There is something very wrong with the American health care system.

My name is Kirk and I live in Bowling Green, Kentucky. I’m 52 years old and am self-employed. I’ve worked hard and enjoyed being productive my entire adult life. I’ve been blessed with the opportunity to be self-employed and be successful and happy in my career. I am fully living the American dream. Our freedom allows us so many opportunities and I thank God for them all. 

Having diabetes type 2, I have quickly learned that there is something very wrong with the American health care system — and it doesn’t take much effort to track the problem back to pharmaceutical corporations. It’s obvious that these companies are putting massive effort into creating monopolies on specialized drug treatments. They make the most money monopolizing drug therapies for life-threatening diseases that affect large amounts of the population. This “formula for success” finds diabetes patients ripe for the picking. 

I have an excellent doctor who takes my health care seriously. She monitors my disease and has developed a comprehensive plan to manage my illness. But the amount of time she and I must spend trying to get access to the medications I need is utterly ridiculous. 

Health insurance companies are rightfully balking at paying out-of-control prices for these drugs. This leaves my doctor having to make multiple attempts at getting drugs approved or finding alternatives that might not be as effective. And it leaves me, the patient, constantly changing drug stores to save any money possible and spending hours of my time each month tracking down manufacturer “patient assistance cards” that are obviously geared to get the maximum price a person can stand to pay without losing the sale. It’s contrived, extremely greedy, and in my opinion, evil. 

I consider myself as fitting solidly in the middle class. My career as a computer network engineer is a rewarding one and I am more than happy with my compensation. In years past, compensation at my level would ensure a worry-free, comfortable retirement. Even after the massive effort from myself and my doctor, the lowest price I pay each month is $1,000 for TWO drugs (Synjardy and Ozempic.) 

I am already cutting back on other areas of my life so I can afford these two drugs. What started out decades ago as a smart plan for a comfortable retirement has ended up being a large fund that will be necessary to simply pay for my medications in retirement — and not much else. I know many people my age who are in much worse shape retirement-wise. This leads to quite a bleak outlook for the future of our nation. Who will these companies squeeze for cash when we all run out of money?

ST. PAUL, Minn. — Bemidji cancer patient Ramae Hamrin will testify in front of the Minnesota House Commerce Finance and Policy Committee today in support of the bipartisan legislation HF 801, which would establish a prescription drug affordability board designed to protect Minnesota patients like Hamrin from unaffordable prescription drugs. 

Hamrin lives with multiple myeloma, an incurable blood cancer, and relies on Revlimid, an oral chemotherapy drug sold by Celgene/Bristol Myers Squibb, to keep her alive. Revlimid is priced at over $250,000 a year and, even on Medicare, Hamrin faces out-of-pocket costs of $15,000 a year. That is simply untenable for Hamrin. 

“In order to continue taking this life-saving drug, there is a chance I will have to deplete my life savings, cash out my 401(k), and sell my house. When those funds run out, I’m not sure what I will do. Usually, I am a planner — but I cannot plan for this,” Hamrin, age 50, will tell the committee. “My circumstances make me feel helpless at times, but I am grateful that I can share my story with all of you.”

“This bill to create a drug pricing board is an essential first step to hold drug companies accountable and fix this broken system. Drugs don’t work if people can’t afford them. I strongly urge you to vote YES on HF 801 to protect patients from the burden of high drug prices.”

HF 801 would:  

• Establish a prescription drug affordability commission and an advisory council. These entities would work together to analyze drug pricing data and determine which drugs are excessively priced and cause affordability challenges. 
• If a drug is found to create an affordability challenge, the commission may establish an upper payment limit to all drug purchasers and payers in Minnesota. 

The hearing and Hamrin’s testimony can be watched here at 3:00 PM CST.  

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Roses are red,
Violets are blue,
We want lower drug prices
And know you do, too.

Welcome to the Week in Review.

1. A Win For Maryland!

• On Thursday, the Maryland House of Delegates joined the State Senate in establishing permanent funding for the first-in-the-nation prescription drug affordability board. Gov. Hogan blocked the funding in 2020, and both chambers of the state legislature overrode his veto to allow the board to move forward. We are grateful to the Maryland Citizens’ Health Initiative for its work to push for full empowerment of the board that will help make drugs more affordable for Marylanders. — (Politico)

2. Racial Justice’s Patent Problem

• The next director of the U.S. Patent and Trademark Office has a unique opportunity to reform the patent system and rein in high prescription drug prices, a problem that disproportionately harms communities of color, writes I-MAK co-founder Priti Krishtel in a new op-ed. Drug makers weaponize patent thickets to allow for continual price hikes. If the administration is serious about achieving health equity, addressing pharma’s patent abuses must be part of the conversation. — (The New York Times)

