WASHINGTON — It was a political rally on Cory Booker’s home turf, meant to showcase support for the Affordable Care Act. But the chilly afternoon in January 2017 ended in a way the New Jersey senator did not anticipate: with him being heckled by constituents as a pawn of “Big Pharma.”
Rather than ignore their jeers, Booker’s staff invited roughly 10 protesters to join the senator in a hotel conference room across the street from the Newark rally. He sat for an hour, as the progressive activists berated him for accepting more campaign funds from the drug industry than any other lawmaker and for, just days earlier, voting against a symbolic measure to allow American patients to import prescription drugs from Canada.
Finally, Booker asked the question his constituents had been waiting for: if giving back those campaign funds would make them happy. The response was a full-throated yes, capping off a day that was by many accounts an awakening for Booker — and a harbinger of what was to come as he launched his bid for the presidency.
“We can’t solely look at what is in the best interest for pharmaceutical companies and be blind to people dying from the cost of pharmaceuticals in New Jersey,” said Diane Moxley, a local activist who attended the meeting with Booker.
For the past two years, Booker has been repeatedly reminded of that kind of anger over high drug prices — and hounded by criticism that he has an overly cozy relationship with the pharma industry. Last week, the hosts of “Pod Save America,” a progressive political podcast, said he had taken “a bad vote on pharmaceuticals.” A viral Facebook (FB) video viewed nearly a quarter-million times questions whether Booker is a “Big Pharma” candidate. And on the left-leaning “Breakfast Club” radio show last week, Booker was pointedly asked whether he could be trusted to hold large pharmaceutical companies accountable.
That reputation, deserved or not, could become a major political liability for Booker, particularly at a time of concern over drug prices and in a race with other progressive lawmakers like Sens. Elizabeth Warren and Bernie Sanders whose disdain for large drug companies is palpable.
Booker knows his ability to win over Democrats appears to rest, in part, on whether he can convince voters he’s in the same league. But he is also wary of painting the industry with too broad a brush.
“I live in Newark, a low-income community where people work for pharmaceutical companies,” Booker told STAT in a recent interview. “They might be the lab assistant, they might be the secretary, and they value those jobs. And even they know that we can have fair pricing and still have thriving companies. This is not an either-or. And right now we have practices going on that are abusing this nation and constituents of mine.”
The past two years have left little doubt that Booker has fully embraced a pivot with regard to pharma.
In a major shift a year before announcing his White House run, Booker publicly swore off corporate campaign money, singling out cash from drug industry executives in particular.
For a senator from pharma-centric New Jersey, it was no small decision. In his most recent election cycle, in 2014, Booker received $223,350 in contributions from the pharmaceutical industry and its employees. According to the Center for Responsive Politics, the haul was the largest of any lawmaker, and among Democrats, almost twice the total of the lawmaker with the next-highest funding.
(Booker’s office contends the figure is misleading, as it includes donations from a special election in 2013 and the regularly scheduled election the following year.)
The pivot has extended to legislation, too.
Over the summer, Booker excitedly texted an aide after reading a NPR investigation into how drug companies impact Medicaid’s drug coverage decisions. His office introduced legislation to more aggressively police that process in December.
Last month, Booker was an unexpected guest at a press conference headlined by Sanders, at which Democratic politicians lamented corporate greed and unveiled bills to lower drug prices. And in a radio interview last week, Booker went so far as to threaten the intellectual property rights of drug companies that raise prices in a manner he deems excessive.
“If I become president of the United States, we’re going to push to be able to punish them if they raise prices [without justification],” Booker said, citing as an example recent price hikes for a cancer drug that has been on the market for over a decade. “It’s unconscionable how people are profiteering off the pain of others, and we’re going to make sure we hold them accountable.”
The radio show remarks were a direct swipe at the New Jersey company Celgene (CELG), which manufactures the cancer drug in question, Revlimid. While the drug has been sold in largely the same form since its approval in 2005, its price has spiked from under $250 per dose in 2007 to nearly $720 in 2019.
In addition to Celgene, New Jersey is home to some of the nation’s largest drug makers, including Merck and Johnson and Johnson. All three of those companies are currently under investigation by at least one congressional committee, making Booker’s political act all the more high-wire.
