BIG PHARMA DEBUNK DAY FIVE: BIPARTISAN SUPPORT

? Big Pharma’s Lie: Big Pharma’s Lie: The package of drug pricing reforms is an unpopular partisan plan pushed by Democratic congressional leaders.

✅ The Truth: Drug pricing reform has overwhelming bipartisan support across the country.

Summary:

Americans – Republicans, Democrats, and independents alike – overwhelmingly support action to lower drug prices. Nine in 10 Americans support allowing Medicare to negotiate prices, limiting annual drug price hikes to the rate of inflation, and capping out-of-pocket costs for insulin at $35 a month. Medicare negotiation is the most popular priority in the president’s economic plan. Nearly 90 percent of voters said drug pricing is an important issue heading into the November midterm elections, and 3 in 4 said a failure by Congress to lower drug prices will affect their vote. In February, over 90 groups representing patients, seniors, consumers, unions, employers, physicians, and disease advocacy groups signed a letter urging the Senate to pass the drug pricing reforms in a reconciliation package. There is a clear path forward for Congress to pass the drug pricing reforms and help patients and taxpayers now.

Patient Perspective:

“While our country wrestles with deep divisions on so many issues, the overwhelming popularity of prescription drug pricing reforms before the Senate right now is striking. Despite Big Pharma’s record spending on lobbying and dark money campaigns to block the drug pricing reforms, patients know the provisions will allow for the innovation we need at prices we can afford, increase access to drugs, continue funding for COVID-19 vaccine development, and save lives. Americans are depending on Congress to fulfill its promise and pass comprehensive drug pricing reforms now,” says David Mitchell, a patient with incurable blood cancer whose drugs carry a list price of more than $900,000 per year and founder of Patients For Affordable Drugs Now.

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? Big Pharma’s Lie: Patients only care about lowering out-of-pocket costs. We don’t need comprehensive reforms. 

✅ The Truth: The Truth: We can’t lower out-of-pocket costs without lowering drug prices or we will just wind up paying higher premiums and taxes. We need comprehensive reform.

Summary:

Big Pharma has attempted to create a false dichotomy by claiming patients only want their out-of-pocket costs to go down. That’s simply impossible. In order to lower out-of-pocket costs for patients, we must lower underlying prices, or we will simply pay more in premiums and higher taxes because insurers and federal health plans will make up the difference through cost shifting. Capping out-of-pocket costs without lowering drug prices simply shifts costs – it doesn’t lower them. The Alzheimer’s drug Aduhelm is a prominent example of this process: After the manufacturer, Biogen, priced the drug at $56,000 per year, the Centers for Medicare and Medicaid Services announced that Medicare Part B premiums would increase by nearly 15 percent the following year — one of the largest increases ever — to accommodate the astronomical cost. Passing the comprehensive drug pricing reforms that include Medicare negotiation will address the headwater of the issue — high list prices — and lead to lower prices and out-of-pocket costs for patients.

Taxpayer Perspective:

High drug prices are a major challenge for small business owners and leaders. In a recent statement, Rhett Buttle, senior advisor for Small Business for America’s Future, explains: “We also need to help small businesses with unreasonable expenses that cut into their bottom line and hinder their growth. … Small business owners identify the cost of healthcare and prescription drug prices as their top concern and strongly support solutions like allowing Medicare to negotiate the price of prescription drugs.”

Nevada teacher and type 1 diabetes patient Jamie Tadrzynski writes in the Las Vegas Sun, “Any proposal that caps the cost of one or more drugs will not fundamentally address the root of the problem, which is rising prices. The government can take action to help seniors and others afford their medicine, but without negotiations that actually stop the drug corporations from charging whatever they want and raising prices at will, cost containment can only have limited impact for a limited number of patients while burdens continue to rise for taxpayers, businesses, and those paying premiums.”

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? Big Pharma’s Lie: Drug companies saved us with their COVID-19 vaccines. Cracking down on their prices now could hinder future vaccine and drug development. 

✅ The Truth: Taxpayers saved ourselves. The reforms will ensure this can continue.

Summary:

Taxpayer funding was the engine behind the COVID-19 vaccines, and the package of drug pricing reforms passed by the House will allow the United States to continue leading in drug development while allowing patients to access the medications and vaccines we need at prices we can afford. Taxpayers paved the way for the successful COVID-19 vaccines by investing billions of dollars in research prior to the pandemic and assuming the financial risk after the pandemic began by funding clinical trials, boosting manufacturing capacity, and making advance purchase agreements. Research into the mRNA technology behind the vaccines began decades ago in federally funded labs, and analysts estimate that the U.S. government spent between $18 billion and $23 billion on developing and manufacturing COVID-19 vaccine candidates after the virus emerged. Moderna even admitted that its vaccine was 100 percent funded using federal dollars — in fact, NIH scientists have filed applications for several patents related to the vaccine. 