3. Patients Can’t Wait

• State legislatures are continuing to take the lead to lower drug prices and hold pharma accountable. Their work is critical for patients like Katherine Pepper, who depends on the pricey drug Humira and often eats just one meal a day to afford her medication. “I’m now in a situation where I have to do Russian roulette, spin the wheel, and figure out what I can do without this month.” — (Kaiser Health News)

4. The State of Affairs

• As Americans enter a second year of dealing with the devastating impact of COVID-19, drug companies continue to raise prices on necessary medications and receive billions from governments for taxpayer-funded COVID-19 vaccines and treatments. Patients need Congress and the Biden administration to act now to drive down drug prices through Medicare negotiation. — (The Philadelphia Inquirer)

5. Pharma Spends Big On Ads

• Top drug makers spent $216 million on TV ads last month, with AbbVie’s best-selling drug Humira and Novo Nordisk’s diabetes medication Rybelsus leading the pack. January’s ad blitz extends a period of high pharma TV spending over the past few months. And yet, drug companies want us to believe that there’s no room to reduce profits without impacting the development of innovative new medicines. It just doesn’t add up. — (FiercePharma)

SANTA FE, N.M. — Albuquerque patient Kristina Caffrey will share her story of relying on a $350,000-a-year prescription medication with the state House Health and Human Services committee today. Caffrey will testify in support of House Bill 154, legislation that would establish a prescription drug affordability board designed to protect New Mexico patients like Caffrey from unaffordable prescription drug prices. 

Caffrey lives with Gaucher disease and relies on the medication Cerdelga, sold by Sanofi Genzyme for $500 a pill. Caffrey’s two-pills-a-day regime runs an annual price tag that equals the price of a house. 

“Genzyme has recouped its investments [on the drug Cerdelga] many times over, but I am still paying the price. They do this because they can — and because no one has ever demanded to know why they’re extorting people like me,” Caffrey, 33, will testify. “The burden of high prescription drug prices is not just monetary. It is also an emotional one. I have made so many decisions out of fear of not being able to obtain or afford medication.”

“This is why New Mexico needs an affordability board, made up of experts who can peel back the curtain of arbitrary pricing that has nothing to do with the costs of production, the costs of development, or the value to patients.”

House Bill 154 would: 

• Establish a prescription drug affordability board and a prescription drug affordability stakeholder council. These entities would work together to analyze drug pricing data and determine which drugs are excessively priced and cause affordability challenges. 
• If a drug is found to create an affordability challenge, the board may establish an upper payment limit to all drug purchasers and payers in New Mexico. 

The hearing and Caffrey’s testimony can be viewed live here at 8:30 AM MT today.  

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Ahead of Super Bowl Sunday, here’s a reminder that Humira generates more in revenue than these two teams AND ALL THE OTHERS COMBINED.

Welcome to the Week in Review.

1. Big Pharma’s Big Lie

• A new report from P4AD debunks one of pharma’s most commonly cited claims that lowering drug prices will destroy its ability to develop innovative new medications for patients. Fact: Reducing pharmaceutical profits within reasonable levels would not harm innovation, and the most innovative new drugs — those that represent clinical advances — are often funded in part by taxpayers. Patients care about innovation more than anyone else, and we won’t let drug corporations hold us hostage with another one of their lies. — (P4AD)

2. Open Your Books

• Pfizer and Johnson & Johnson, both companies with a COVID-19 vaccine, are fighting to block shareholder resolutions seeking transparency into pharma’s pricing practices. Despite the fact that public money helped finance COVID-19 vaccines, when it comes to price, pharma wants to keep hiding in the shadows. — (Newsweek)

3. States Get The Ball Rolling

• There is growing evidence that in the absence of federal action, states will act. This week, state legislatures and governors around the country jump-started efforts to lower drug prices. A Montana Senate committee heard testimony for a bill that would increase transparency into drug prices, while lawmakers in New Jersey and New York are aiming to pass legislation to establish or strengthen insulin copay caps.Massachusetts Gov. Charlie Baker proposed penalizing drug makers for price gouging, and Wisconsin Gov. Tony Evers revealed a slate of drug pricing proposals, including the establishment of a prescription pricing review board. We stand ready to support these efforts! — (Montana Free Press, WNYC, CommonWealth Magazine, AP)

This isn’t a GAME. STOP gouging prescription drug prices, pharma. Welcome to the Week in Review.