But Booker has never suggested that it is his duty to support New Jersey interests by dint of his office.
Last year, he released a report that skewered drug companies for using their savings from a Republican tax bill for stock buybacks instead of increasing pay for low-level employees. When Celgene announced it would be absorbed by Bristol Myers-Squibb in a $74 billion merger, Booker singled out the New Jersey company specifically.
“I’m very cognizant that there are thousands and thousands and thousands of people in my state that are employed by this industry. And as an American, I want us to be on the cutting edge of biological research,” Booker told STAT last month. “I want us to be on the cutting edge of solving and curing diseases. But what you see happening right now is ill-gotten profits that are being used not for more research and not to raise pay but to manipulate stock.”
Deciding whether legislation amounts to a handout or helps to develop tomorrow’s medicines, however, is sometimes in the eye of the beholder.
In 2016, some progressives voted against the 21st Century Cures Act, which bolstered funding for the National Institutes of Health and for addiction treatment. While supportive of those aims, several Democratic senators, including Warren, Sanders, and Jeff Merkley (Ore.) — who is also considering a 2020 run — objected to provisions that reduced requirements for clinical trials in the spirit of speeding treatments to market.
Sanders cited the provisions as evidence of “the greed of the pharmaceutical industry.”
Booker — along with declared 2020 candidates Amy Klobuchar (Minn.) and Kirsten Gillibrand (N.Y.), as well as prospective candidate Sen. Sherrod Brown — voted yes.
With voters’ perception of drug companies far underwater and with their desire to pay less for pharmaceuticals at the top of Capitol Hill’s priority list, early 2020 prognosticators have taken as a given that any Democrat who runs will have to speak both to high drug prices and to the pharmaceutical industry’s broader unpopularity.
And already, those Democrats have made bashing drug companies a feature of their campaigns.
Kamala Harris, the California senator, said in her campaign launch speech that “big pharmaceutical companies have unleashed an opioid crisis from the California coast to the mountains of West Virginia.”
Others use similar language in singling out drug companies for price hikes.
Sanders makes regular reference to “the greed of Big Pharma.” Warren, weeks before she announced her White House bid, tweeted that “giant drug companies only care about one thing: raking in profits on the backs of patients.” Klobuchar, while announcing her campaign on Sunday, told supporters that “the big pharma companies think they own Washington.”
If Booker plays the same game, his increasingly aggressive stances will be viewed with a healthy dose of skepticism — both by progressive activists and by drug industry lobbyists who, in interviews with STAT, shrugged off his tough talk as a necessary element of a presidential campaign in the current political climate.
“[Booker] has already positioned himself in anticipation of the attack that someone from New Jersey is too close to the drug companies,” said Earl Pomeroy, a former congressman who now works on health policy issues at the lobbying firm Alston & Bird.
It would be a mistake, Pomeroy said, “if Democrats, in their zeal, have a litmus test that anyone who drives by a drug company building is suddenly disqualified from the race for president.”
Booker’s run-in with protesters in Newark was, in a way, the start of his journey toward the ranks of staunchly anti-corporate Democrats.
Although he spent an hour in the hotel conference room attempting to defend his voting record and his fundraising, his explanations did not sit well.
“It didn’t resonate with anyone,” said activist Moxley, who left the Democratic Party in part due to concerns over corporate influence. (In 2018, she ran for Congress in New Jersey as a Green Party candidate.)
Despite that outcome, the senator did pledge to decline corporate PAC money and contributions from drug industry executives, and has challenged other Democratic candidates to do the same.
Booker would later also support legislation allowing drug importation from Canada, saying the updated versions included the safety provisions it had lacked when Booker initially voted no.
Elaine Kamarck, a senior fellow at the Brookings Institution and author of a book about the presidential primary process, said Booker will have to make the case to voters that he is on their side instead of drug companies’.
“Drug companies are almost up there with Donald Trump in terms of being one of the devils for Democrats,” she said. “In politics, people have to make these adjustments all the time — it depends on whether he can be convincing.”
An earlier version of this story incorrectly stated that Sen. Sherrod Brown is a declared presidential candidate.