My name is Ken and I’m from Gibsonia, PA. I live with an incurable blood cancer called multiple myeloma, as well as atrial fibrillation and a number of other health conditions.
Thankfully, my multiple myeloma is in remission so I am not currently taking Revlimid, a popular but expensive treatment. But I used to pay about $1,100 out-of-pocket every month for it while my insurance was billed another $8,000. I’m not eligible for the drug company’s patient assistance programs, so if I relapse and need to get back on Revlimid, I’ll be facing about $16,000 in out-of-pocket payments next year.
Even in remission for my cancer, I still find myself in the Medicare donut hole. I’m not getting assistance for the other medications I take, and my drug and other health care costs are piling up quickly. Just one drug I need, Eliquis, costs me $328 for a 90-day supply, and I spend about $150 every three months for several eye drops that help treat my glaucoma. I’ve also spent about $15,000 on hearing aids. Looking further down the road, I will probably need a pacemaker as well.
I worked as a teacher of computer technology for 38 years, so I have a guaranteed pension and have been able to make my payments so far. However, these exorbitantly high drug prices have forced me to make some difficult choices. I had to sell one of my cars and take out a home equity loan in order to pay for my medications. I also cut back where I can on everyday necessities, like phone and internet services.
The average person can’t afford prices like this, especially those living on a fixed income. There’s only so much money to go around, and I live with the possibility that I may one day not be able to access all the drugs I need due to these high prices. But I try not to think about that because it really wears on my mind. All I can do right now is take things day by day.
Drug companies keep playing with the numbers and finding ways to make more money any way they can. It seems like they keep increasing their prices in anticipation of the implementation of minor cost-cutting measures. I hear lawmakers say they want to help Americans with prescription drug costs, but I need to see them work on legislation that meaningfully lowers drug prices for all of us. We need help now.
WASHINGTON, D.C. —An insidious culture of greed is pervasive across the pharmaceutical industry, and today the scale of the problem was revealed. The House Oversight Committee’s investigation into drug corporations exposed a disturbing pattern of abusive pricing practices, anti-competitive behavior, and manipulative marketing campaigns.
Not a single price increase was linked to investment in research and development, according to the documents. Instead, drug corporations took unrelenting price increases to meet revenue goals, increase executive bonuses, and maximize corporate profits.
The reports examine Amgen, Novartis, and Mallinckrodt and reveal the falsehoods behind pharma’s favorite talking points.
Read highlights from the damning documents below.
1. Pharma Claim: High prices exist to recoup R&D, not drive profits.
The reality: Executives’ motivations for price hikes is devoid of desire to recoup or invest in R&D — instead the hikes are intended to increase revenue. Internal company documents showed that company executives weighed price increases against public backlash, not the actual impact on research and development funds. Ultimately, executives decided in favor of price hikes because “we will receive the same press regardless” and “any price increase obviously has positive results.”
2. Pharma Claim: We make life-saving drugs — it’s not about the money for us.
The reality: The committee’s investigation found that executive compensation policies incentivized price hikes. Novartis increased the price of Gleevec 22 times, and its revenue soared. As a result, more than 100 Novartis employees made $1 million in 2014 and 2015.
3. Pharma Claim: Our decision-making centers on the health and well-being of patients.
The reality: After public outrage at its $40,000 price for a single vial of Acthar Gel, Mallinckrodt’s CEO urged changing the vial size of Acthar gel (nearly cutting it in half) to appear like the company decreased the price.
4. Pharma Claim: Charity programs ensure our drugs are affordable and accessible.
The reality: Patient assistance programs serve both as a public relations tool for companies and to increase their bottom line. Novartis’ internal strategy documents estimated the rate of return of its co-pay assistance program would be $8.90 for every dollar invested. When weighing “key messages” to employ after a highly scrutinized price hike, one Novartis executive urged colleagues to emphasize contributions to the copay foundation.
5. Pharma Claim: It’s a robust marketplace and drug companies compete based on price.
The reality: Drug companies often collude — not compete. Amgen’s business strategy for its blockbuster Enbrel centered on matching price hikes by its biggest competitor, AbbVie’s Humira. Internal presentations reveal that Amgen planned its price hikes based on the behavior the company anticipated from AbbVie.
6. Pharma Claim: High prices fuel innovation.
The reality: Taxpayer funding fuels innovative new drugs. High prices fuel the growth of Big Pharma revenue. Drug companies don’t invest until public research shows commercial promise.
