With President Joe Biden starting to stake out his preferred strategy to lower drug prices, Washington, D.C. insiders say that policies allowing the importation of drugs from Canada and pegging Medicare drug prices to an index of international pharma costs are still under consideration by Congress. However, the experts add that both measures face long odds of making their way through the Senate. The concept of an international drug pricing index is tied to a policy that would see Medicare negotiate the reimbursement rate of drugs with manufacturers. The international pricing index — which would likely see HHS aggregate price data from other developed countries, particularly those with Most Favored Nation trade status — would serve as the basis for the drug prices HHS negotiates with pharma. The Trump administration in December 2020 unveiled a mandatory demonstration of a most-favored-nation model that was blocked by a federal court in January. The rule was under review by the Biden administration until Aug. 6, when Biden’s HHS issued a proposed rule that would cancel the demonstration. But that draft regulation left the door open for a similar policy to be implemented later.