The chief executives of three main pharmaceutical firms defended the costs of their medication in entrance of the Senate well being committee on Thursday, drawing them additional right into a confrontation with lawmakers and the Biden administration over the price of among the most generally used prescription drugs.
Lawmakers, together with Senator Bernie Sanders of Vermont, the panel’s chairman, famous that the businesses charged extra in america than in different rich international locations, accusing them of profiting on the expense of American sufferers. The pharmaceutical executives — from Johnson & Johnson, Merck and Bristol Myers Squibb — conceded that sufferers in america paid an excessive amount of however mentioned that new drugs arrived there quicker than anyplace else on the planet.
Mr. Sanders, an impartial who has made reining in drug costs a signature trigger of his late-career years in Congress, acknowledged that the businesses had produced lifesaving medication. However he singled out a number of broadly used drugs, together with Bristol Myers Squibb’s blood thinner Eliquis, which he famous may very well be bought for a lot much less in Canada than in america.
“These medication imply nothing to anyone who can’t afford it,” Mr. Sanders mentioned, including that “thousands and thousands and thousands and thousands of our folks can’t afford the outrageously excessive price of prescribed drugs on this nation.”
The three executives who testified — Joaquin Duato of Johnson & Johnson, Robert M. Davis of Merck and Christopher Boerner of Bristol Myers Squibb — acknowledged that drug costs had been usually greater in america than in different rich international locations.
However they mentioned decrease costs in Europe and Canada, the place governments are extra centered on constraining prices, got here with essential downsides, like lengthy waits for brand new medication and restricted insurance coverage protection.
“The USA has constructed a well being care system that prioritizes affected person and doctor selection in addition to the broad and fast availability of cutting-edge medicines,” Mr. Boerner mentioned.
At one level, Mr. Sanders, who accused the businesses of utilizing their drug income to counterpoint executives and shareholders whilst sufferers struggled to pay for drugs, tried to solicit a promise from Mr. Boerner that the corporate would decrease the U.S. sticker worth of Eliquis to that in Canada. Mr. Boerner declined, citing the variations in Canada’s well being system.
The listening to happened as a brand new federal program authorizing Medicare to barter the costs of some expensive drugs is getting underway. Federal well being officers final week made their preliminary provides to the makers of the primary 10 medication chosen for negotiations, a listing that features Eliquis and 4 different medication offered by the businesses whose executives testified on Thursday. Drugmakers, together with all three firms represented on the listening to, have filed a flurry of lawsuits arguing that the negotiation program is unconstitutional.
Because the pharmaceutical executives sat earlier than them, lawmakers described anguished selections that sufferers with excessive drug prices had confronted. Mr. Sanders talked about a lady in Nebraska who he mentioned had died of most cancers after she arrange a GoFundMe marketing campaign to pay for Keytruda, a blockbuster most cancers drug from Merck.
Senator Christopher S. Murphy, Democrat of Connecticut, mentioned that one in every of his constituents on Eliquis had to decide on between the price of the medication, meals and hire.
Republicans on the committee pointed to what they mentioned had been the rightful market incentives that the businesses used to cost their medication.
“In capitalism, in case you’re working an enterprise the place you might have a fiduciary duty to your homeowners, you attempt to get as excessive a worth as you possibly can,” mentioned Senator Mitt Romney, Republican of Utah. He added: “You assume Chevrolet sits again and says, ‘Gosh, how can we get the worth of this Chevrolet down?’ No, it’s like, ‘How excessive a worth can I get and maximize the revenue for my shareholder?’”
The listening to got here after a standoff between Mr. Sanders and two of the pharmaceutical executives, Mr. Duato of Johnson & Johnson and Mr. Davis of Merck, who agreed to testify solely after being threatened with subpoenas. The 2 firms prompt final month that Mr. Sanders was looking for to retaliate for his or her lawsuits difficult the Medicare worth negotiation program.
Senator Invoice Cassidy of Louisiana, the highest Republican on the committee, mentioned the panel’s technique had been to “threaten a subpoena when C.E.O.s are suspicious that they received’t get a good shake, maintain the listening to, get sound bites, then choose one other set of C.E.O.s for a present trial.”
“However we don’t cross significant laws,” he mentioned.
Costs for brand-name medication in america in 2022 had been on common at the least 3 times as excessive as these in 33 different rich international locations, a current report funded by the Division of Well being and Human Providers discovered, even when taking into consideration reductions that cut back how a lot American well being plans and employers pay.
Evaluating drug costs in america with these in different international locations will be difficult as a result of the well being care techniques are so totally different. Whereas European international locations depend on a centralized negotiator, the U.S. system is fragmented, with tens of hundreds of well being plans and employers counting on intermediaries to deal with their negotiations.
Whereas many prescribed drugs will be purchased for a lot much less at European pharmacies, insurance coverage protection is usually broader in america, that means that American sufferers generally face decrease out-of-pocket prices than Europeans for a similar drugs.
On the listening to, the drug firm executives blamed middlemen referred to as pharmacy profit managers for saddling sufferers with excessive out-of-pocket prices. These companies procure reductions from producers that cut back the invoice for American well being plans and employers however not for sufferers. Profit managers earn more money when the sticker worth of a drug is greater, however sufferers usually need to pay extra. Lawmakers have proposed making modest adjustments to the practices of profit managers.