7. Pharma Claim: Pharmacy benefit managers are responsible for price increases.
The reality: Big Pharma loves to point fingers, but internal documents show price increases on Amgen’s Enbrel and Sensipar are unrelated to rebates negotiated with PBMs. Instead, the price hikes are used to raise the company’s revenue.
Read our takeaways from yesterday’s reports from the House Oversight Committee into pharma giants Celgene and Teva.
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By Sarah Kaminer Bourland, Legislative Director
1. Pharma Claim: High prices exist to recoup R&D, not drive profits.
The reality: Executives’ motivations for price hikes is devoid of desire to recoup or invest in R&D — instead the hikes are intended to increase revenue. Internal company documents showed that company executives weighed price increases against public backlash, not the actual impact on research and development funds. Ultimately, executives decided in favor of price hikes because “we will receive the same press regardless” and “any price increase obviously has positive results.”
2. Pharma Claim: We make life-saving drugs — it’s not about the money for us.
The reality: The committee’s investigation found that executive compensation policies incentivized price hikes. Novartis increased the price of Gleevec 22 times, and its revenue soared. As a result, more than 100 Novartis employees made $1 million in 2014 and 2015.
3. Pharma Claim: Our decision-making centers on the health and well-being of patients.
The reality: After public outrage at its $40,000 price for a single vial of Acthar Gel, Mallinckrodt’s CEO urged changing the vial size of Acthar gel (nearly cutting it in half) to appear like the company decreased the price.
4. Pharma Claim: Charity programs ensure our drugs are affordable and accessible.
The reality: Patient assistance programs serve both as a public relations tool for companies and to increase their bottom line. Novartis’ internal strategy documents estimated the rate of return of its co-pay assistance program would be $8.90 for every dollar invested. When weighing “key messages” to employ after a highly scrutinized price hike, one Novartis executive urged colleagues to emphasize contributions to the copay foundation.
5. Pharma Claim: It’s a robust marketplace and drug companies compete based on price.
The reality: Drug companies often collude — not compete. Amgen’s business strategy for its blockbuster Enbrel centered on matching price hikes by its biggest competitor, AbbVie’s Humira. Internal presentations reveal that Amgen planned its price hikes based on the behavior the company anticipated from AbbVie.
6. Pharma Claim: High prices fuel innovation.
The reality: Taxpayer funding fuels innovative new drugs. High prices fuel the growth of Big Pharma revenue. Drug companies don’t invest until public research shows commercial promise.
7. Pharma Claim: Pharmacy benefit managers are responsible for price increases.
The reality: Big Pharma loves to point fingers, but internal documents show price increases on Amgen’s Enbrel and Sensipar are unrelated to rebates negotiated with PBMs. Instead, the price hikes are used to raise the company’s revenue.
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By Sarah Kaminer Bourland, Legislative Director
1. Pharma Claim: High prices exist to recoup R&D, not drive profits.
The reality: In a 2014 email from Mark Alles, Celgene’s CEO, the executive admits that he’s planning a price hike to meet sales targets. Furthermore, the investigation concluded that Celgene’s internal pricing decisions “were divorced from its calculus regarding future R&D or recouping of past R&D expenditures.”
2. Pharma Claim: We make life-saving drugs — it’s not about the money for us.
The reality: Instead of inviting a competitive market, drug companies thwart competitors at every turn. When news broke that a generic competitor had been delayed, Teva employees celebrated by exchanging emails about the financial implications for their bonuses.
3. Pharma Claim: Our decision-making centers on the safety and well-being of patients.
The reality: Celgene has long cited “safety” concerns as the company’s rationale for blocking generic competition through the FDA’s risk evaluation and mitigation strategies (REMS) program. But internal documents published today show that the company views their REMS program not as a means to promote safety, but as a tool to prevent “generic encroachment” and extend its monopoly.
4. Pharma Claim: Charity programs ensure our drugs are affordable and accessible.
The reality: An internal presentation reveals that Teva averages a 451 percent return on every dollar invested in its copay assistance program. Teva’s program covers out-of-pocket expenses for patients while generating a full reimbursement for the drug corporation from each patient’s insurance company.
5. Pharma Claim: We support solutions to lower drug prices for patients.
The reality: Between 2017 and 2020, Teva spent $11.6 million lobbying Congress in order to thwart reforms that would harm its bottom line. According to internal documents, one of Celgene’s internal goals was to prevent the “legislative erosion” of the program it uses to prevent generics from coming to market.
6. Pharma Claim: High prices fuel new drugs.
The reality: Copaxone generated $34.2 billion in net U.S. revenue for Teva over nearly two decades. The drug corporation spent only 2 percent of that on R&D for the drug. Instead, Teva invested in developing “new” versions of old drugs that offer no therapeutic benefit.
