Wild, Susan Rep
https://www.alternet.org/2022/02/big-pharma/
Dozens of vulnerable House Democrats are worried that the party's stalled spending negotiations with Joe Manchin will cost them seats in the midterms — and hand Congress to the Republicans
Democrats planned to include legislation allowing Medicare to negotiate drug prices, fulfilling a campaign promise that helped them win control of the House in the "blue wave" of 2018, as part of President Joe Biden's Build Back Better legislation. The plan ran into an expensive lobbying blitz from the pharmaceutical industry, prompting Democrats to significantly water down the bill to limit the number of drugs Medicare could negotiate amid pushback from Sen. Kyrsten Sinema, D-Ariz., and other industry-aligned Democrats –– and that was before Manchin blew up the Build Back Better package entirely.
"We cannot overstate the paramount urgency of fulfilling the promise of lowering drug prices now for the American people," a group of 40 House Democrats, led by Rep. Susan Wild, D-Pa., said in a letter to party leaders on Monday.
The letter came after pharmaceutical companies hiked prices on hundreds of medications to start the year. A recent report from the patient advocacy group Patients for Affordable Drugs found that drug companies have increased prices on more than 550 drugs, including 183 drugs whose prices were raised by $100 or more, and 118 drugs that now cost more than $5,000. Pfizer alone raised prices on 125 drugs, more than any company, even as it shattered profit records thanks to $36 billion in sales from its widely-used COVID vaccine.
"Even as we enter the third year of a pandemic, Big Pharma continues its practice of targeting American patients and consumers with price increases, completely undeterred by the financial and health challenges facing American families," David Mitchell, the founder of Patients for Affordable Drugs, said in a statement.
"Drug corporations can do this because we let them — unlike other nations that use their purchasing power to get a better deal," said Mitchell, who suffers from an incurable blood cancer that is treated with a cocktail of drugs carrying a list price of more than $900,000 per year. The original drug-pricing agreement in the Build Back Better Act, he said, "would curb rising drug prices for millions of patients and halt abusive annual price hikes by limiting increases to the rate of inflation, which is projected to return to 2.3 percent in 2023."
Election forecasts generally suggest that Democrats will lose control of the House in the midterms, making the popular drug legislation a key priority, especially after Manchin and Sinema effectively killed off several other popular Democratic proposals, including a rollback of the Trump-era tax cuts, an extension of the expanded Child Tax Credit, and paid family leave.
A Data for Progress poll last fall found that likely voters support the Medicare legislation by a 55-point margin, including 83% of Democrats, 71% of independents, and 65% of Republicans.
"Taking action on prescription drugs is one of the most popular political issues Democrats can pursue — it's overwhelmingly supported by a bipartisan majority of voters," Sean McElwee, the founder and executive director of Data for Progress, said in an email. "Democrats need to take every opportunity to lower costs for voters and deliver popular legislation that visibly improves their lives this November."
Manchin, who walked away from Build Back Better negotiations in December after the White House called him out by name in a statement over the bill's delay, said on Tuesday that the Build Back Better bill is "dead" and any negotiations on potential spending programs would have to start from scratch. Biden has said that he hopes to include "chunks" of the original bill in a potential compromise package with Manchin.
Last year, Manchin said he supported the drug-price legislation, calling it the "one thing that should be done for sure." But the West Virginia senator appears to be prioritizing bipartisan negotiations to reform the Electoral Count Act over any would-be spending bill, leaving a key Democratic campaign promise in limbo.
"President Biden supports this plan. We support this plan," the House Democratic group said in their letter. "Every Democratic member of the U.S. Senate supports this plan. And most importantly, the American people support this plan. It is time to enact it into law. Already this year, drug corporations have raised prices on more than 400 drugs. Action can't happen soon enough to make medicines more affordable for the millions who need them."
The price increases came after the pharmaceutical lobby shattered its own record for lobbying spending as it rallied around the cause of defeating Biden's legislation. Democrats like Sinema and Rep. Scott Peters, D-Calif., two of the biggest recipients of Big Pharma donations, led an effort to cut the number of drugs that could be negotiated by Medicare. Even so, the compromise legislation would save taxpayers an estimated $80 billion while capping price increases on certain medications, capping out-of-pocket costs for seniors, and capping the cost of insulin at $35 for people on Medicare and on private plans.
