Drugmakers would raise their prices in other countries to compensate for lower prices in the U.S. For new drugs, pharmaceutical companies would likely introduce them at higher prices to try and offset discounts. And there would be a slight decrease in the number of new drugs developed, the CBO projected.

With the toxic politics of impeachment pervading Washington — not to mention a wide gap between the Democrat-controlled House and the Republican-led Senate — the bill is a longshot to become law. But the $345 billion risk to the drug industry shows just how high the stakes can be in any drug price overhaul.

President Donald Trump has repeatedly called for the government to negotiate drug prices, and has even directly phoned industry leaders whose companies raised the cost of their products.

In the Senate, Republicans and Democrats have worked together on their own bill. Pushed by Senator Charles Grassley, the Iowa Republican, the package would cap drugmakers' price increases, pegged to inflation, and would limit out-of-pocket spending by people on Medicare.

The lawmakers have said the bill would save taxpayers around $100 billion over a decade.

Read more: 

• Political drama sidelines bipartisian effort to bring down drug prices
• GOP senators distancing themselves from drug price reform
• Federal judge shoots down rule requiring drug price disclosures in TV ads

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