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WASHINGTON — Drug makers and their middlemen counterparts spent the first three months of the 116th Congress successfully dodging hard blows from members of Congress over the high cost of prescription drugs. That all changed Wednesday.

Insulin makers and drug industry middlemen faced hours of hard questions Wednesday from an irate panel of lawmakers, many of whom appeared far more interested in threatening to blow up the entire drug pricing system than in hearing from the pharma company or pharmacy benefit manager executives who testified.


“I don’t know how you people sleep at night,” Rep. Jan Schakowsky (D-Ill.) told the assembled panel. “You’re in trouble … if you think you can just out talk us without any transparency, without any accountability, I just want you to know your days are numbered.”

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  • A simple start: mandate that any advertising of any drug must prominently display the LIST PRICE throughout the ad.

    No “discount” price, no “we can help” nonsense – just the “MSRP” equivalent, the price that is the cost to the payer, whether that payer is an insurer, the government, the patient, a charity, a discounter, or any combination of these.

    Free-market advocates insist that the market will solve this. Fine. Let the market work. But the market has to know what the costs are, and the public usually is blind to these costs because they are not out-of-pocket.

    If Humira costs $6,500 per month, or $13,000 per month, say so. Out loud, so we can hear it.

  • A very simple start would be to give Medicare the right (and duty) to negotiate pricing just like any fiscally responsible authority. Isn’t that the basic right and tenet of Capitalism?

    • “A very simple start would be to give Medicare the right (and duty) to negotiate pricing just like any fiscally responsible authority. Isn’t that the basic right and tenet of Capitalism?” No. First off – since when is Government Negotiation a basic right and tenet of Capitalism?, Secondly, “government negotiation” is an oxymoron – the government doesn’t “negotiate” … it dictates (and this dictation already exists in FSS and Medicaid with guaranteed price ceilings among many other aspects of FSS and Medicaid and “the Big 4”).

    • No. Government negotiation is not dictation. Contracting happens all the time, and prices are negotiated. And medicare isn’t allowed to negotiate price due to Medicare part d. I mean we should just stop paying social security and medicare/medicaid anyway. If people can’t take care of themselves thats their problem. Right?

    • The US Healthcare system is a complex thing – and any “simple” solution will likely be both damaging and ineffectual – Single payer is not the answer in this country if one hopes to keep innovation, choice, and quality.

    • Simple answer for your simple solution of single payer – no. Bad idea if one wants to keep healthcare innovation and choice along with a variety of other positive aspects of the present, albeit imperfect system

  • It is a travesty what we struggle to pay for drugs that are orders of magnitude cheaper in Canada and Mexico. Insulin is 10x more expensive here. PBMs should be non-profits and our drug prices should be in-line with other developed countries.

    • The pharmaceutical industry in this country, and the system in general, subsidizes the ‘other developed countries’ so to the extent one cares about innovation – removing the reward for risk taking on the part of R&D efforts will likely have negative downstream effects. Regarding your call for PBMs to be non-profits – since when is non-profit a synonym for “efficient” or “altruistic”? There are a number of instances where non-profits in all sectors have been guilty of financial mismanagement – including in the healthcare sector (BCBS is non-profit for example and I know of a few BCBS plans where they were “non-profit” but “retained earnings” were found to be used by executives for perks and by the organization for “lavish” sales, marketing, and executive meetings. Finally, according to CMS NHE data for 2017, retail Rx drugs accounted for 10% of the total US healthcare expenditure of $3.5 trillion. Hospital care accounted for 33%, and Physician and clinical services 20% – both greater cost drivers than drug spend. Generics account for 90% of the Rx. Though I know this article is focused on Drugs and the drug distribution system – the hew and cry and hand-wringing of congress and others is largely an exercise in grandstanding while majoring in minors. Is the US healthcare system perfect? No – but if you want to fix what is wrong with it, a good place to start is where most of the money is being spent – and it’s not in the pharma delivery and supply chain. As with any large group – there are good and bad actors in pharma – and there are plenty of good people focused on patient health. Likewise there are plenty of good people in the supply chain focused on member health – continued attempts to beat them down and blame them for working in and responding to the healthcare system as created by US government statutes and regulatory interpretations are misguided and wrong.

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