While drug companies like Pfizer and Moderna try to scare patients by threatening the future of vaccines under the drug pricing reforms, theirexecutives have reaped enormous profits on the COVID-19 vaccines. Pfizer is expected to shatter records with $32 billion in sales this year while Moderna projects $19 billion in sales this year. As COVID-19 is expected to be endemic, Moderna CEO Stéphane Bancel says the company is preparing to raise prices. To ensure Americans are protected from price gouging on life-saving vaccines, we must pass reforms to limit price hikes to the rate of inflation.

Patient Perspective:

In this New York Times op-ed on the role taxpayers played in developing the COVID-19 vaccines, P4AD founder David Mitchell writes, “Americans should stop buying the pharmaceutical industry’s argument that innovation and new drug development will dry up if the government uses its purchasing power and bargains to get a better deal. The United States spends more per capita than any other wealthy nation for prescription drugs — often the same drugs available for far less overseas. … This year, we can achieve reforms that both advance innovation and ensure Americans can afford the medicines — and vaccines — we need.”

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? Big Pharma’s Lie: Drug pricing reforms will make it harder for patients to get their medications. 

✅ The Truth: The biggest barrier to patient access right now is the high prices of drugs. The reforms will increase patient access by lowering prices.

Summary:

The biggest barrier to patient access is high prices – far too many patients across the country struggle to afford their medications. A 2021 survey found that nearly 40 percent of patients did not take their drugs as prescribed due to high costs, and 20 percent of patients took on debt to pay for their medications. It’s estimated that more than 5 million Medicare beneficiaries had trouble affording their medications in 2019, with rates highest among Black and Latino seniors. If current trends continue, 1.1 million beneficiaries could die this decade because they can’t afford the drugs they need. Lower drug prices from Medicare negotiation and limits on price increases would improve medication adherence and people’s health, according to the Congressional Budget Office. 

The reforms being considered by the Senate would address the high prices driving patients to go without their needed medications and preserve long-standing government policies on drug coverage that protect access. Medicare will continue to be required to cover all drugs in six protected classes and at least two medications in each class of drugs. Medicaid must still cover every drug offered by a manufacturer in the United States if the manufacturer agrees to give Medicaid a best price guarantee. Additionally, even with lower prices, drug companies will continue to file for drug approval first in the United States, given that we are by far the largest market in the world with the highest prices in the world.

Patient Perspective:

Katherine Pepper, a Washington patient who lives with an autoimmune disease, takes Humira, a medication that has a monthly price of $6,409. Katherine writes, “As a senior living on a fixed income, I’ve had to choose between filling my Humira prescription or buying groceries. That’s a decision no one should have to make.” 

Therese Humphrey Ball, an Indiana patient living with multiple sclerosis, shares about a time when she couldn’t access her medication at all because of its price. “In 2017, I was forced to go off of Copaxone entirely because I simply could not pay its $6,000 monthly cost,” she writes. “Without the medication I needed, I began having difficulty with my cognitive function. I work really hard to keep my life in order and my memory intact even with MS, so this was devastating. I lost something that is so valuable to me.” 

Vanessa Ladson, a Delaware patient living with lupus and fibromyalgia, writes, “I am on a fixed income, and I have to scrimp and save just to be able to eat. I can’t afford all of my prescriptions, including the blood thinner Eliquis, which is priced at $500 per month. Instead, I take a cheaper drug that gives me a higher risk of bleeding.”

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BIG PHARMA DEBUNK DAY ONE: INNOVATION 

? Big Pharma’s Lie: Drug pricing reforms will stifle innovation. 

✅ The Truth: We can maintain the innovation we need at prices we can afford.

Summary:

The comprehensive drug pricing reforms before the Senate will bring an end to the pharmaceutical industry’s unilateral power to set and raise prices at will, while maintaining the valuable drug innovation we need. As Big Pharma’s profits have continued to soar, the industry is falsely claiming that these reforms would grind research and development of new drugs to a halt. In reality, the legislative package passed by the House of Representatives would only decrease the number of new drugs over the next 30 years by 10 out of 1,300 expected new drugs – that’s less than 1 percent. Further, only 10 to 15 percent of new drugs are truly innovative in the first place. Any biopharmaceutical industry revenue lost from the proposed drug price reforms would only be a drop in the bucket for an industry with profits that are almost three times the average of the S&P 500. 

