AP FACT CHECK: Trump hype on drug costs, hydroxychloroquine

President Donald Trump is making grandiose claims about slashing drug prices and the efficacy of a treatment for COVID-19 that don’t hold up to reality.

In a tweet Sunday, he asserts that he will reduce drug prices by at least 50%. That’s highly unlikely. Measures announced last month by the president will take time to roll out and their effects are uncertain. They also have been less ambitious than a plan by Speaker Nancy Pelosi that passed the House.

Meanwhile, Trump once again asserted that hydroxychloroquine is a drug safe and effective for treating COVID-19, only to be firmly rebutted Sunday by his own testing coordinator, who said people should “move on” to more effective measures, such as social distancing and wearing masks.

A look at Trump’s statements on health care, as well as his distortions over the past week on mail-in voting and Democratic rival Joe Biden’s record:

PRESCRIPTION DRUGS

TRUMP: “When you see the Drug Companies taking massive television ads against me, forget what they say (which is false), YOU KNOW THAT DRUG PRICES ARE COMING DOWN, BIG.” — tweet Sunday.

TRUMP: “We think we’re going to cut prescription drug prices 50, 60, even 70%.” — remarks Thursday to New Hampshire supporters.

TRUMP, promising a big reduction in drug prices: “No other President would be able to produce what I have.” — tweet Tuesday.

THE FACTS: Actually, no massive, across-the-board cuts are in the offing for drug prices.

Efforts announced last month by the president — such as allowing importation of medicines from countries where prices are lower — take time to roll out. It remains to be seen how much they’ll move the needle on prices.

Drug importation, for example, requires regulatory actions to be taken and supply chains to be established, a tall order when the election is just three months away.

Trump has taken actions to reduce patient costs for some drugs, such as insulin, but the steps have been less ambitious than those in a bill from Speaker Nancy Pelosi that the House passed last year. Her proposal would authorize Medicare to negotiate prices for expensive medications and use savings from lower drug costs to establish Medicare coverage for dental care, hearing and vision.

She would cap Medicare recipients’ out-of-pocket costs for medicines at $2,000 a year. No limit exists on those annual costs now. The vast majority of Medicare recipients have low drug costs, but the Kaiser Family Foundation estimated that in 2017, about 1 million Medicare recipients paid much more, averaging $3,200 in a year.

White House actions, while not insignificant, don’t amount to the massive changes Trump brags about. One major initiative would give people on Medicare the option of limiting their out-of-pocket costs for insulin to $35 a month starting next year, by picking an “enhanced” prescription drug plan for a slightly higher premium.

___

VIRUS DRUG

TRUMP, on the use of hydroxychloroquine to treat or try to prevent the coronavirus: “I happen to be a believer in hydroxy. I used it. I had no problem. I happen to be a believer.” — remarks Wednesday to reporters.

THE FACTS: Trump’s continued promotion of the anti-malaria drug for COVID-19 has been repeatedly dismissed by his own health experts, including Adm. Brett Giroir, the administration’s lead official on testing, who made clear Sunday he does not recommend the treatment.

“Most physicians and prescribers are evidence-based, and they’re not influenced by whatever is on Twitter or anything else,” he told NBC’s “Meet the Press.” In this case, “anything else” includes endorsements of the drug by the president.

Giroir said “the evidence just doesn’t show hydroxychloroquine is effective right now.”

He said people need to “move on” and “talk about what is effective.” He pointed to measures such as hand-washing, social-distancing and wearing masks, as well as treatments such as remdesivir and steroids.

Trump’s own health agencies as well as Dr. Anthony Fauci, the government’s top infectious diseases expert, have cautioned that taking hydroxychloroquine to stave off the virus could be dangerous due to side effects. If the president is to be believed, he took the drug himself.

Trump repeatedly has pushed hydroxychloroquine, with or without the antibiotic azithromycin. But no large, rigorous studies have found them safe or effective for COVID-19, and they can cause heart rhythm problems and other serious side effects. The Food and Drug Administration has warned against the drug combination and said hydroxychloroquine should only be used for the coronavirus in hospitals and research settings.