7. Pharma Claim: Pharmacy benefit managers are responsible for price increases.
The reality: Drug companies alone set and control prices. In company PowerPoints, Teva boasted about its success increasing prices.
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My name is Cheryl and I live in Maine. When my husband, Harold, was prescribed Spiriva to manage his COPD three years ago, we were grateful there was a medication that could effectively manage his symptoms and allow him to continue to work. But we were shocked when we found out the medication would cost us $1,200 every three months. We simply can’t afford that, but Harold needs the medication.
We were forced to make choices no one should ever have to make — keep paying for electricity, or pay for Harold’s medication? Buy healthy groceries, or pay for Harold’s medication? For us, there was no option. We kept paying the $1,200 and stopped paying for our electricity. We stopped buying meat and other nutritious food and stuck to canned soups and noodles, all so my husband could breathe.
We are lucky — after a year, we were able to qualify for a plan that covers much of Harold’s expenses for the Spiriva. It has meant we can return to life more or less as normal. But we are at the mercy of the assistance program and it will stop at the end of the year. That means we will be faced with applying all over again, a process that took a full year last time. Come January, we might be back where we were before — making sacrifices so Harold can breathe.
Without Spiriva, Harold would not be able to work as a farmhand growing potatoes in our home state of Maine. We would be dependent on my salary from managing a local McDonald’s. We have a good life. We like our jobs, and we are proud of our hard work. But right now we know our lives could change as soon as the financial assistance ends. I live in fear of that day.
No one should have to make the choices we have. We need drug prices to come down now.
My name is Tammy L. de la Cruz and I live in North Las Vegas, Nevada. I live with a rare autoimmune disorder, and to treat my condition, every week I receive Intravenous Immunoglobulin (IVIG) treatment. I would become paralyzed without this treatment, which terrifies me.
When I first began IVIG treatment I was covered by Medicaid, so the treatment came at no cost to me. I later switched to marketplace insurance when I started receiving SSDI benefits. The cost under my new insurance increased to about $30 every three weeks when I would go to the doctors for my treatment.
In August of 2018, I began receiving Medicare benefits. I distinctly remember going for my first IVIG treatment after switching to Medicare. When I heard that the copay would be $1,491, I couldn’t believe it. That single copay would cost more than my monthly SSDI benefits. At the time I was going every three weeks for IVIG treatment, but quickly increased to once a week as my doctor suggested.
If the agency I went through to receive my treatments didn’t provide a grant to cover the cost, I simply wouldn’t be able to afford treatment. When Medicare didn’t cover the cost of my medication, I began to give up hope, thinking about what would happen without these life-changing treatments.
During that time, before I found my grant, I thought a lot about what I would lose without my treatment. I have eight grandkids and love helping them out. I volunteer with my local food pantry and with a social service agency that serves those that have intellectual and developmental disabilities. In addition, I enjoyed watching the Special Olympics and even volunteered a few times. I love coloring, reading, and up until a few months ago I attended college full time –– and thanks to my IVIG treatments, I was able to walk across the stage to get my BS in Psychology. Not being able to afford my treatment would have made these enjoyable hobbies more difficult, if not impossible, for me.
I found a grant at the 11th hour, saving myself from paralysis. I know the future of this grant funding is not guaranteed. People with illness shouldn’t have to work so hard to fund extreme drug costs; it’s cruel.
Patients like me shouldn’t have to rely on grants to cover the cost of our treatments. We shouldn’t have to deal with the uncertainty of constantly changing costs and the concerns of what will happen if we lose access to our grant and therefore our prescriptions. No one should have to experience the feeling of hopelessness I felt when I thought I wouldn’t be able to afford the treatment I needed. It doesn’t have to be like this. We need changes to our system that make prescription drugs more affordable.
My name is Kris Garcia and I’m from Denver, Colorado. I have four bleeding disorders, asthma, and several allergies. Having multiple bleeding disorders, including hemophilia, leaves me in a constant position of uncertainty. I have to be incredibly careful, as any emergency can quickly turn into both a health and financial crisis. Since cauterization is more difficult with my bleeding disorders, I rely on Humate-P should an emergency occur. But the astronomical cost of these drugs only increases the stress of an emergency. Each vial of Humate-P costs $10,000, and for each infusion, I would need four vials.
These costs create a high level of stress for me and have exacerbated health costs for surgeries. When I had tonsil surgery a few years ago, the cost ended up being $1.8 million before insurance as I needed infusions every day and ended up staying in the hospital for a month and a half. The toll such a medical experience takes on someone is taxing enough; the financial burden only makes such a situation more stressful.
