Senators push for drug execs to testify

U.S. lawmakers holding hearings about drug prices threatened Tuesday to force pharmaceutical executives to testify after they wouldn't do it voluntarily.

Sen. Charles Grassley, R-Iowa, said he asked drug executives to testify at a series of hearings but that most had said no.

"The companies that declined said they would be very happy to have discussions in private but not in public," Grassley said at a hearing of the Senate Finance Committee. "That is not what I mean when I talk about transparency."

He didn't name the companies.

Sen. Ron Wyden of Oregon, the ranking Democrat on the committee, noted that even tobacco executives were willing to go before Congress.

"The drugmakers are going to have to show up as well," he said.

The hearing was one of several on health care that were happening on Capitol Hill on Tuesday. It opened with testimony from Kathy Sego, from Madison, Ind., whose college-age son has Type 1 diabetes and relies on insulin.

He began secretly rationing the drug at college when he found out it cost $487 per vial, Sego said, endangering his health.

The costs have put a strain on her family.

"Our electricity was turned off because I needed to purchase the medicine to keep my son alive," she said. "Almost every dollar I make goes toward health care expenses."

Wyden singled out Humalog, an insulin made by Eli Lilly & Co., as a drug with unwarranted price increases, from $21 per vial in 1996 to $275 today.

"The companies have unchecked power to set prices on their own, and often it's to meet Wall Street's expectations rather than to meet demand in the market," he said.

Lilly didn't immediately respond to a request for comment.

Wyden said the committee would compel drug company executives to testify if they wouldn't do it voluntarily.

Across Capitol Hill, the House Oversight Committee held its own hearings. Chairman Elijah Cummings, D-Md., has already announced a sweeping investigation of drug industry pricing practices, sending detailed information requests to 12 major manufacturers.

Although Democrats want Medicare to directly negotiate prices and Republicans prefer free-market approaches, they seem united in their disdain for the industry's pricing. At the White House, President Donald Trump, who once accused drugmakers of "getting away with murder," has backed multiple regulatory actions that include approving more generic drugs and an experiment to use lower international prices to save money for Medicare.

It all adds up to a politically perilous time for a powerful industry used to setting its own terms. However, it's still unclear whether lawmakers in the end will be able to agree on a plan of action.

The Pharmaceutical Research and Manufacturers of America points to research suggesting that price spikes of a few years ago have eased. Government price regulation will stifle innovation and deprive patients of timely access to innovative medications, the industry warns.

Insulin to treat diabetes is a particularly sensitive issue, since patients depend on the drug to try to maintain normal blood sugar and forestall complications of the disease, from heart problems to blindness and amputations. As yet there's no effective generic competition to brand insulin that costs hundreds of dollars a month.

A handful of companies dominate the insulin market, including Novo Nordisk, Sanofi and Eli Lilly, which formerly employed U.S. Health Secretary Alex Azar as a high-ranking executive.

The American Medical Association has called on the government to investigate rising prices for insulin, which saw a nearly 200 percent increase from 2002-13, according to the physician group.

At the House hearing, Antroinette Worsham of Ohio told lawmakers of losing a daughter who was in her early 20s and had been rationing insulin because she couldn't afford the cost. A surviving daughter also has diabetes. "I fear the same thing will happen," Worsham said.

Sanofi said in a statement that it understands that some patients are angry because they have not benefited from discounts negotiated with insurers and pharmacy benefit managers. Sanofi said it is cooperating with lawmakers.

Grassley is an old adversary of the drug industry, having previously battled the companies over safety problems and pricing for government programs like Medicaid. Together with Wyden, he also investigated the pricing of Sovaldi, a costly breakthrough medication for hepatitis C.

Grassley has returned to the chairmanship of the finance panel after leading the Senate Judiciary Committee. Finance has jurisdiction over the government's major health care programs.

Grassley issued a call for greater public accounting of how pharmaceutical companies set their prices, and he endorsed the Trump administration's move to require drugmakers to disclose prices in advertising. Cummings is pushing a package of bills that would empower Medicare to directly negotiate prices, open up generic competition to drugs deemed "excessively priced," and allow consumers to import lower-cost medications from Canada.

"There is a strong bipartisan consensus that we must do something to rein in out-of-control price increases," said Cummings.

Consumer concerns are focused on brand-name drugs, particularly new medications that promise breakthrough results. Generics account for nearly 90 percent of prescriptions filled, but brand-name drugs account for more than 70 percent of the spending.

Information for this article was contributed by John Tozzi of Bloomberg News and by Ricardo Alonso-Zaldivar of The Associated Press.

Business on 01/30/2019

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