Is Congress too afraid to fight Big Pharma?

Millions of Americans are struggling to afford their prescription drugs. Big Pharma corporations are enjoying billions in profits and tax breaks. We the people want to know: Is Congress too afraid to fight?

In 2003, lobbyists from Big Pharma pressured Congress to stop Medicare from negotiating for cheaper prescription drug prices as part of the Medicare Drug Benefit (also known as Medicare Part D). That corporate coercion paid off handsomely. For just one drug, insulin, Medicare Part D spending increased by 840 percent between 2007 and 2017, from $1.4 billion to $13.3 billion.

Insulin was first discovered in 1922. Yet there are no generic manufacturers of it. Just three corporations — Sanofi, Novo Nordisk, and Eli Lilly — make America’s insulin. Together, they rake in billions while patients dangerously ration this life-sustaining medication.

As a pediatrician, I’ve seen the grandmothers of my young patients forced to make heartbreaking choices at the pharmacy. They wonder how to pay for their own medications and their grandchildren’s prescriptions, while still having enough money left to feed everyone? My patients and their families are not alone. In 2016, everyday Americans spent $2 billion out of their own pockets for prescriptions while sacrificing their health in other areas: buying fewer groceries, postponing utility bills and spending less time with family.

Across the entire political spectrum, the American people want Congress to fight Big Pharma and put patients before profits. Recent polling from Social Security Works and Data for Progress shows 79 percent of voters support competitive drug licensing. If a pharmaceutical corporation won’t negotiate fairly on the price of a certain drug, they lose their patent monopoly. The government can give a generic manufacturer the right to make that drug and sell it at a cheaper price.

Competition with generics is exactly the kind of pressure Big Pharma needs. By issuing competitive licenses, our government can target what Big Pharma cares about most — its patents and profits — while ensuring that patients still have access to their prescriptions. Competitive drug licensing is popular among Democrats (84 percent), Republicans (73 percent), and independents (80 percent).

Sen. Bernie Sanders (I-Vt.) and Rep. Ro Khanna (D-Calif.) have introduced legislation that would drastically reduce the prices of prescription drugs through competitive licensing. The Medicare Negotiation and Competitive Licensing Act, which is sponsored by Rep. Lloyd Doggett (D-Texas) and has 127 co-sponsors, also incorporates competitive licensing.

Voters and politicians are eager to find common ground and get to work on major priorities. Taking the fight to Big Pharma with bold policies is an opportunity to strengthen public health and save lives. In addition to competitive drug licensing, voters strongly support the government manufacturing generic versions of prescription drugs if prices skyrocket (83 percent of MSNBC fans, 61 percent of Fox News fans). Sen. Elizabeth Warren (D-Mass.) and Rep. Jan Schakowsky (D-Ill.) have a plan to do just that. 

Voters, including 81 percent of Democrats, 63 percent of Republicans, and 68 percent of independents, also support increasing government funding of research to develop affordable medications. 

House Democratic Leaders, including Speaker Nancy Pelosi (D-Calif.), recently unveiled the Lower Drug Costs Now Act. This bill would regulate the prices of between 25 and 250 of the most expensive drugs, requiring pharma companies to charge Americans no more than the average of the prices charged for these drugs in Australia, Canada, France, Germany, Japan, and the United Kingdom.

The Lower Drug Costs Now Act does not go as far as the Sanders or Warren proposals. It does not go nearly as far as the British Labor Party’s new “Medicines For The Many” platform, which is the gold standard for drug pricing policy (it incorporates competitive licensing, public manufacturing, and publicly-funded research).

That said, the Lower Drug Costs Now Act is an important step in the right direction. In the coming weeks, the bill will go through the U.S. House under regular order, including hearings and markup. House Democrats should take the opportunity to strengthen the bill.

They must increase the minimum number of medications that will be covered. Only reducing the prices of 25 drugs will not be enough for my patients, or for patients across the country. They should also eliminate the ceiling of 250 medications.

We are told that the number of drugs negotiated is limited due to the government not having enough capacity. That should be addressed by taking some of the savings from lower drug costs and using them to increase the government’s capacity, such as by hiring additional staff. This would enable us to double the number of drugs negotiated each year until all medications are covered.

We also need to include a provision for a drug to be added to the negotiation list based on public health necessity. Otherwise, the bill as currently written would exclude vital medications like the EpiPen. Additionally, we need to strengthen the provisions aimed at high launch prices to prevent new drugs from launching with $2 million price tags.

What Democrats absolutely should not do is weaken the legislation in an attempt to placate Republicans or Big Pharma donors. The polling shows that voters of every political persuasion back even bolder policies than those in the Lower Drug Costs Now Act. If Republicans insist on standing in the way, they will pay the price at the polls.

As a doctor and public health activist, I want Congress to stand up to Big Pharma on behalf of all my patients, regardless of their political leanings. Asthma, diabetes, depression, cancer, seizures, and other conditions do not care who you vote for or where you get your news. All of my patients fight for their health. Congress must follow their example. Let’s pass bold legislation to take on Big Pharma’s greed and lower drug prices for everyone.

Dr. Sanjeev Sriram is senior adviser to Social Security Works.