I keep four vials in the fridge, but should anything happen, I only have these four doses –– and anything beyond that would put me in financial ruin. Compared to other conditions, little is known about bleeding disorders, so finding a remedy can often be difficult. I’ve found one that has worked for me for the past 20 years, but unless I am receiving grants to cover the costs, there is no way I could afford these treatments.
Additionally, I’m stuck with a decision between high financial costs and risking my health when deciding whether to buy EpiPens for my allergies. The price of EpiPens has increased greatly over recent years and now costs about $600 for two EpiPens. Even with insurance, I would be paying $180 out of pocket. Comparatively, with my current coverage, an ER visit costs about $200. When budgets are tight, I’m left with a terrible decision –– do I play Russian roulette with my life and not buy the EpiPens to save that money, or do I take the risk that I may have to go to the ER should an emergency occur? I shouldn’t be left deciding which is the lesser of two evils, whether to pay for an expensive treatment or to risk my health to save on cost.
The cost of these prescriptions has affected many decisions in my life. I had to give up my business and seek other employment because of how expensive my insurance and medications were. Switching jobs becomes scary since my medications are often only available at special pharmacies, which are not always covered. I currently am insured through my work for an airline, but have a likely furlough coming in September. I’m incredibly concerned about where my coverage will come from, especially if I were to have an emergency.
I shouldn’t have to live in constant fear of a medical emergency also bringing financial ruin to me and my family. These astronomical drug prices have affected decisions in my life and have created a fear of financial ruin. Manufacturers get tons of government funds to produce drugs, but still profit off their patents and charge us unreasonable prices. We need changes to reduce these unaffordable prices so that people like me don’t live in a state of constant fear of whether we’ll be able to access our prescriptions.
My name is Kolton Chapman and I live in Pickerington, Ohio. I am a transgender man living with a chronic illness. My life hasn’t always revolved around my illness –– I am an artist who enjoys coloring books and helping people design logos and other items to help with their businesses. I am a son who loves to spend time with his family, and I am an insurance agent. That last one is what I am most proud of. I have worked very hard to get to where I am today, and even with everything working against me, I was able to achieve my goals. I view every scar that I carry as proof that I have survived this long, and that it is going to take a lot more than that to break me.
In 2014, I was diagnosed with ulcerative colitis. After my diagnosis, I began taking Lialda to try and put my disease into remission. Just one month’s supply of that cost me $250, because there was no alternative drug available. That $250 was my cost even after what my insurance company covered. Two years in, I began receiving Entyvio infusions for my ulcerative colitis every four weeks. When I first began infusions, Entyvio was totally covered by my insurance. But I later had to change insurance coverage due to circumstances out of my control, and the price became astronomical. Every four weeks, I had to pay $1,200 per infusion under my new insurance.
At the time of this cost increase, I was in college and was already feeling the financial burden of student debt. Budgets for students are already tight enough, but the immense increase in cost for my infusions left me in an incredibly difficult position. Unfortunately with the added financial burden from my infusions, I had to choose between affording the cost of my infusions or school. This decision really wasn’t a decision at all since I needed the infusions to stay alive. The unreasonable price of my prescriptions forced me to leave college.
Because of the astronomical cost of my Entyvio infusions, I now owe more in medical debt than I do in student loans. The massive financial burden from medical and student debt factors heavily into my decisions. I had to remove my colon, knowing that it was the only thing I could do to avoid more debt. Our medical decisions shouldn’t be driven by what will protect us from the most debt, but what will bring about the best health outcomes.
In 2019, I was diagnosed with moyamoya disease, a rare blood vessel disorder, and have already suffered a stroke. My main priority through my health challenges should be focusing on my health –– not on bills and making ends meet. But unfortunately, with high prescription costs, their prices and my medical debt always factor into my decisions. Although I now have different coverage and am taking different prescriptions, I still spend over $150 per month on my four medications. This cost may seem more manageable compared to the $1,200 I was spending monthly on infusions before, but it’s still an incredible financial burden that is only being added on top of the remaining medical debt hanging over my head from earlier infusions.
My life path has been completely altered by expensive prescription drugs and drug company greed. I often feel like I’m behind all of the people my age — even people younger than me — because I’ve had to focus my time and money on staying alive. We shouldn’t have to give up on pursuing a college education because of crippling medical debt. We shouldn’t have to make every financial decision with the cost of prescriptions and medical debt in the back of our minds. Things can be better if our leaders rein in drug companies’ greed and make the needs of patients like me the priority.