___

TRUMP, on hydroxychloroquine: “Many, many people agree with me. A great test just came out from the Ford clinic in Michigan — very respected.” — remarks Wednesday to reporters.

THE FACTS: Trump is cherry picking a study widely criticized as flawed, ignoring multiple studies finding hydroxychloroquine doesn’t help.

Numerous rigorous tests of hydroxychloroquine, including a large one from Britain and one led by the National Institutes of Health, concluded that the anti-malaria drug was ineffective for treating hospitalized coronavirus patients.

The Henry Ford Health System study that Trump refers to was an observational look back at how various patients fared. It was not a rigorous test where similar patients are randomly assigned to get the drug or not and where each group is compared later on how they did.

In the study, some people with heart or certain other conditions were not given the drugs, which can cause heart rhythm problems, so those patients were fundamentally different from the group they were compared with. Researchers said they adjusted statistically for some differences, but the many variables make it tough to reach firm conclusions.

Some patients also received other treatments such as steroids and the antiviral drug remdesivir, further clouding any ability to tell whether hydroxychloroquine helped.

___

NOVEMBER ELECTION

TRUMP: “Must know Election results on the night of the Election, not days, months, or even years later!” — tweet Thursday.

TRUMP: “I want to have the result of the election. I don’t want to be waiting around for weeks and months.” — news conference Thursday.

THE FACTS: He’s demanding something no one can deliver. The president appeared unaware that American democracy can’t be shaped to produce a same-day result to sate his impatience.

There’s certainly no requirement for a winner to be declared election night, and the prospect of having to wait to know who won has not been used as justification to try to delay the vote itself.

State election officials in some battleground states recently warned it may take days to count an expected surge of ballots that people send by mail because they don’t feel safe showing up to the polls. In an election as close as 2016′s, a delayed tally in key states could keep the outcome from being quickly known.

Delayed results are common in a few states where elections are already conducted largely by mail. But a presidential election hasn’t been left in limbo since 2000, when ballot irregularities in Florida led to weeks of chaos and court fights.

___

TRUMP: “With Universal Mail-In Voting (not Absentee Voting, which is good), 2020 will be the most INACCURATE & FRAUDULENT Election in history. It will be a great embarrassment to the USA. Delay the Election until people can properly, securely and safely vote???” — tweet Thursday.

THE FACTS: Trump has persistently theorized about voter fraud and never supported those theories with facts. He appointed a commission to get to the bottom of voter fraud and it disbanded without making any findings.

Time and again, voter fraud has proved exceedingly rare, and voting without going to polling places has become more common.

Multiple checks, such as signature verification in many states, must happen before a ballot can be counted, and experts say any fraud can be detected.

Five states relied on mail-in ballots even before the coronavirus pandemic raised concerns about voting in person. Those states say they have the necessary safeguards in place to ensure that a hostile foreign actor doesn’t co-opt the vote. More states intend to rely more heavily on mail-in voting for the same reason.

“Trump is simply wrong about mail-in balloting raising a ‘tremendous’ potential for fraud,” Richard L. Hasen, an elections expert at the University of California, Irvine, School of Law, wrote recently. “While certain pockets of the country have seen their share of absentee-ballot scandals, problems are extremely rare in the five states that rely primarily on vote-by-mail, including the heavily Republican state of Utah.”

Indeed, election experts widely say that all forms of voter fraud are rare. The Brennan Center for Justice in 2017 ranked the risk of ballot fraud at an infinitesimal 0.00004% to 0.0009%, based on studies of past elections.

Even so, Trump has sketched wild scenarios, recently imagining “thousands and thousands of people sitting in somebody’s living room, signing ballots all over the place.”

As for the extraordinary step of moving the Nov. 3 election, the chances are almost nil. On Sunday, Trump campaign senior adviser Jason Miller suggested Trump won’t push for a delay.

“The election is going to be on Nov. 3,” Miller told “Fox News Sunday.” “President Trump wants the election on Nov. 3.”

The date of the presidential election — the Tuesday after the first Monday in November in every fourth year — is enshrined in federal law and would require an act of Congress to change. Democrats, who control the House, will not support Trump on this. Republicans, who control the Senate, are unlikely to, either.

___

TRUMP: “Mail-In Voting is an easy way for foreign countries to enter the race.” — tweet Thursday.

