Don't Slow Research on Promising Drugs
Last month, the House Energy and Commerce Committee considered 16 individual elements of President Joe Biden’s $3.5 trillion Build Back Better agenda. I supported 15 and opposed one: a proposed drug pricing reform plan known as H.R.3, which the Congressional Budget Office and other analysts believe will stifle investment in medical research and reduce drug discovery. Instead, I offered an alternative that would lower prescription drug costs for seniors and other consumers without hindering the development of new cures.
H.R. 3 passed the House twice before, and both times died in the Senate. Thus, it has not lowered the price of one single prescription drug. Enough senators have signaled that it was destined for failure again this time, and I was not willing to watch history repeat itself. Millions of Americans are struggling to pay for their medicines at the pharmacy counter, and we need a plan to succeed.
My alternative can gain the support needed to become law. The Reduced Costs and Continued Cures Act provides greater support than H.R. 3 for those who need it most. It would — for the first time — cap out-of-pocket drug expenses for lower-income seniors at $1,200 per year. No senior would pay more than $3,100 annually. Our bill caps insulin expenses at $50 per month for Medicare beneficiaries. It pays for these benefits by imposing a cap on the price increases drug companies can impose to the rate of inflation and clawing back excess profits from drug companies going back five years.
Like H.R. 3, our plan empowers Medicare to negotiate drug prices. The major difference is that ours excludes newer drugs for a period of time so as not to discourage investment in future drug discovery. It closes patent loopholes abused by drug manufacturers to delay access to less expensive generics. It also places fair checks on insurers, manufacturers and drug companies by establishing strict rules to increase transparency in pricing. These provisions benefit all patients, not just seniors.
Drug development is a partnership of the public and private sectors. Taxpayers invest about $40 billion in the National Institutes of Health each year to do basic research, but we rely on the private sector to then use that research to invent medicines, conduct clinical trials and take them to market. It’s expensive — each drug costs about $1 billion to bring to market. And it’s risky — 95 percent of drug ideas don’t make it. In 2018, the private sector invested $102 billion in drug development, at no risk to taxpayers, dwarfing public sector investment.
I can’t support H.R. 3 because it puts our medical innovation ecosystem at risk. It allows the government to set a drug’s price, then charge a 95 percent excise tax against companies that refuse to accept that price. This would destroy the incentive for investment into drug development because if investors know they can’t earn a return at the back end, they won’t invest up front. And H.R.3 would set drug prices based on what’s paid in other countries that keep drug costs down, in part, by rationing who gets access to them based on quality-of-life measures. That’s why the National Council on Disabilities does not support the price-setting mechanism in H.R.3 — it’s inherently discriminatory against the disabled, the ill and the elderly.
The investors who put up the money for drug development have explained how H.R. 3 would dry up investment and cost jobs. This would be devastating for San Diego, the third-largest biotechnology cluster in America, where 68,000 people are employed in nearly 1,000 companies in the life sciences, mostly doing research.
The independent, nonpartisan Congressional Budget Office has projected we will lose cures over time if we enact H.R. 3; independent analysts have suggested the number of cures lost would be far greater than the CBO predicts. Those cures could be for a rare disease that affects only a few, or for something widespread like Alzheimer’s. Who thinks we should take that risk?
That is why over 50 rare disease patient advocacy groups fighting for cures for cancer, amyotrophic lateral sclerosis or ALS, multiple sclerosis, lupus and other autoimmune diseases have publicly expressed concerns with H.R. 3. They worry the cures we could lose might be the ones that save the lives of the sick people they fight for.
Our bill would pay for itself and, we estimate, generate another $200 billion to help bolster Medicare. “Visit my website here to review my full proposal.” I hope my proposal will become the foundation for achievable legislation. We all agree we must lower prescription drug costs. I’m committed to doing the hard work to get it done.