by October 29, 2021
One of us (HL) recently cared for a patient with severe lung disease who was struggling to breathe, his high-pitched wheezing heard from down the hall. This patient, Mark, could utter hardly three words before he had to pause and take another breath. All of this because the inhaler — umeclidinium/vilanterol (Anoro Ellipta) — to treat his chronic obstructive pulmonary disease was exorbitantly priced and he could not afford it.
Mark is not alone. More than a quarter of American adults have difficulty paying for their prescription drugs and may be forced to skip doses or ration their medications, putting their lives at risk. Medications don’t work when people cannot afford them.
Yet, not all policymakers are supportive of measures to lower drug prices. Pairing this with the growing influence of the pharmaceutical industry, it has become even more challenging for Congress to pass legislation that can meaningfully help patients access much-needed medications.
Growing Influence of the Pharmaceutical Industry
Last month, Representatives Scott Peters (D-Calif.), Kathleen Rice (D-N.Y.), and Kurt Schrader (D-Ore.), all three on the House Energy and Commerce Committee, voted against a key measure to allow Medicare to negotiate lower drug prices. They claim that they did so in part because of the “goodwill” they feel that they owe the pharmaceutical industry for its contributions in fighting the COVID-19 pandemic. Investigative reporting has pointed out the hefty personal campaign contributions they received from the drug industry, which runs the most robust lobbying effort in the country.
Yesterday, the White House announced its Build Back Better framework and it’s conspicuously missing measures aimed at lowering prescription drug prices.
If anyone deserves goodwill from Congress, it is primarily our patients who are suffering from the harmful effects of high drug prices.
The success of the heavily publicly funded COVID-19 vaccines has been used by the pharmaceutical industry to enhance its public image. The proportion of Americans with a positive view of the pharmaceutical industry has risen from 32% in January 2020 to 56% in September 2021. Meanwhile, Pfizer CEO Albert Bourla, PhD, is rallying his employees to fight drug pricing reforms.
While everyone should appreciate the high-quality work by scientists at BioNTech, Moderna, the University of Pennsylvania, and numerous other institutions that went into developing the COVID-19 vaccines, we should also recognize that American taxpayers heavily funded the research, development, clinical trials, and manufacturing of COVID-19 vaccines. We would not have had these vaccines in record time if it were not for millions of dollars in pre-pandemic basic and translational research funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the Department of Defense. NIAID funding led to the discovery of the spike protein, which is used by every FDA-approved or authorized vaccine and monoclonal antibody against COVID-19 to date. U.S. government funding was so instrumental that the NIH has co-ownership of the intellectual property for the mRNA vaccine it co-developed with Moderna. Most recently, Operation Warp Speed invested over $18 billion to accelerate vaccine development and manufacturing, and to guarantee purchase orders, thereby reducing the risk of the manufacturers involved.
Yet, the pharmaceutical industry continues to pursue profits from the vaccines at the expense of health equity. For example, international vaccine distribution and allocation has been lopsided. Nearly 75% of the 7 billion plus vaccinations administered globally have been in high- and upper-middle income countries with fewer than 1% in low-income countries, including in sub-Saharan Africa. Johnson and Johnson, Moderna, and Pfizer-BioNTech have thus far refused to share the vaccine recipe and manufacturing process with vaccine-makers in the global south, citing the complexity of the process.
Lower Drug Prices Are Essential
While the pharmaceutical industry tries to argue that it deserves goodwill, companies continued to raise prices for prescription drugs during the pandemic. Policymakers can substantially lower the cost of prescription drugs for patients and taxpayers by allowing the federal government to directly negotiate lower drug prices in Medicare, capping annual out-of-pocket costs for patients, and preventing excessive annual drug price increases above inflation. Beyond only direct cost-savings for patients, government savings from reform can be used to increase patients’ access to medical care by providing Medicare beneficiaries with dental, hearing, and vision benefits, and expanding Medicaid in non-expansion states, as part of funding the Biden “human infrastructure” agenda. While the latest White House framework does not include measures to lower drug prices, the ultimate power to legislate resides within the halls of Congress. A strong majority of Americans (83%) support Medicare price negotiation and leaving the issue unaddressed will lead our patients to experience additional suffering.
As House and Senate leaders deliberate and debate reforms, the stories of patients like Mark should drive them to allow Medicare to negotiate drug prices. That’s the sort of goodwill we need.
Hussain Lalani, MD, MPH, is a primary care physician at Brigham and Women’s Hospital and a clinical research fellow at the Program on Regulation, Therapeutics, and Law (PORTAL). He is a member of the Doctors for America Drug Affordability Action Team. Aaron S. Kesselheim, MD, JD, MPH, is a professor of medicine at Harvard Medical School, and director of PORTAL in the Division of Pharmacoepidemiology and Pharmacoeconomics in the Department of Medicine at Brigham and Women’s Hospital.
The material on this site is for informational purposes only, and is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.
© 2022 MedPage Today, LLC. All rights reserved.
Medpage Today is among the federally registered trademarks of MedPage Today, LLC and may not be used by third parties without explicit permission.
Opinion | Lower Drug Pricing Is About Our Patients – MedPage Today
by October 29, 2021