Q&A: What’s Driving Up Rx Prices?
With U.S. Senator Chuck Grassley
Q: What’s happening with your efforts to reduce prescription drug prices?
A: I’ve got good news and bad news. The bad news is our drug pricing regime is broken. A web of secrecy shrouds flaws in the system that rewards certain stakeholders at the expense of independent pharmacy operators, employers, patients and taxpayers. Mergers among insurance companies, pharmacy benefit managers and others raise concerns about anti-competitive practices that call into question if consolidation helps patients or harms their pocketbooks. The good news is I’m not giving up to fix what’s not working. The pricing supply chain needs a big dose of transparency to rein in anti-competitive shenanigans that cause sticker shock at the pharmacy counter. In the 117th Congress, I’ve re-introduced bipartisan bills with Sen. Amy Klobuchar to root out secrecy and stop anti-competitive practices that derail competition and allow prices to climb year after year. We need robust competition, better enforcement and more transparency to allow the free marketplace to drive up innovation and drive down prices. Our Preserving Access to Affordable Generics and Biosimilars Act would limit anti-competitive “pay-for-delay deals” that effectively shift more affordable generic versions of branded pharmaceuticals to the back burner, or more accurately, off the pharmacy store shelf because of murky financial arrangements between drug companies. Drug companies use this business practice to pay competitors to delay introduction of cheaper substitutes. Our bill would curb pay-for-delay deals and include biosimilar and interchangeable biologics in addition to generic drugs. In addition, our Stop STALLING Act would reduce the incentives for branded pharmaceutical companies to file sham petitions with the Federal Drug Administration (FDA). This tactic effectively puts up hurdles to the regulatory approval process for generics and biosimilars that would otherwise compete for market share with the branded products. Our bill would beef up the authority for the Federal Trade Commission (FTC) to take action against those who file sham petitions. I’ve also teamed up on a bill with Sen. Klobuchar to allow for the safe importation of prescription drugs from Canada.
For generations, Americans have come to expect advances in pharmaceutical sciences to discover cures and therapeutic treatments to save lives and improve the quality of life for loved ones managing chronic diseases. In 2020, pharmaceutical companies developed and delivered historic COVID-19 vaccines in record time. Americans don’t want drug pricing reform to harm the pace of innovation and cures. One of the cardinal sins of government overreach that would stifle innovation is meddling with the free market by inflicting price controls. Americans want the free marketplace to work as intended. Our bills would inject much-needed transparency and more effective enforcement of anti-competitive behaviors that pad profits at the expense of the taxpayer. I’m doubling down to build on the bipartisan legislative success I secured with Sen. Pat Leahy in 2019 to end an abusive tactic with passage of the Creating and Restoring Equal Access to Equivalent Samples Act (CREATES). This law curbs interference from branded drug companies and paves the way for developers of potential drug and biological products to obtain samples of brand products they need for the FDA regulatory approval process. The nonpartisan Congressional Budget Office estimated it would save taxpayers nearly $4 billion over the next decade due to reduced drug prices for Medicare and Medicaid.
Q: Why are you doubling down on your efforts to reduce drug prices?
A: At my county meetings, Iowans talk with tangible urgency about the high cost of prescription drug prices. It reminds me when I heard from seniors nearly two decades ago about pinching pennies to afford their medicine. In 2003, I steered historic legislation through the U.S. Senate that modernized Medicare and created the first-ever prescription drug benefit for seniors. Medicare Part D is arguably one of the most successful and cost-effective social programs the federal government administers. For the last several years, I’ve continued my crusade with Sen. Ron Wyden to lower drug prices and cap out-of-pocket drug costs for seniors. According to the congressional budget scorekeeper, our bipartisan Prescription Drug Pricing Reform Act would save taxpayers $95 billion, reduce out-of-pocket spending by $72 billion and reduce Medicare Part D premiums by $1 billion. The lion’s share of the savings would be from rebates drug manufacturers pay on products for which prices increase faster than inflation. Congress must pass this bipartisan, negotiated prescription drug bill. From county meetings to constituent emails, Iowans have made their concerns heard loud and clear.
Consider one example. So many families struggle to pay for insulin, a century-old drug whose list price soars every year, creating a financial hardship for diabetic patients who require insulin to manage their disease. In my two-year bipartisan investigation of the insulin market, we identified detrimental business practices and competitive relationships between manufacturers and middlemen, the pharmacy benefit managers. The arrangements have created a vicious cycle of price increases that impact patients and taxpayers with higher list prices at the counter for the very drug that helps manage their disease. There’s hunger at the grassroots for Congress to act on meaningful reforms to end sticker shock at the pharmacy counter. If ever there was a time for Congress to reach agreement on making prescription drugs more affordable, it’s this moment as we fight to save lives and kick COVID-19 to the curb.