The truth is, the drug pricing package continues to incentivize the industry to find new, innovative drugs in the same way we do now by allowing drug companies to set launch prices and giving new drugs nine to 13 years before becoming eligible for Medicare negotiation. The provisions protect special incentives to develop rare disease treatments and continue to reward pharmaceutical innovation.

Patient Perspective: 

Don Kreis’ daughter, Rose, lives with a type of cystic fibrosis for which the current breakthrough medications don’t work. Rose is still waiting for her miracle drug, but Don fears when it comes to market, Big Pharma will price it out of reach. “When a new drug comes to market, will she be able to even consider taking it? No one cares more about innovation than us — but these drugs are worthless if Rose can’t afford them,” he writes. 

Kris Garcia, who lives with four bleeding disorders, asthma, and several allergies, explained in a recent op-ed in The Colorado Sun that, “We do not have to choose between innovation and lower drug prices. We can and will have both once the Senate passes these reforms through reconciliation.” Each vial of his medication, Humate-P, is priced at $10,000, and for each infusion, he needs four vials. “For me, these reforms would help bring predictability and consistency to my drug prices.”

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Drug pricing was trending in 2021. Here’s a look back at patient advocacy wins and progress toward victories in the year to come.

Welcome to the Year in Review.

1. One-On-Ones With The White House

• As the Biden administration worked with lawmakers to craft the reconciliation package, patients across the country brought their stories to the highest office in the land. They offered the president their support as he pushes to deliver on his commitment to lower drug prices. Patient advocates Gail deVore, Iesha Meza, and Sa’Ra Skipper, who all live with type 1 diabetes, met with President Biden at the White House to share their experiences with high insulin prices and discuss the urgent need to include drug pricing reforms in the legislation. Iesha also introduced the president ahead of his December remarks on how the Build Back Better Act will lower drug prices, and Gail followed up with Vice President Harris to talk about getting the bill across the finish line.

2. Fighting Pharma’s Falsehoods

• The pharmaceutical industry and its front groups worked overtime in 2021 to spread misleading claims that drug pricing reforms will hurt patients, but the facts aren’t on their side. In response, P4AD released an innovation report and a video debunking pharma’s falsehoods that reforms would hinder innovation and explaining how we can have the innovation we need at prices we can afford. To refute unsubstantiated claims that drug price reforms will lead to reduced access to prescription drugs, P4ADNow launched a video and David Mitchell penned an op-ed emphasizing how lower drug prices will increase patient access to medications they need. Price hike reports show that pharma raises prices at will, resulting in outrageous costs for patients, enormous profits for drug companies, and huge paydays for their executives. To highlight Big Pharma’s web of influence, P4AD released a report detailing how the financial and organizational relationships between drug companies and major patient groups constrain these groups from advocating for meaningful legislation to lower drug prices. Over and over again, independent fact checkers rated pharma and its allies’ claims as false. The truth is that patients need Medicare negotiation now for real relief from high prices, and we must not fall for pharma’s fear-mongering. 

3. Congressional Priority: Drug Pricing

• This year, Congress is closer than it has been in nearly two decades to addressing high drug prices. Lawmakers wrapped up an investigation into pharmaceutical pricing practices and the House passed the Build Back Better Act including a hardfought compromise on drug pricing reforms. Patients shared their stories at all of the congressional hearings held on drug pricing and utilized an advocacy hub launched by P4ADNow to voice how they have been harmed by high prescription drug prices. P4AD founder David Mitchell spoke at hearings and press conferences about the urgent need for reforms. P4ADNow and influential organizations representing seniors, union workers, and patients ran ad campaigns urging Congress to seize the opportunity to help Americans by lowering drug prices. These groups, along with frontline Democrats, also sent letters to congressional leadership and penned op-eds pushing Congress and the White House to include drug pricing reform in the reconciliation package.  

4. Patients Fired Up

• In addition to sharing their stories with the White House and Congress, patients advocated for drug pricing reforms by writing to national and local publications, appearing in ad campaigns urging members of Congress to support Medicare negotiation, signing letters to Capitol Hill, and speaking to news media. Patients in Colorado, Maine, Massachusetts, Minnesota, New Jersey, New Mexico, and Oregon also delivered testimony and wrote op-eds in support of state legislation, including bills that would ban pay-for-delay deals and create prescription drug affordability boards. We are so thankful to all the patients who have dedicated their time to fighting for legislative reforms. The national conversation on drug pricing would not exist without your voices.

