Still on hold: lower drug prices legislation

The U.S. pays at least three times what other developed countries pay for brand name drugs--precisely because we don’t negotiate prices with the drug companies. In 2020 alone, price increases among 7 of 10 top-selling medications cost the U.S. health care system almost $1.7 billion (AARP, according to a report from the Institute for Clinical and Economic Review). One in three Americans splits drugs in half or leaves them at the pharmacy due to their high costs. Stories of the consequences of high drug prices for Americans whose very lives are dependent on these drugs are heart rending.

TIme and again, polling of the American people has shown that the vast majority are in favor of allowing Medicare to negotiate drug prices in order to bring costs down. A recent Kaiser Family Foundation (KFF) poll showed that 83% overall were in favor of negotiations. This figure includes 95% of Democrats, 82% of independents and 71% of Republicans.

The majority of Americans are not falling for PhRMA’s (the pharmaceutical trade organization) warnings that such negotiations would reduce drug companies’ ability to do research and create new life-saving drugs. Most of us see through this fallacious argument, given that much new drug research is actually performed and/or funded by the federal government, not by drug manufacturers. In fact, drug companies spend far more on advertising and lobbying than they do on research, and even with those enormous, questionable expenses, these companies still make out like bandits in corporate profits. A study of financial data on drug pricing conducted by the House Oversight Committee revealed that the 14 largest drug companies spent $577 billion on stock buybacks and shareholder dividends between 2016 and 2020, a period that included the windfall those companies got from the Trump tax law. They spent far less than this on research and development. Even since the COVID pandemic surged, drug companies’ profits have continued to soar.

Where does federal legislation on drug pricing now stand? Having been included in Biden’s original Build Back Better (BBB) bill, it was withdrawn and subsequently cut back due to the lack of support of all Republicans and two recalcitrant Democrats (Kyrsten Sinema of Arizona and Joe Manchin of West Virginia). According to Kaiser Health News (KHN), the revised Congressional proposal on drug pricing that made it back into the BBB spending package does have some strong consumer protections. These include limiting out-of-pocket prescription drug payments for Medicare beneficiaries to $2,000 annually and limiting yearly price increases, which have outpaced inflation for several years. A November 21st AARP Bulletin adds that the penalty for drug companies that raise their prices higher than general inflation would apply to prescriptions in both the Medicare and the commercial markets, beginning in 2022.

But when it comes to allowing the government to negotiate lower prices, KHN calls the latest bill’s provisions “narrow, byzantine and distant.” The government would identify 100 high-cost medicines and choose only 10 for price negotiation annually, with those prices first taking effect not until 2025. Furthermore, Medicare would be allowed to negotiate prices only on medicines that had been on the market for at least nine to 13 years, depending on the drug type.

Corporate money in politics has long been a major factor in blocking or watering down legislation to lower drug prices, in spite of its popularity. Having made lower prescription drug prices a major campaign issue in 2018 in her state of Arizona, for example, Kyrsten Sinema received about $100,000 in campaign contributions from Big PHARMA in 2019-2020, becoming one of the leading congressional recipients (KHN). She then reversed course and voted against the proposal to allow Medicare to negotiate drug prices in the Build Back Better bill. Many people are outraged by the two Democrats (Sinema and Manchin, whose constituents would have greatly benefitted from lower drug prices) for reneging even on the watered-down drug pricing bill. We must not forget, however, that not one Republican Senator voted for this legislation (or for the BBB bill as a whole), making any losses among the low-number majority of Democrats in the Senate fatal to the bill.

Many of us who lived through the Obama years have become too resigned to Republican “obstructionism,” especially in the Senate. Other opinion piece writers in the Gettysburg Times have asked “what are Republicans for?” They are supposed to be there to serve the people of their states, their constituents, and to uphold the Constitution of the United States. When proposals to spend money to help their people are before them, they wave the flag of the need to lower the “dangerous” deficit, an argument that has been debunked by most economists. Their true purpose, I posit, is to retain power in every branch of the government--even as they are a minority party in terms of registered voters nationwide. And they can do this by accepting millions of campaign dollars from their billionaire donors (corporate and individual), ostensibly in return for protecting their donors’ wealth--as if the superrich need such protection! While several of the old guard Democrats (and even younger ones like Sinema) belong in this group of politicians who are beholden to corporate lobbyists and billionaires, many if not most of the younger Democrats in Congress depend on thousands of small-dollar donations, which unfortunately cannot compete with the moneyed interests.

What can you do to counteract this situation? Number one: be an engaged citizen and vote in every election. Equally important, be an educated voter. Listen to or watch more than one news channel. Read a mainstream newspaper as well as our local paper. (Most have digital subscriptions that are inexpensive.) Research the issues and know who you are voting for: what are their positions and why? Are they most interested in serving big business or you, their constituent? From whom do they get their financial support (which is public information)? What have they done or promised to do for ordinary people?

For some time now, the Washington Post has run this statement on its banner head: “Democracy Dies in Darkness.” Think about it and act on it.

Jeanne Duffy, Ph.D., has served as a college professor, an analyst and project manager for several large companies, and a college administrator in charge of foundation and government support. She is chair of Gettysburg Democracy for America’s healthcare taskforce.