Let them eat cake.
This is effectively what Health and Human Services Secretary Alex Azar told Americans when asked about whether a treatment for the fast-moving coronavirus will be affordable.
“We would want to ensure that we work to make it affordable, but we can’t control that price because we need the private sector to invest,” he told a congressional committee on Wednesday in response to a question about affordability. “The priority is to get vaccines and therapeutics. Price controls won’t get us there.”
Talk about a Darwinian view of health care. Such a remark can only come from someone who should be diagnosed with Tin Ear Syndrome.
Predictably, his attempt to soothe anxious Americans — who fear the virus will erupt at any moment and are already fed up with the rising cost of medicines — sparked a backlash. Twitter was alight with criticism. Seizing on an opportunity to eviscerate the Trump administration, presidential candidate Sen. Bernie Sanders called his comments “outrageous.”
Indeed, his comments are outrageous, especially because the White House has claimed to work so hard to lower prescription drug costs. Just last May, Azar boasted “President Trump has done more than any president in history to tackle drug prices.”
Really? Too bad none of those efforts have so far amounted to anything.
The coronavirus, however, represents an opportunity to make a difference.
Rather than simply do the basic R&D work for a treatment and then offer an exclusive license to a drug maker to develop and market a product, the federal government ought to reach a deal that does ensure affordability.
After all, taxpayer funds are being used and taxpayers should be able to have access to any treatment. This is not a new concept. The notion has been broached several times over the past few years as companies have marketed high-priced medicines that somehow began with federally funded research.
Just last week, nearly four dozen lawmakers asked the White House to issue limited licenses requiring companies to make any coronavirus treatment available at a reasonable price. Instead, Azar made clear that an untold number of Americans will be out of luck.
I understand that a company devoting resources to develop a treatment deserves a return on its investment. This is also not a new concept. And no one said profits are verboten. But should we let some Americans who may contract the coronavirus die because the price is out of reach?
Americans are funding potential treatments. They should not have to pay twice, especially not with their lives.
Unfortunately, the federal government has been reluctant to push the pharmaceutical industry.
Why? Drug makers have resisted commitments to pricing terms while such projects are in the early stages of development. For this reason, the National Institutes of Health in 1995 removed what were called “reasonable pricing” clauses from cooperative R&D agreements. At the time, former NIH director Harold Varmus described such clauses as a “restraint” on new product development.
No doubt, Azar is familiar with this argument. He was, you may recall, head of U.S. operations for Eli Lilly, one of the world’s largest drug makers, before joining the Trump administration.
Funny, though, how a public flogging can change one’s mind.
By Thursday, Azar seemed more sensitive to concerns that a coronavirus treatment should be affordable to everyone.
At yet another congressional hearing, he made a point of saying “I have directed my teams that, if we do any joint venture with a private enterprise that we’re co-funding the research and development program, that we would ensure there’s access to the fruit of that, whether vaccines or therapeutics.”
Of course, any deal the administration might reach with one or more drug makers should be fully disclosed, so the American public can see the details. Freedom of Information Act requests should not be required. And released documents should not be redacted.
Meanwhile, if one day the federal government licenses a pricey treatment for Tin Ear syndrome, Azar should get the first prescription.
And most likely, he will be able to afford it. Hopefully, others will, too.