5. Thank You, Taxpayers

• In the second year of the pandemic, drug companies pointed to the development of the COVID-19 vaccines as a reason why prices must be kept high — failing to tell the full story involving billions of dollars in government investment in vaccine research and development. P4AD’s David Mitchell penned a New York Times op-ed, Wall Street Journal letter, and blog post that lays out how the government and taxpayers underwrote the risk while drug companies now stand to shatter sales records and collect billions of dollars from the vaccines. “To all those drug corporations and executives making billions from those of us paying the bills,” Mitchell writes, “You’re welcome.”

WASHINGTON, D.C. — Big Pharma is at it again. On Wednesday, the drug lobby will roll out its objections to the proposed HHS Part B Demonstration. During a media briefing at its Washington headquarters, PhRMA is sure to pull out all the tired scare tactics: “socialized medicine,” ‘‘reducing access,” “interference in the doctor/patient relationship,” “rationing,” and other well-worn claims from its playbook.

Here are three questions for PhRMA and a fact check ahead of the media briefing:

3 Questions for PhRMA

1. Since the only way patients would receive worse care is if drug companies withhold drugs from Medicare, are PhRMA member companies willing to withhold drugs while being paid 126 percent more than other countries?
    
2. What are two proposals PhRMA supports to lower the list price of drugs? Not PBM reform or Medicare policy changes. How is PhRMA willing to lower drug prices, since drug companies collect 66 percent of Part D drug spending and an even higher share of Part B spending?
    
3. If high prices are necessary for quality care, how does PhRMA account for thesuperior outcomes and life expectancy in international countries despite lower prices for prescription drugs?

FACT CHECK: PhRMA’s False Claims About the Medicare Part B

MYTH #1: The Part B demonstration will restrict access to lifesaving drugs.
FACTS:

• Americans ration drugs today based on price.
  • NPR: “Insulin’s high cost leads to lethal rationing.”
  • Vox: “It means that our system, even if we don’t like to admit it, has to pick and choose who gets access to lifesaving drugs.”
• There is no evidence the Part B demonstration would harm patient access to drugs unless drug corporations choose to withhold drugs from patients. 
  • HHS: The proposal is to “lower drug prices—without any restrictions on patient access.”
• All protected classes of drugs in Medicare will be maintained.
  • HHS: “We propose no changes to the Medicare benefit, just more discounts from drug companies.”
  • Bloomberg: “The aim is to drive down the cost of those medications by 30 percent.”

MYTH #2: The Part B demonstration will establish drug prices that are impossibly low — damaging drug companies and hurting our health system.
FACTS:

• Americans would still pay Pharma more for drugs than other developed countries.
  • The New York Times: “A government study that said Medicare was paying 80 percent more than other advanced industrial countries for some of the most costly physician-administered medicines.”
  • Secretary Azar: “Over the next five years under this model, we will go from paying 180 percent of what other countries pay for these drugs to 126 percent of what they pay.”
• Lowering prices in Part B will have little to no impact on innovation.
  • National Academy of Sciences: “NIH funding contributed to published research associated with every one of the 210 new drugs approved by the Food and Drug Administration from 2010–2016. “
  • HHS: “The possible savings American patients would receive over five years represents less than 1 percent of pharmaceutical R&D spending during that time; and the pharmaceutical industry has offered no evidence of that amount having a meaningful impact on innovation.”
• Drug companies can easily make that up by reducing advertising and marketing spending.
  • Washington Post: “Nine out of 10 big pharmaceutical companies spend more on marketing than on research.”
  • JAMA: “From 1997 through 2016…DTC prescription drug advertising increased from $1.3 billion to $6 billion with a shift toward advertising high-cost biologics and cancer immunotherapies.”

MYTH #3: The demonstration will result in worse care for patients. The government should not replace a market-based system with government price setting.
FACTS: 

