‘A mess across the board’: Senate committee kicks off talks on drug pricing reforms
The US is still the only country in the world that doesn’t negotiate pharmaceutical prices across the board, experts told a Senate committee on Tuesday, but how exactly to fix that remains unclear and few of the solutions discussed will surprise anyone watching the pricing debate play out over the last decade.
Setting the tone for the hearing, which featured comments from a type 1 diabetes patient, Elia Spates, who has seen her insulin costs triple over about a decade, Sen. Bernie Sanders (I-VT) honed in on the fact that Spates is not alone, and 1 out of 5 Americans could not afford their prescription drugs last year.
“How crazy is that?” he asked rhetorically.
Sanders recently introduced three bills co-sponsored by other Democrats to tackle drug prices, offering recycled ideas on pegging the price of drugs in the US to foreign countries’ prices (an idea also floated by former President Trump), allowing HHS to negotiate drug prices under Medicare Part D (which has been debated for more than a decade), and allowing drug imports from Canada (which is already ongoing).
Experts at the hearing offered their own solutions for what should be done. Aaron Kesselheim, professor of medicine at Harvard Medical School, explained a more detailed approach – calling for the US to evaluate new drugs upfront based on a review of their clinical benefits and then allowing the government to negotiate prices based on their findings. He also called for the federal government to crack down on price increases “well beyond inflation,” and to ensure that patents for new medicines are legitimate.
“The pharmaceutical lobby is large and well-funded and will argue that any reduction in revenues will harm innovation. But most drugs approved each year are not truly innovative and in a review of 2017 new approvals, only a minority of those reviewed by independent expert bodies offered more than minimal clinical advantages over available treatments,” he said in his written testimony.
But Democrats hold a razor-thin majority in the Senate, meaning Republicans will need to be won over to get a standalone bill passed.
Alex Lawson, the executive director of Social Security Works who’s been working behind the scenes on drug pricing on Capitol Hill, told Endpoints News in a phone interview that he thinks major drug pricing reforms will be tagged onto another infrastructure bill, which has to happen before September, because it would be impossible for the Democrats to get 60 votes to pass a standalone bill.
“I think negotiation will be the heart of what it is – some form of negotiation,” he said. “Industry thinks that they won’t have to deal with extraordinarily high drug prices because the vaccines are turning the corner on this pandemic, and I think they’re sorely mistaken.”
The idea of having the savings from high drug prices pay for new infrastructure is also attractive to Democrats, he noted.
But some Republicans, hesitant to harm a biotech ecosystem that is flourishing and has brought the US multiple Covid-19 vaccines in less than a year, focused their comments Tuesday on ways to reduce patients’ out-of-pocket expenses without hurting drugmakers’ bottom lines, as well as ways to increase transparency and ensure rebates end up in patients’ pockets.
Louisiana Republican Bill Cassidy also expressed concerns about the federal government setting drug prices unilaterally, which could have a chilling effect on VCs that fund the work that takes a compound from the bench to a trial, and are expecting a return on their investments.
Republican Susan Collins of Maine noted she hopes Congress can find common ground on the issue of drug prices because “when a doctor prescribes a needed medication, an insurmountable issue should not be the cost.”
Indiana Republican Mike Braun, however, went in the other direction and indicated a willingness to let the government step in, calling the current drug pricing system “a mess across the board.” He also said of the pharmaceutical industry, “There is no other sector of our economy that has less transparency, less competition and more barriers to entry and disengaged consumers. One alternative is to bring in government.”