WASHINGTON — “Is Heather Bresch here?”
The mock roll call from Rep. Mark Pocan (D-Wis.) was orchestrated largely in jest. In front of him stood six empty shares and an empty table, topped by six nameplates without faces to match. Bresch, the CEO of the generic drug maker Mylan, was not there. Nor were the other five pharmaceutical industry executives who progressive lawmakers had “invited” to testify, and whose names Pocan called out to be met by silence and snickers from a room of left-leaning drug pricing advocates.
But the sham hearing nonetheless provided dual opportunities for the Congressional Progressive Caucus: to poke fun at a favorite target in “Big Pharma” and to further criticize Democratic leadership for what progressives say has been a lackluster effort to lower prescription drug prices.
“It’s unfortunate that our CEOs aren’t here today,” said Rep. Pramila Jayapal (D-Wash.), who co-chairs the progressive group with Pocan. “Since they’re not here, let us tell you a little bit about some of the drugs and what’s happening to those prices.”
Jayapal launched into a criticism of Mylan, the manufacturer of the long-available asthma medication albuterol, the price of which has nonetheless skyrocketed in the past decades. Next came diatribes about five other companies and drugs whose prices the lawmakers said have increased without justification: Merck’s cancer drug Keytruda; Gilead’s HIV-prevention drug Truvada; Eli Lilly’s insulin drug Humalog; Mallinckrodt’s Acthar gel, used to treat seizures in infants, and Pfizer’s nerve pain drug Lyrica.
Executives from drug makers and pharmacy benefit managers have already appeared on Capitol Hill five times in 2019 for more formal proceedings before the Senate Finance and House Energy and Commerce committees.
But it was unlikely the executives had even considered the progressives’ Thursday invitation. As a political group and not a formal congressional committee, the Progressive Caucus has little power to compel the industry figures’ presence here. The invitations, to boot, were issued with barely a week’s notice.
Pharmaceutical executives or not, the trumped-up hearing’s intention was clear: to signal to House Speaker Nancy Pelosi that while some on the Democratic Party’s left flank are pleased with recent modifications to long-awaited drug pricing legislation, other members won’t be so easily satisfied.
In fact, the lawmakers quickly shifted their focus away from the companies and the unpopular price hikes they’ve enacted. They turned instead to Democratic leadership and its approach to formulating prescription drug legislation.
In particular, they attacked the concept of using binding arbitration as a leverage mechanism in drug-price negotiations. Rep. Lloyd Doggett (D-Texas), who chairs the House Ways and Means Committee’s health panel, noted that Democrats vehemently opposed forced arbitration in labor contexts.
He also criticized the scope of Pelosi’s as-yet-unveiled idea. An early version contained a proposal to allow Medicare’s drug benefit to negotiate for the cost of at least 25 drugs; that number has since increased to at least 250 drugs, which could represent the vast majority of Medicare drug spending. But even the expanded plan, Doggett said, would be insufficient following Democrats’ 2018 campaign pledge to allow Medicare negotiation more broadly.
“Medicare must be able to negotiate for all drugs,” Doggett said. “Anything less is a breach of trust.”
Doggett is the author of a popular drug-negotiation bill co-sponsored by more than 100 Democrats, most of whom are Progressive Caucus members. Despite his powerful subcommittee chairmanship, Democratic leadership has not granted Doggett a hearing for his legislation, to say nothing of a vote on the House floor.
In lieu of drug industry testimony, the progressive lawmakers heard from a panel of drug-pricing advocates from left-leaning organizations including Social Security Works, Public Citizen, and T1International, a diabetes advocacy group.
And while those witnesses were largely invited to discuss policy, Rep. Ro Khanna (D-Calif.) asked them a political question anyway. Democrats, he said, were “negotiating against ourselves” with no guarantee of support from either the White House or the Republican-majority Senate.
“What I don’t understand is the logic of not having a vote on Mr. Doggett’s bill,” said Khanna, who has authored legislation that would enact an international price index for medicines similar to a proposal from the Trump administration. “Am I missing something?”
The panel’s response: silence.