For soaring drug costs and overdoses, officials offer blame and shame

drughearing-300x172As tens of thousands of Americans die from overdoses and many millions struggle with skyrocketing prescription medication costs, lawmakers and regulators in the nation’s capital plodded along with procedural steps they claimed would help attack what voters insist are some of their top public policy priorities.

On Capitol Hill, seven of Big Pharma’s top executives danced and dodged with members of a U.S. Senate Committee about who is to blame for the relentless rise and unaffordable cost of American drugs. Media reports of the Senate Finance hearing called it “political theater,” and it offered lawmakers a chance to vent at execs from AbbVie, AstraZeneca, Bristol-Myers Squibb, Johnson & Johnson, Merck, Pfizer, and Sanofi.

Sen. Ron Wyden, the senior Democrat on the committee from Oregon (shown above), blasted Big Pharma, telling the stone-faced corporate suits arrayed before him, “You’re willing to sit by and hose the American consumer while giving price breaks to consumers overseas,” the New York Times reported. He added that Big Pharma attempts to justify its prices, when so many patients cannot afford them, are “morally repugnant.” Sen. Bill Cassidy (R-La.) decried sky-high U.S. drug prices, especially compared with lower rates for patients elsewhere, saying, “It is almost as if the taxpayer has ‘stupid’ written on their face.”

Despite the furious exchanges, what are ordinary patients to make of this latest congressional salvo to blame and shame Big Pharma? The Kaiser Health News Service article summarized the corporate push back, thusly:

Almost in unison, the executives expressed support for eliminating rebates that flow to industry middlemen instead of patients; for increasing transparency about how they set prices; for shifting to a more value-based pricing system, in which outcomes are rewarded. Together they demurred when asked to commit to lowering list prices on drugs like insulin and the blockbuster rheumatoid arthritis drug Humira.

The session, though it demonstrated how difficult it may be for lawmakers to take concrete actions to reduce or roll back drug prices, may have provided bread crumbs for officials to follow to find paths to tougher negotiating with Big Pharma, notably over its efforts to block lower-cost generic drugs and its claims on links between medication prices and corporate spending on research and development.

And though the hearing focused in part on lower drug costs overseas and showed some legislative support for Trump Administration proposals to tie American prices to them, the federal Food and Drug Administration may have complicated the issue by blasting an existing, major foreign provider: CanaRx, which the New York Times noted, “sells many common prescription medicines at a lower cost to hundreds of public and private employer programs in the United States.”

FDA Commissioner Scott Gottlieb says the Canadian drug distributor sells unapproved and mislabeled medicines to unsuspecting Americans looking to save money on prescriptions, and warned it to stop, the newspaper reported. The company said it would cooperate with the FDA, but it denied there are safety issues with any medications it provides to American customers.

The FDA and opioids

The FDA itself was taking heat for proposing yet more criticized responses to the opioid crisis. These include its call for smaller dose packaging of the pills, new forms and labels describing their dosage, and fundamental research into the painkillers’ use and abuse, notably whether the powerful drugs lose their effectiveness quickly as patients build resistance to them.

The latest FDA opioid-battling measures were attacked by critics, who called on the agency to wield its extensive and existing powers and not to dither with more study about the damages of legal and illicit drugs that caused 70,000 overdoses in 2017 and have become a leading cause of death for Americans younger than 55. Andrew Kolodny, director of Physicians for Responsible Opioid Prescribing, said of the FDA calling for yet more opioid studies, “Here we go again. That’s exactly what the FDA said to us in 2013. . . . Five years later, we don’t have the studies and another FDA commissioner says, ‘We’re going to do the studies.’ ”

In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent medical care, especially as the costs of treatments and prescription medications skyrocket. This is truer, too, as the complexity and uncertainties abound about medical therapies and medications, especially the havoc that can be wreaked on patients by expensive and too often dangerous drugs like opioids.

Americans have learned a lot already about the causes of the opioid crisis and why prescription drug prices keep soaring (hint: because Big Pharma can pretty much do what it pleases). Voters made these and other health-related matters, especially health care costs and insurance coverage, priorities when they went to the polls for the midterms. They punished Republicans for bungling the issues, which haven’t budged from the front of Americans’ minds, polls show. The 2020 election campaign — sigh — has launched and it promises to be ferocious. We’ll need to see what the folks in the seats of power can show us they have accomplished on drug prices and abuses when they want our votes. It needs to be better and more than what we’re getting now.

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