Bill Overview
Title: American Made Pharmaceuticals Act of 2022
Description: This bill requires the Centers for Medicare & Medicaid Services to conduct a demonstration program that gives preference to domestically manufactured drugs under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). The program must be conducted in at least eight states and for at least seven years. Applicable drugs include critical drugs that are needed to respond to a public health emergency and that have a vulnerable global supply chain. Preference may take the form of reduced cost-sharing, preferential treatment on formularies, bonus payments, and other specified methods.
Sponsors: Sen. Smith, Tina [D-MN]
Target Audience
Population: Individuals reliant on Medicare, Medicaid, CHIP, and those affected by global drug supply chains
Estimated Size: 60000000
- The bill affects Medicare, Medicaid, and CHIP programs, which are significant components of the U.S. healthcare system.
- Medicare provides health insurance for older adults and some younger people with disabilities in the U.S., covering over 60 million individuals.
- Medicaid provides health coverage to low-income individuals, including families, children, pregnant women, elderly, and people with disabilities, covering around 75 million people in the USA.
- The Children's Health Insurance Program (CHIP) provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid, covering over 9.6 million children.
- By focusing on drugs critical during a public health emergency, the bill targets the global population needing access to effective responses in such emergencies.
- The bill also addresses drugs with a vulnerable global supply chain, potentially impacting populations that depend on drugs that are often scarce or have supply issues.
Reasoning
- The policy directly impacts individuals reliant on Medicare, Medicaid, and CHIP, with a particular focus on those using critical drugs that respond to public health emergencies.
- Given that the policy budget is substantial, the simulation reflects diverse experiences based on demographics and current use of applicable drugs.
- Interviewees include individuals from various walks of life who either directly or indirectly benefit from the implementation of the policy.
Simulated Interviews
Retired teacher (Texas)
Age: 72 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 7.0 years
Commonness: 15/20
Statement of Opinion:
- I believe making more drugs within the country is important for our own reliability and safety.
- Currently, I rely on a few medications that have become costly over the years.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 9 | 7 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
Pharmaceutical Lab Technician (Illinois)
Age: 35 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- I support making more drugs here to prevent shortages.
- The cost of diabetes treatment is a constant concern.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Freelance Artist (New York)
Age: 29 | Gender: other
Wellbeing Before Policy: 8
Duration of Impact: 3.0 years
Commonness: 8/20
Statement of Opinion:
- While directly benefiting isn't apparent, the idea of having more reliable drug supplies is reassuring.
- Healthcare costs have been an issue for family while on CHIP.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 7 | 6 |
Stay-at-home parent (Florida)
Age: 45 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 7.0 years
Commonness: 12/20
Statement of Opinion:
- It's comforting to know medications might become more affordable and accessible.
- The family often faces high copays for essential drugs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 5 |
Construction worker (California)
Age: 57 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 7.0 years
Commonness: 10/20
Statement of Opinion:
- Drugs made here can hopefully bring down costs and keep my options open.
- My pain management is heavily reliant on medication.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 3 |
Retired Nurse (Ohio)
Age: 63 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- Healthcare should always prioritize reliability, and I see this policy as a move in the right direction.
- Access to lifesaving medications keeps the stress of managing my condition lower.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Small Business Owner (Arizona)
Age: 50 | Gender: male
Wellbeing Before Policy: 9
Duration of Impact: 0.0 years
Commonness: 15/20
Statement of Opinion:
- Support for local industries often aligns with my values.
- We use medications sparingly, tend to focus on holistic health.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 8 |
| Year 20 | 8 | 8 |
Retired Engineer (Michigan)
Age: 68 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 10/20
Statement of Opinion:
- Reducing dependence on foreign-made drugs could be beneficial.
- The number of medications I take is large and costly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 9 | 4 |
Chef (Oregon)
Age: 40 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- A domestic angle on pharmaceuticals could enhance security and my mental health care.
- Access to a steady supply of my antidepressants is crucial.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Retired Military Personnel (Georgia)
Age: 74 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 12/20
Statement of Opinion:
- The policy preference for locally produced drugs may make my medicines more affordable.
- My military benefits are helpful but each drug cost adds up.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 4 |
Cost Estimates
Year 1: $250000000 (Low: $200000000, High: $300000000)
Year 2: $260000000 (Low: $210000000, High: $320000000)
Year 3: $270000000 (Low: $220000000, High: $340000000)
Year 5: $300000000 (Low: $250000000, High: $370000000)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The effectiveness of incentivizing the use of domestically manufactured drugs without causing significant disruptions in access or cost.
- Potential competitive reactions from foreign drug manufacturers and the impacts on trade relations.
- The ability of domestic manufacturers to meet the demand within the required quality and timeframes.