Medicare is the only government agency that is barred from negotiating bulk pricing discounts — the result of an infamous scheme hatched by Big Pharma lobbyists and a Republican leader who rammed the provision into a bill that required Medicare to cover the cost of prescription drugs, shortly before he left Congress and became the top lobbyist for the industry. A three-year investigation by the House Oversight and Reform Committee last month found that pharmaceutical companies exploit the Medicare program to boost revenues, noting that taxpayers could have saved more than $25 billion over five years if Medicare was allowed to negotiate the cost of just seven popular drugs such as Humira and Lyrica.
The investigation also found that drug companies "aggressively raise prices" to hit revenue targets and incentives for executives and have targeted the U.S. market for higher prices while keeping costs lower overseas. The report also concluded that drug companies "abuse the patent system" to suppress competition and maintain monopoly pricing. Drug companies contend that their huge profits are necessary to fund research and development, but the investigation found that the 14 leading drug companies spent $577 billion on stock buybacks and dividends over just five years, $56 billion more than they spent on research and development over that same period.
The limited Medicare negotiation bill approved by the House last year would allow Medicare to negotiate the cost of 20 popular drugs and dozens of insulin products used by 8.5 million Medicare beneficiaries,according to a recent analysis by the Kaiser Family Foundation, although many of the drugs with the highest Medicare spending would be exempt.
The Congressional Progressive Caucus, which pushed for a more expansive bill that would have saved taxpayers an estimated $450 billion over 10 years but ultimately agreed to back the scaled-down version, set a target date of March 1 to pass the revised spending plan ahead of Biden's State of the Union address.
"This is both achievable and necessary,"CPC Chairwoman Pramila Jayapal, D-Wash., said in a statement, noting that in the weeks since negotiations had stalled out, "the case for this legislation has only become more urgent."
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Pharmaceutical industry likely to shatter its lobbying record as it works to shape Democrats’ spending bill
A years-long battle over prescription drug prices reaches its apex as the industry spends tens of millions to alter the plan.
By Yeganeh Torbati and Jonathan O'Connell
November 5, 2021
In September, Rep. Andy Kim (D-N.J.) began noticing mailers arriving at homes across his district, including his own and that of his parents, with an alarming message. The mailers alleged that Kim was intent on preventing Medicare patients from getting the drugs they needed.
That was news to Kim, who has made lowering seniors’ health-care costs and expanding their access to Medicare a signature issue. The mailer, along with a slew of digital ads and text messages, was sponsored by a group called A Healthy Future, LLC, and claimed that Kim and other New Jersey Democrats wanted to cut off “access to lifesaving medicines” and shift Medicare money into other social safety-net programs.
Soon after the mailers landed in New Jersey mailboxes, Kim’s office began receiving calls from puzzled constituents.
“I’ve been attacked before, but I’ve never seen one as egregious as this one in terms of ‘Andy Kim’s trying to cut Medicare,’” Kim said. “That’s just so absurd, and I actually think that has affected how the district has responded.”
Watershed or watered down? Democrats’ drug pricing deal leaves many unsatisfied.
Kim was certain the attacks were coming from the pharmaceutical industry, but it was hard for him to be sure. A Healthy Future’s website includes no contact information, and a message to its Facebook page went unanswered. But a nonprofit group called A Public Voice listed A Healthy Futureas being under its control in its 2018 and 2019 tax filings and described the LLC’s primary activity as “supporting a vibrant health care system.”
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A Healthy Future and its anonymous funders, it turned out, had fought previous efforts in Washington to reduce the cost of prescription drugs. According to Google digital ad data, A Healthy Future also paid for ads in fall 2020 arguing against a Trump administration attempt to address prescription drug costs.
Brian Newell, a spokesman for PhRMA, the pharmaceutical industry’s chief lobbying arm, when asked whether the organization had ever had any financial or other relationship with A Healthy Future or A Public Voice, said: “Like most industries and associations, PhRMA engages with groups and organizations that have a wide array of opinions and priorities, including those who do not want the government to come between patients and their medicines.” DENIAL NON-DENIAL ~ WATERGATE b&wOODWARD
The ads targeting Kim and others were one strand of a massive, months-long advertising, lobbying and political donation blitz undertaken by the pharmaceutical industry and its allies, perhaps the strongest of all corporate voices in Washington, to kill a Democratic proposal to lower the cost of prescription drugs by empowering the federal government to negotiate their prices.
That provision to control drug prices became a focal point of the $1.75 trillion spending package Democrats are trying to move through Washington. The measure was in, then out, then watered down, going through a fierce ping-pong of backroom negotiations that is likely to continue once the Senate considers the bill in coming weeks.
