Prepared Testimony
by U.S. Senator Chuck Grassley of Iowa
At the U.S. House
Judiciary Subcommittee on Antitrust Hearing to Address Competition in the
Health Care Industry
Thursday, April
29, 2021
I
appreciate the invitation to testify today.
Millions
of Americans started their day with a dose of prescription medication.
Unfortunately, for many patients, those drugs aren’t affordable. Prescriptions
are left at the pharmacy counter. Doses are skipped or rationed until the next
paycheck.
That’s
unacceptable.
As
Chairman of the Finance Committee last Congress, I explored several approaches
to reduce health care costs. Senator Wyden and I started by investigating
insulin pricing. We found that the business practices and
competitive relationships between manufacturers and middlemen, the
Pharmacy Benefit Managers (PBMs), have created a vicious cycle of
price increases. PBMs spur drug makers to hike list prices in order to
secure prime formulary placement and greater rebates.
I
also investigated the debt collection practices of non-profit hospitals. I
examined how these hospitals make financial-assistance plans available to
patients who can’t afford to pay. Non-profit hospitals enjoy certain benefits
under the tax code because they’re supposed to serve the needs of their
communities, including patients with limited means. It’s only fair that we
ensure compliance with the law if they get special treatment.
I’ve
worked with Senator Wyden on a prescription drug bill that would lower drug
costs and save taxpayers $95 billion. Our bill would cap out-of-pocket drug
costs for seniors at $3,100. It would slow the growth of drug costs in the
future while protecting innovation by keeping government out of the business of
setting prices. It’s the only prescription drug bill that can get 60 votes in
the Senate.
I
also believe that the importation of safe and affordable prescription drugs
from Canada would lower health care costs. Senator Klobuchar and I have a bill
to allow this, creating savings for consumers and injecting more competition
into the pharmaceutical market.
When
I chaired the Judiciary Committee, I conducted an investigation into EpiPen’s
misclassification in the Medicaid Drug Rebate Program. My investigation started
when a constituent contacted me about high EpiPen costs. Those constituent
contacts, and its resulting congressional investigation, ultimately contributed
to implementation of the bipartisan Right
Rebate Act.
We
must deter companies from engaging in activities that aim to reduce
competition, including regulatory interference, pay for delay, product-hopping
and rebate bundling, just to name a few.
Senator
Klobuchar and I re-introduced our bill to combat anti-competitive pay for delay
deals, where brand drug companies pay their generic competitors not to compete.
We’ve also re-introduced our bill to reduce the incentives for brand drug
companies to interfere with the regulatory approval of generics and biosimilars
that would compete with their own products.
The
largest PBMs have merged with insurance companies, and these conglomerates often
own other players in the health care industry. It’s important to determine
whether consolidation helps patients, or creates anticompetitive behavior and
increased costs.
I’ve
introduced a bill with Senator Cantwell to bring transparency to the PBM
industry by requiring the Federal Trade Commission to study the effect of
consolidation on pricing and potential anti-competitive behavior.
Further, Congress should codify regulations requiring hospitals and insurers to
disclose their low, discounted cash prices and negotiated rates to consumers
before they receive medical care. We should pass Senator Braun’s PRICE Transparency Act, which I’ve
cosponsored.
We
should work in a bipartisan and bicameral fashion to tackle the problem of
rising healthcare costs.
Thank
you again for the opportunity to testify today.