The decades-long debate over whether the federal government can and should use its legal muscle to lower prescription drug prices may be reaching an inflection point, especially with President Biden's drug pricing agenda stalled on Capitol Hill.

Why it matters: Democrats would love to be able to show voters they've acted to lower drug prices before the November midterms, and progressive groups are urging them to so both legislatively and administratively. But taking on pharma through executive action risks uncertain legal outcomes, and opponents say that it could have a chilling effect on innovation.

State of play: Democrats' dreams of sweeping drug pricing proposals — including Medicare negotiations, which is hugely popular with their base — are being dashed in the Senate with the rest of Biden's domestic agenda.

• If the stalemate continues, that would put pressure on the administration to find ways to lower prices administratively. In a drug pricing plan that HHS released in September, the agency said that using legal authorities to circumvent drugmakers' patents on medicines developed with the government's help is still on the table.
• "HHS, NIH, and other agencies have been petitioned to take action under these provisions, and HHS will continue to give such petitions due consideration," the plan states.

The intrigue: A test case of how far the administration is willing to go is already teed up. The NIH is currently reviewing a request for it to lower the price of...

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