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Pharmaceutical industry lobbyists defended their effort, alleging that the Democrats’ proposal would stifle research. They also said many other groups poured millions of dollars into the other side of the debate.
“As we’ve said repeatedly, our advocacy has focused on delivering solutions that will lower what patients pay out of pocket for prescription medicines, while opposing reforms that would ultimately leave patients trapped in a broken insurance system, restrict access to lifesaving medicines, and destroy the development of new treatments,” Newell said.
The influence campaign at times worked through groups whose funding sources are hidden. At least 20 different advertisements were run on television and online across the country. The advertisements were augmented by a campaign byPhRMA, which spent nearly $23 million on lobbying through the first nine months of 2021, according to data compiled by OpenSecrets, which tracks corporate spending and political influence. That puts PhRMA on track this year to beat its own spending recording of $29.3 million in 2019.
“The intensity right now of K Street and the deployment of lobbying and dark money is extraordinary,” said Nick Penniman, chief executive of Issue One, which advocates for transparency in Washington. “It is a frenzied state right now.”
The intense effort is reflective of just how much many companies have at stake in the Democrats’ evolving tax-and-spending bill. This article, which is based on interviews, documents and lobbying and ad spending data, offers a window into the efforts one sector took to shape the bill, much of which was crafted in secret.
The drug pricing provision agreed to by House Democrats this week does not go as far as many Democrats including Kim had hoped. But it still delivers reforms that could cut costs for millions of Americans bycapping out-of-pocket spending for seniors at $2,000 a year, capping insulin costs, preventing price increases that exceed the rate of inflation, and allowing Medicare to begin negotiating prices for some drugs.
“What we’re trying to do is defying one of the most powerful special-interest lobby groups in Washington, D.C.,” Kim said. “The fact that we were able to get something that will meaningfully help people was important.”
Other industries, including tobacco and electric vehicles, have worked aggressively to pare down or reshape parts of the bill in their favor, too. But the effort to fight back on drug-price increases stands out because of the enormous scope of the campaign waged by the pharmaceutical industry and its allies, which have derailed similar proposals for the past two decades, despite how popular many of the changes are with voters, according to polling data.
“They’re the Goliath,” said Sheila Krumholz, executive director of OpenSecrets. She said that aside from the U.S. Chamber of Commerce, of which pharmaceutical firms are members, the industry had spent more than any other by a wide margin so far this year, deploying so many lobbyists — 1,600 — that they outnumber members of Congress 3 to 1.
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The industry made $90.6 million of political contributions during the 2020 election cycle, according to OpenSecrets,61 percent of that to Democratic candidates and groups.
The industry’s focus on drug pricing has increased dramatically in recent years as the issue became more top-of-mind for voters. In 2012, lobbyists registered to work on the issue of “drug prices” 69 times for 20 different clients. In 2021 so far, they have filed to lobby on the issue 1,192 times for 242 different clients, according to OpenSecrets data.
While the industry lobbies on many different issues in a given year, the Democratic bill H.R. 3 that would have given the government more expansive power to negotiate drug prices was the bill PhRMA cited most often for lobbying; the bill appeared in its reports 35 times so far this year, OpenSecrets found.
Research by Patients for Affordable Drugs Now, which advocates for lower prices, found that PhRMA and its allies spent at least $26.5 million on television and digital ads attacking proposals on price negotiations between July and early November. That included $2.7 million spent by PhRMA, but also $4.5 million in ads by the 60 Plus Association, which bills itself as a conservative version of AARP anddid not respond to a request for comment.
Also lining up behind the effort was the American Action Network,a major conservative nonprofit advocacy group, with $7.9 million in ads. PhRMA gave the American Action Network $4.5 million in 2019, along with $75,000 to the 60 Plus Association, according to tax filings.
Rep. Elissa Slotkin (D-Mich.) holds one of Congress’s most competitive seats, having wrested it from Republican control in 2018 and narrowly winning reelection in 2020. She shaped her campaign around a platform of tackling rising health-care costs and has maintained focus on that issue, inviting a Type 1 diabetes patient with sky-high insulin costs to be her guest at the 2020 State of the Union address.
According to data tracked by Patients for Affordable Drugs Now, the American Action Network funded an ad in Slotkin’s district starting in August that accuses Democrats of pushing a “socialisthealth-care plan to control what medicines you can get.”
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Her office is now accustomed to fielding calls from constituents who see ads like that one on television, Slotkin said.