1. Americans Pay More

• A new report from the RAND Corporation found that prescription drug prices in the United States are 256 percent of the prices in other wealthy nations. That number jumps to nearly 350 percent for brand-name drugs. And prices show no sign of dropping anytime soon: Drug companies have hiked prices on at least 783 drugs in the first month of 2021 alone. — (Axios)

2. Welcome to the Team!

• This week, P4AD and P4ADNow welcomed Sheila McLean as our new executive director. Sheila comes to us with decades of experience in advocacy and public health work, as well as her own patient experience with high-priced prescription drugs. We are thrilled to have her leadership! — (P4AD)

3. A Mandate for Congress

• Eighty-seven percent of voters say that they want lawmakers to keep their promises “to lower prescription drug prices and hold Big Pharma accountable,” according to a new poll from Morning Consult. An overwhelming majority of voters also believe that lawmakers must prevent drug companies from pandemic price gouging. Voters are sending a clear message — the time for action is now. — (Morning Consult)

4. Say No to Pandemic Price Gouging

• The U.S. government has pumped over $18 billion into the development and manufacturing of COVID-19 vaccines, and now it must ensure that the vaccines are affordable for all Americans, writes Aaron Kesselheim, an associate professor of medicine at Harvard Medical School. Drug companies should be allowed to make a reasonable profit for their work, but price gouging on taxpayer-funded vaccines is not how we will keep the virus at bay long-term. — (Bloomberg)

5. “A Vicious Cycle”

• High prescription drug prices disproportionately impact communities of color. According to a new report, Latinos are more likely to live with chronic health conditions and depend on prescription drugs to manage their health. Sixty percent of Latinos report having delayed seeking medical care or filling prescriptions due to high prices. We must fix this broken drug pricing system that contributes to a cycle of health and economic inequality. — (UnidosUS Action Fund)

 Here’s to a historic week. Welcome to the Week in Review.

1. The Time is Now

• Candidates who campaigned on promises to lower prescription drug prices have taken their seats as members of the 117th Congress, creating the best environment in years for serious drug pricing reform. Patients are ready to work with Congress and President Biden to get it done. — (FiercePharma)

2. One Step Closer

• Last Friday, the Maryland Senate voted to override the governor’s veto of a bill that would provide permanent funding for the state’s prescription drug affordability board. Now, the House of Delegates must follow the Senate’s lead and allow the first-in-the-nation board to continue its important work of lowering the costs of prescription drugs for Marylanders. — (The Washington Post)

3. These Are Our Stories

• This month, patient advocates living with conditions like cystic fibrosis, type 1 diabetes, and psoriatic arthritis spoke out about the high prices of their prescription drugs and their worries about what the future holds. “In order to avoid these interruptions in my dosing, I’ve been forced to dip into my savings and jeopardize my financial health to preserve my physical health. I felt that I had no choice. And I consider myself one of the lucky ones,” writes Kip Burgess, who lives with psoriatic arthritis. Jay Gironimi, who lives with cystic fibrosis, adds, “We shouldn’t be forced to decide between financial ruin and detrimental health outcomes.” — (P4AD)

My name is David Cruz and I live in Fort Collins, Colorado. In 2015, I was diagnosed with diabetes after my sugar levels reached near fatal levels. After spending time in the hospital where my levels continued to rise, my medications were finally able to bring my blood levels down. I now take Lantus, metformin, lisinopril, and allopurinol.

I dread seeing what the cost will be every month when I have to refill my prescriptions. I’m retired and have insurance coverage through Medicare, but every year my out-of-pocket costs increase. My Lantus insulin alone has a monthly list price over $1,100 and even with insurance still costs me about $130 every month. Once I hit the Medicare cap, which I hit in September of this year, my monthly cost goes up to $250. That’s a huge expense for anyone, but especially for someone who’s retired.

These prices are already unmanageable, but with Lantus continually increasing its price, my out-of-pocket costs continue increasing as well. Every year I hit the Medicare limit for out-of-pocket costs just on my prescriptions, and it seems that I hit this limit earlier and earlier every year. 

The high costs of my prescriptions kill my budget. It’s incredibly difficult to plan around the hundreds of dollars I spend on prescriptions each year when retired. I want to be able to plan ahead and stick to a budget, but the uncertainty about my rising prescriptions costs makes that difficult, and with such high prices, I’m lucky if I can afford all my prescriptions and not get behind on bills.

Earlier this year I broke a vial of my Lantus insulin, which only makes affording my drug even more expensive. It’s frustrating that one accident can destroy my budget for the rest of that month and put my health at risk. Because of their astronomical and constantly increasing cost, my drugs are unaffordable for me. I need these drugs to survive, so I end up making sacrifices in other ways, but I don’t know how much longer I’ll be able to keep up with these costs.

I don’t understand how drug companies expect seniors to survive with these high drug prices. Our necessary medications cost hundreds of dollars and many of us are left deciding whether to buy our prescriptions or pay our bills. We should never have to make a decision between staying healthy and paying the bills to keep a roof over our head, and an accident like breaking a vial shouldn’t set us up for financial ruin. 

We need leaders willing to work for patients and seniors like me. Our system should work to bring down drug costs and limit price increases like I’ve experienced with my prescription drugs. Insulin prices are already high enough and keep rising with no just reason. Patients across the country are suffering and sacrificing just to afford their medicine.