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s President Obama winds down his tenure, he took a parting shot at the pharmaceutical industry.

Tucked within a lengthy essay he wrote to defend the Affordable Care Act, Obama chastised drug makers for their stance on pharmaceutical pricing and challenged the companies to renew their commitment to improving public health.

After lambasting Congress for refusing to work with him to more quickly to provide health coverage, he singled out drug makers as another example of obstinacy. “The pharmaceutical industry oppose(d) any change to drug pricing, no matter how justifiable and modest, because they believe it threatens their profits,” he wrote in an essay in the Journal of the American Medical Association that appeared Monday.

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“We need to continue to tackle special interest dollars in politics. But we also need to reinforce the sense of mission in health care that brought us an affordable polio vaccine and widely available penicillin,” he continued.

Obama noted that there was a 12 percent increase in prescription drug spending in 2014, and the costs “remain a concern for Americans.” And he acknowledged that ACA remedies, such as more substantial Medicaid rebates and regulatory steps for approving lower-cost versions of expensive biologic medicines, have not alleviated those concerns.

But the president also chided Congress for not doing more to alter the steady climb in pharmaceutical costs. Obama reiterated proposals that have regularly appeared in the annual White House budget. These included forcing drug makers to reveal their manufacturing and R&D costs; increasing rebates companies must pay for drugs prescribed for certain Medicare and Medicaid beneficiaries; and giving the federal government the authority to negotiate prices for certain high-priced drugs.

He also argued that Congress should not advance legislation that undermines the Independent Payment Advisory Board, “which will provide a valuable backstop if rapid cost growth returns to Medicare.” This advisory panel was created as part of the ACA and can look for ways to reduce Medicare spending and cut spending on such items as drug payment reimbursement to manufacturers.

His complaints and suggestions are not new, but remain at the center of the national debate over drug pricing, which has accelerated over the past year.

So what does the pharmaceutical industry have to say in response? We asked the Pharmaceutical Research and Manufacturers of America for comment, but have not yet heard back. It would be surprising, though, if they want Obama to have the last word.

[UPDATE: A few hours later, a spokeswoman for the trade group sent us this: “Focusing on the share of health care spending going toward lifesaving treatments instead of looking at delivering greater value across the system is shortsighted. The share of health care spending attributable to medicines is projected to continue to grow in line with overall health care cost growth for at least the next decade. Instead, we need to focus on policy solutions that help deliver innovative treatments to patients, including modernizing the drug discovery and development process; promoting value-driven health care; engaging and empowering consumers; and addressing market distortions. In doing so we will enhance the private market and address costs holistically.”]

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  • The pharmaceutical industry is highly unregulated at this time in history. Oncologists are having a field day recommending any new FDA chemo drug along with a host of expensive “cocktails”.
    I am an advocate for both the IMF AND ICER. My initial recommendation for ICER included the need for clinitions (technicians) to work along with oncologists to assist in evaluating patients on an individual basis and determining a scientific basis of prescribed meds, chemo and stem cell treatments. This will help by pass the the questionable second guessing of recently approved drugs and provide a cost justification for approved med therapies by medical personnel to their patients. Technicians will have advanced training and certification. This advancement within the industry is expected to be ready by August 2016. Stay tuned for future developments.

    • Mr. Bershader I recommend you read the book “Being Mortal” by Dr. Atul Gawande to understand the thinking process of oncologists. Two complementary points: 1) most terminally ill patients believe that if the oncologist can come up with the “right combination” of drugs they will get more survival. 2) the average oncologist has a pathologic aversion to telling their patients that there is nothing further to offer, and to quote a movie line they go to great lengths to avoid that difficult conversation where they advise the patient to “get busy dying”. In fact Gawande quotes one survey that found that 44% of oncologists would recommend a course of chemotherapy that they KNEW had absolutely zero chance of working.

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