-name versions, although the Food and Drug Administration has approved them all for safety and efficacy.
In the Nixon administration, over fierce industry opposition, HPAG member Caspar W. Weinberger, as secretary of health, education and welfare, launched the maximum cost plan in an effort to hold down the government's large bill particularly for trade-named drugs, some of which were priced several times higher than generics.
Pending more "field testing," slow down FDA's plans to require manufacturers of most prescription drugs to supply consumers with easy-to-read brochures listing the benefits and risks and other key facts in the official prescribing instructions for physicians.
Walsh said that HPAG felt the wording of the brochures "should be done by outsiders," including health professionals, but was vague as to why this was necessary when the brochures are basically translations of the technical medical language of the official labeling.
Discontinue FDA's guide to the comparative costs of prescription drugs because, Walsh said, it is "expensive" and includes "faulty" and "misleading" information that is sometimes out-of-date by the time it becomes available.
Stop FDA from providing lists of therapeutically equivalent drugs because, according to Walsh, they contain "costly, undocumented opinions and assumptions" and were issued "without legal authority."
Make it easier for manufacturers to export drugs, particularly those that may not be needed here while being needed abroad.
Enhance the profit incentives for the industry to invent new medicines by starting the clock on 17-year drug patent monopolies not when the patent issues, as at present, but when the FDA -- years later, in some cases -- approves the product for sale.
This idea is embodied in a bill that Rep. Steven D. Symms (R-Idaho), now a senator-elect, introduced in the House. The bill also contains a more drastic proposal: repeal the law requiring that a manufacturer document claims for a drug with substantial scientific evidence.
Implementation of this law, in Democratic and Republican administrations alike, has been so slow that in 1979 -- 17 years after enactment -- the public paid an estimated $1 billion for prescription drugs of unproved effectiveness.
"We support the 1962 effectiveness law 100 percent," Walsh said. "The public would be up in arms" if repeal were to be attempted. Even the industry wouldn't support repeal, said HPAG member C. Joseph Stetler, former president of the Pharmaceutical Manufactureres Association.