• The 16 countries used for reference by and large have better health outcomes and longer life expectancy than the U.S., while spending about half as muchper capita for health expenditures. 
  • Kaiser Family Foundation and Peterson Center on Healthcare: Of the 16 other developed economies in the IPI, Americans have worse health outcomes than: Austria, France, Germany, Japan, Sweden, and the United Kingdom.
  • Central Intelligence Agency: Of the 16 other developed economies in the IPI, Americans have shorter life expectancies than 13 of them: Austria, Belgium, Canada, Finland, France, Germany, Greece, Ireland, Italy, Japan, Spain, Sweden, and the United Kingdom.
  • World Bank: Of the 16 other developed economies in the IPI, Americans spend more on health care as a percentage of GDP than all of them: Austria, Belgium, Canada, Czech Republic, Finland, France, Germany, Greece, Ireland, Italy, Japan, Portugal, Slovakia, Spain, Sweden, and the United Kingdom.
• The current system is broken.
  • CNN: “Americans pay anywhere from two to six times more than the rest of the world for brand name prescription drugs.”
  • Wall Street Journal: “Compared with the U.S., drug prices are far lower in many overseas countries…Critics have long held that the [U.S.] percentage-based ‘add-on’ fee create incentives for doctors to use higher-priced drugs.”
• The Part B demonstration does nothing to slow the FDA approval process.
  Multinational drug corporations will still want early access to the higher prices in the U.S. 

MYTH #4: Americans do not support the Part B proposed changes. 
FACTS: 

• According to a GOP pollster, Americans overwhelmingly support the International Pricing Index to lower drug prices.
  • Voters support the HHS proposal to lower drug prices by a 71-point margin (80 percent support vs. 9 percent oppose).
  • Majorities from both parties agree that Democrats and Republicans in Congress should support the proposal.
  • Notably, 8 in 10 voters believe the proposal will result in better care or have no impact on the care they receive.

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WASHINGTON, D.C. — Big Pharma is opening its wallet and pulling out the same old scare tactics to block a proposal that would lower drug prices in Medicare Part B. Under a draft proposal from the Department of Health and Human Services, Medicare would pay only 26 percent more than other wealthy countries for drugs administered by physicians or in hospital settings instead of the 80 percent more it pays today. But before public comments have been filed, special interest groups and drug company lobbyists are mounting an effort to kill the proposed reforms. A Big Pharma front group is bankrolling a $1 million ad campaign to falsely smear proposed Part B changes. The claims in the ads are lies — pure and simple. Patients For Affordable Drugs NOW will be sending letters to radio stations requesting that they cease airing these misleading ads immediately.

BIG PHARMA SPENDING TO KILL A MEDICARE PART B CHANGE

Radio ads: A Pharma-funded front group secretly bought $998,884 in radio ads across the country. The ads encourage residents to call Senators and tell them to oppose the Part B proposal. See a list of the ad rates and stations running the spot here and here, and listen to the ad here.

Digital Ads: The drug industry’s lobbying arm, PhRMA, is blanketing Washington health publications in an attempt to mislead policymakers and the public. Click here to view the PhRMA-sponsored ads.

New Web Pages: PhRMA’s misleading campaign includes a raft of blogs packed with inaccurate information that suggests patient care would be under threat if drug prices are lowered in the Medicare program.

AstroTurf Tactics: A coalition of hundreds of so-called patient advocacy groups entangled with Big Pharma interests sent a misleading letter to Congressional leadership. Read the letter here. 

MYTH vs FACT 

Blog posts and advertisements by Big Pharma contain a multitude of falsehoods, misleading statements, and outright lies. Here are a few:

Big Pharma Myth: Changes to Medicare Part B “threaten patient access to treatment options and care.”
Fact: As an organization that represents patients who are kept alive by Part B drugs, we are outraged that Big Pharma claims the proposal would hinder patient access. Under this proposal, Medicare would pay only 26 percent more than other wealthy countries, down from the current average of 80 percent more. This move would increase access to lifesaving drugs by bringing U.S. prices more in line with other wealthy nations. There is no evidence this proposed Part B demonstration would impact patient access to drugs unless drug corporations withhold drugs from patients.

Big Pharma Myth: The system works fine just the way it is and the government should not “replace a market-based system with government price setting.”
Fact: The system is broken. Doctors who administer Medicare Part B drugs are incentivized to choose higher-priced medications because they benefit from the reimbursement structure in the Medicare program. Patients are forgoing medication because they cannot afford the drugs. Medicare already sets the prices for these drugs –– it is the average sales price plus 6 percent, which is 80 percent higher than what people pay in other wealthy nations.

Big Pharma Myth: The Part B demonstration will “weaken incentives for the development of new treatments for serious, life-threatening diseases.”
Fact: Nine out of 10 big pharmaceutical companies spend more on advertising and marketing than on research. Taxpayers foot the bill for basic science that leads to new drugs through the $37 billion spent by the National Institutes of Health. According to HHS, the proposed Medicare changes could reduce drug company R&D spending by less than one percent. We can have both innovation and lower prescription drug prices.

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