US drugmakers say they are “disappointed but not surprised” that the House of Representatives has voted in favour of its health care reform legislation.

Late Saturday night, the House voted 220-215 to support the Affordable Health Care for America Act (HR 3962); 219 Democrats and one Republican - Joseph Cao from New Orleans - voted to back the bill, while 176 Republicans and 39 Democrats were opposed. Ken Johnson, senior vice president at the Pharmaceutical Research and Manufacturers of America (PhRMA), said the “uneasiness” felt by nearly half the members of the House who voted against the bill was “echoed by millions of hardworking Americans.”

The House bill aims to provide health insurance coverage for 96% of the population - 46 million Americans are estimated to have no health cover – and would set up a government-run insurance programme to compete with private-sector health insurers. Features of the bill which are strongly opposed by the industry include its requirement that drugmakers should provide rebates on their medicines for people enrolled in both Medicare and Medicaid – costing the industry an estimated $60 billion over 10 years - and empowering the federal government to negotiate drug prices for the Medicare prescription drug programme. Analysts believe these measures could cost the industry as much as $150 billion over ten years – nearly double the $80 billion, 10-year cost savings deal agreed back in June between the industry and Senate Finance Committee chairman Senator Max Baucus - and “blessed” by the White House.

As required by President Barack Obama, neither the House nor the Senate health reform bills would add to the federal budget deficit, but estimates of the cost of HR 3962 over a 10-year period vary between $900 million and $1.2 trillion.

PhRMA’s Mr Johnson said that while the House bill is “well-intentioned” it would – if it passes as it now stands – “have the unintended consequences of killing tens of thousands of jobs in our industry at a time when the American economy is struggling and unemployment has soared above 10%. This is absolutely the worst time to be putting additional strains on the economy with punishing job losses,” he said.

“We remain convinced that the approach taken by the Senate Finance Committee provides the best blueprint for comprehensive reform,” he added.

Ahead of the vote, America’s Specialty Medicines Companies (ASMC), a new and, in its own words, “informal working group of mid-market and smaller innovator pharmaceutical companies,” warned that the House bill's required rebates and mandated discounts would raise new barriers for small companies seeking to fund life-saving research.

"Small pharmaceutical companies often bring needed specialty medications to market when no one else will. Unfortunately, HR 3962 would stifle that innovation and prevent those efforts. Ultimately, the patients who need these medicines will suffer most," said Steve Cannon, an attorney representing the ASMC.

Meantime, Senators are expected to debate their own health care reform this week, after which the two bills will go through a reconciliation process before being submitted to President Barack Obama for his signature.

Welcoming the House vote, Pres Obama urged the Senate to “follow suit,” adding: “I am absolutely confident it will, and I look forward to signing comprehensive health insurance reform into law by the end of the year."