“We can really tell the first couple of days those ads run because that’s when we’ll see a spike in the number of people calling our office,” she said. “We literally write a response that our staff can use to forcefully push back and try to contradict the purposeful misinformation.”
Asked about the accuracy of the advertisement targeting Slotkin, American Action Network spokesman Calvin Moore reiterated its message, saying such proposals amount to “socialist price controls” that could limit development of new prescription drugs. “Stifling innovation to this degree has profound consequences,” Moore said.
Many of the backers of these efforts are difficult to identify because of rules allowing anonymous funding of political groups. A Public Voice, which described itself on its 2018 and 2019 tax forms as the “direct controlling entity” of A Healthy Future, is based in Thornville, Ohio.It listed nearly $5 million in contributions in 2018, though it declined to name its donors, and spent the money on consulting, marketing and funding conservative causes across the country. That year, its donations included $240,000 to Fund for a Working Congress, a political action committee that supported Republican candidates, and $370,000 to Ohio First PAC, which supported a challenge by Republican James B. Renacci against Sen. Sherrod Brown (D-Ohio).
A voice mail left at a number listed on tax filings for A Public Voice received no response. Documents filed with the state of Ohio show that the entity originally formed in 2012 as Protect Your Vote Ohio and show its registered agents as lawyers with Langdon Law, a Cincinnati-area law firm known as a nexus for “dark money” groups on the right.
David Langdon of Langdon Law did not respond to an email and voice mail requesting comment.
The approximately 20 digital and television video ads compiled by Patients for Affordable Drugs Now and reviewed by The Washington Post warned viewers about an array of crises that could befall them should Congress allow Medicare to negotiate prices for drugs, among them that the industry could no longer develop new medications, that the government would limit access to prescriptions, that Medicare would be cut or that millions of jobs would be lost.
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“They call it negotiation, but it really means government decides what medicines I can get,” says “Sue,” awoman labeled in one ad as a diabetic from Ohio.
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“Imagine a future in which a vaccine for covid-19 was never discovered,” says a voice in another spot.
Pro-industry advertising ran during opinion shows on Fox News, CNN and MSNBC, as well as during college football games, according to the advertising data firm iSpot.tv.
Once the drug cost proposal was added to President Biden’s larger legislative package, some advertising took direct aim at Democrats’ spending priorities. One claimed the proposal called for “gutting Medicare” in exchange for “pie-in-the-sky special-interest kickbacks.” It depicts House Speaker Nancy Pelosi (D-Calif.) riding atop an animated unicorn, she and Rep. Alexandria Ocasio-Cortez (D-N.Y.) sliding down rainbows, and Senate Majority Leader Charles E. Schumer (D-N.Y.) at a dessert buffet. Another depicts the proposal as a shell game that “loots Medicare.”
Jayapal says Democrats almost have the votes to pass Build Back Better
Rep. Pramila Jayapal (D-Wash.) described her frustration with lengthy negotiations on the Build Back Better act in an interview with The Washington Post Nov. 5. (Zach Purser Brown/The Washington Post)
Previous presidents, including Barack Obama and Donald Trump, vowed to pass bills to lower prescription drug costs, only to see their efforts die on Capitol Hill, in part because of a relentless lobbying blitz.
When Montana’s Brian Schweitzer ran for Senate in 1999, he elevated his long-shot campaign by busing senior citizens to Canada so they could illegally buy drugs at lower prices.
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He got his first taste of the pharmaceutical lobby shortly afterward, when he said television ads started attacking him for trusting medicines made in other countries. He said in his case, the attacks helped make his political career. “Virtually everybody in America has a friend or family member who is taking that expensive medicine,” he said.
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Rep. Susan Wild (D-Pa.) holds anothercompetitive seat, representing an Allentown, Pa., district that narrowly favored Biden in the 2020 election. She said that as she began supporting drug price reform early in her career, lobbyists began relentlessly calling her office, even though she had vowed not to take corporate PAC donations.
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“If they’re calling me nonstop, imagine what they’re doing to those who actually do take their money,” she said.
During the most recent negotiations, Wild began receiving automated emails from constituentsworried they wouldn’t be able to get their medicines if the government could negotiate prices. But on Sunday she joined 14 colleagues from other competitive districts, including Kim and Slotkin, to urge Democratic leadership to deliver on their promise to reduce drug prices.
She said she knows what comes next.
“I am quite certain that because I have been so outspoken on this issue, that I am going to face an attack ad,” Wild said. “I have an idea for what it could be, but I don’t want to tell you in case they see it. I don’t want to give them any ideas.”