THE FACTS: No, it’s one of the most difficult ways for a foreign adversary to meddle in a U.S. election.

Swaying a federal election using absentee ballots would mean paying thousands of U.S. citizens, carefully selected in key cities in battleground states, who are willing to conspire with a foreign government and risk detection and prosecution.

Far easier and cheaper would be a social media campaign seeking to discourage certain groups of people from voting, something the FBI has already warned about. Or launching a sophisticated cyberattack on voter registration data that would eliminate certain voters from the rolls, causing havoc at polling places or election offices as officials look to count ballots from people who are “missing” from their voter databases.

Last month Attorney General Bill Barr raised the possibility that a “foreign country could print up tens of thousands of counterfeit ballots.” He argued they would be hard to detect, but that’s been disputed by election experts.

Absentee ballots are printed on special paper and must be formatted correctly in order to be processed and counted. Ballots are specific to each precinct, often with a long list of local races, and would be easily identified as fraudulent if everything didn’t match precisely.

“This is a complete red herring,” said Wendy Weiser, director of the democracy program at the Brennan Center for Justice. “It’s completely not plausible, and not something that security and election experts are actually worried about.”

___

BIDEN’S PLATFORM

TRUMP: “Biden came out against fracking. Well, that means Texas is going to be one of the most unemployed states in our country. That means Oklahoma, North Dakota, New Mexico are going to be a disaster. Ohio, Pennsylvania — disaster. No fracking.” — news conference Thursday.

THE FACTS: No, that’s not Biden’s position at all.

In a March 15 primary debate, Biden misstated his fracking policy to suggest he’d ban it and his campaign quickly corrected the record. Trump continually ignores the correction.

Biden has been otherwise consistent on his middle-of-the-road position, going so far as to tell an anti-fracking activist that he “ought to vote for somebody else” if he wanted an immediate fracking ban. He proposes to deny new fracking permits only on federal lands. Such a limited step cannot spell “disaster” for entire states. By far the most fracking happens on private land.

___

TRUMP: “Joe Biden said he would defund the police. Biden would defund them. He’d abolish them, I guess.” — remarks Thursday to New Hampshire supporters.

THE FACTS: We’ve heard this falsehood many times. What’s new is that Trump was informed face to face nearly two weeks ago that Biden does not propose defunding or abolishing police, yet he is still saying it.

Biden actually proposes more money for police departments and he has explicitly rejected the calls of some on the left to defund or abolish departments. He’d spend more to support improvements in police practices.

Two weeks ago, Fox News reporter Chris Wallace confronted Trump on the matter when the president tried to hang a defund-abolish label on Biden. Trump cited a policy document drafted by aides to Biden and ex-rival Bernie Sanders. It contains recommendations, not necessarily policies embraced by the candidate. But even that document would not defund or wipe out police departments.

It seeks, for example, “increased funding for officer health and well-being in police departments across the country, including for personal safety equipment and mental health services.”

___

RUSSIAN BOUNTIES

TRUMP, on a U.S. intelligence assessment that Russia was paying a bounty to militants in Afghanistan to kill Americans there. “If it reached my desk I would have done something about it.” — interview Tuesday with “Axios on HBO.”

THE FACTS: His claim that the matter didn’t reach him is unconvincing.

The Associated Press reported in June that the assessment was included in at least one of Trump’s written daily intelligence briefings last year. As well, then-national security adviser John Bolton told colleagues he briefed Trump on the intelligence assessment and the subject was the sole purpose of that meeting with the president.

This was according to U.S. officials with direct knowledge of the intelligence who spoke on condition of anonymity because they were not authorized to discuss the highly sensitive information publicly.

Trump said this past week he did not raise the matter in recent phone calls with Russian President Vladimir Putin. Secretary of State Mike Pompeo would not tell senators in testimony whether he has brought it up with his Russian counterpart. He said he discusses with the Russians all threats that they pose to Americans and U.S. interests.

White House officials have argued that Trump wasn’t briefed on the suspected bounties because the assessment is not conclusive. However presidents are commonly informed of the most consequential intelligence even if the findings are not complete, so they can make decisions about potential or emerging threats.