Only about one in four — 27 percent — adults say they have heard or read about President Donald Trump’s prescription drug plan, according to a a POLITICO-Harvard T.H. Chan School of Public Health poll. | Mark Wilson/Getty Images Americans skeptical of Trump’s drug plan — if they’ve even heard of it

President Donald Trump was hoping for a big win with voters when he rolled out a massive blueprint to lower drug prices in May. But two months later, most Americans haven’t even heard about it, a new poll shows.

And few of the Americans who are aware of his plan believe it will lower drug prices.


Only about one in four — 27 percent — adults say they have heard or read about Trump’s prescription drug plan, a new POLITICO-Harvard T.H. Chan School of Public Health poll found. Of that group, just 37 percent believe it will lower the prices Medicare pays for prescription drugs while 42 percent think it will accomplish the task for the country overall.

On another high-profile health challenge, Americans think the Trump administration needs to spend more money to help people with opioid addiction. Thirty-nine percent of respondents say they think federal spending on addiction treatment is too low, with Democrats even more likely to say that the government isn’t spending enough. Congress a few months ago injected a record $4 billion in new funding to address the opioid crisis, with about half of that directed to treatment and prevention programs and the remainder going to law enforcement.

The doubts about whether the drug pricing plan will bring down the cost of medicine could present a problem for lawmakers hoping to campaign on the issue, said Harvard’s Robert Blendon, an expert on health care policy and public opinion who designed the poll with POLITICO. “When you have something like this where people think it’s an important issue, but they aren’t following what the president does, it suggests it won’t be a major differentiator in the campaign.”

That’s likely to shock people who have been teeing up drug pricing as a key issue for voters, based on earlier polling showing that the cost of medicines is a top concern for large majorities of Republicans and Democrats.

“The electoral impact of this issue if the election was in the next two weeks is much smaller than people have written articles about,” Blendon said. If people aren’t paying attention to the details, it becomes too difficult for political opponents to convince them that they have a better plan, he explained.

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Several of the major components of Trump’s plan are popular with voters. Both Democrats and Republicans favor requiring TV drug commercials to include price information. They want to allow pharmacists to tell customers whether directly paying the retail price of a prescription drug would cost them less than paying their health insurance co-pay. A Senate panel is going to vote on lifting those gag rules this week.

Majorities of both parties also favor having FDA approve greater numbers of generic, over-the-counter and biosimilar drugs to encourage more competition.

But despite their receptiveness to those ideas, respondents said only one — having the FDA approve greater numbers of generic, over-the-counter and biosimilar drugs — would lead to lower prices. Fifty-six percent believed this option would lead to lower prices. In comparison, 28 percent believe that requiring drug prices in TV ads would lower medicine costs and 42 percent believed allowing pharmacists to tell customers about the retail price-co-pay comparison would lower prices.

Overall, Republicans were more likely than Democrats to have confidence that Trump’s drug pricing ideas would result in lower costs.

Forty percent of Republicans believe they or their family will pay less for prescription drugs due to Trump’s plan, compared to 9 percent of Democrats and 21 percent of independents.

The drug industry is taking most of the blame for the high cost of medicines, the polling found. When asked to list their first and second choices of who is most responsible for high drug prices, 63 percent said drug companies, while 34 percent pointed the finger at pharmacy benefits managers who negotiate between drug makers and insurers over which medicines will be covered by health plans and how much patients will pay for them. About a third called out the federal government and insurance companies for their role. Trump himself has sometimes identified the PBMs as middlemen who raise prices.

On opioids, the poll also found that many Americans are wary of medication-assisted treatment. While they are overwhelmingly embraced by the medical community and the federal government as the gold standard of care and have the most evidence for successfully treating opioid addiction, the stigma associated with medications that reduce withdrawal symptoms has made many people hesitant to support them.

Just one third of Americans said they considered long-term treatment using a milder but potentially addictive opioid to be effective, while about 66 percent said they would consider a regimen that included non-opioid medication to be effective.

“This suggests a major gap between public perceptions of treatment and those of clinicians and federal agencies,” the Harvard researchers said.

The survey also found that despite national efforts to limit opioid prescribing, many Americans reported getting more prescription painkillers than they needed. According to the poll, 31 percent of adults say they or a family member received a prescription opioid from a doctor or dentist, and more than a third of that group said they received more pills than necessary. That’s even with at least 28 states imposing limits on opioid prescribing.

Despite broad efforts to reduce stigma surrounding addiction, the poll found that roughly 37 percent of all respondents believe opioid addiction is a personal weakness, not a medical condition. Half of Republicans categorized it as a personal weakness, while about two-thirds of Democrats believe it is an illness.

The opioid crisis has heightened the risks of infectious diseases like HIV spreading through injection drug use. The CDC has endorsed the use of needle exchange services, in which drug users can exchange dirty needles for clean ones to prevent the risk of spreading diseases, but respondents were split on merits of those programs. Less than half, or 47 percent, support needle exchanges while 48 percent are opposed.

The poll also found that about two in five — 41 percent — support safe injection sites where people can get clean needles and inject drugs under the supervision of medical professionals. More than half (56 percent) are opposed.

Congress is considering new measures to fight the epidemic, including new treatment programs, and lawmakers have left the door open to appropriating more money for opioids in the future. But advocates say a significant increase in investment is needed to stem the crisis.

The poll also examined public attitudes on selected agriculture and nutritional policies, some of which the House and the Senate will be negotiating as they try to finalize a farm bill.

It found a lot more public support across party lines for increasing subsidies for small and medium-sized farms (46 percent) than for large agricultural businesses (16 percent). And there was extremely strong support — 3 out of 4 respondents — for public disclosure of who is receiving subsidies.

The biggest issue facing House-Senate negotiators stems from the House‘s proposals to strengthen work requirements on between 5 million and 7 million food-stamp recipients and to fund a significant expansion of state-run employment and job training efforts under the Supplemental Nutrition Assistance Program. The Senate would keep current work rules, while taking some steps to counter fraud.

Responses on SNAP funding varied according to party affiliation. In total, 37 percent favored a spending increase for SNAP, 19 percent said funding levels should be lowered, and 39 percent backed keeping them the same. Just 13 percent of Republicans said SNAP should get a funding boost, compared with 63 percent among Democrats and 32 percent of Independents.

Interviews were conducted with 1,001 adults from June 27 through July 2. The margin of error was plus or minus 3.8 percentage points overall, and 5.3 percentage points for questions asked of smaller samples.

John Lauinger contributed to this report.