Full Measure After Hours: Big Pharma's Battle Against Drug Price Controls

Episode: After Hours: How much did Big Pharma spend to try to stop new drug price control initiatives?
Release Date: January 23, 2025
Host: Sharyl Attkisson

Introduction

In this episode of Full Measure After Hours, host Sharyl Attkisson delves into the tumultuous battle between the pharmaceutical industry and recent legislative efforts aimed at controlling drug prices. Specifically, the discussion centers on the Inflation Reduction Act (IRA) passed in 2022, which marked a significant shift in how drug prices are negotiated in the United States. Attkisson explores the extent of Big Pharma's lobbying expenditures to thwart these initiatives and examines the implications for American consumers and the healthcare system.

Overview of the Inflation Reduction Act

The Inflation Reduction Act represents a pivotal moment in U.S. healthcare policy, introducing mechanisms for the federal government to negotiate drug prices directly for Medicare. This initiative aims to curb the soaring costs of prescription medications, which have long burdened both taxpayers and patients.

Cheryl Attkisson opens the discussion by highlighting the importance of the IRA:

"The Inflation Reduction act does allow a series of older pharmaceuticals to be negotiated by CMS within the Health and Human Services Division of the government." [03:09]

Lisa Gilbert from Public Citizen underscores the significance of this legislative change, noting it as a "huge victory for people who have wanted fair prices for so long." [02:39]

Big Pharma's Lobbying Efforts

Public Citizen conducted an in-depth analysis of Big Pharma's response to the IRA, revealing substantial financial efforts to influence political outcomes. The focus was on three major pharmaceutical companies: Bristol Myers Squibb, Johnson & Johnson, and Merck.

Lisa Gilbert explains the scope of their investigation:

"We were looking in advance of an important hearing that Bernie Sanders held in the help committee... checking in on their lobbying and who they've been hiring, how many people they've been hiring to try to make that influence happen." [01:14]

The report highlighted that these companies collectively spent approximately $43 million between July 2022 and July 2023 lobbying against the IRA's price negotiation provisions. This financial assault included not only direct lobbying but also legal challenges aimed at undermining the legislation.

Gilbert emphasizes the unprecedented nature of the IRA's provisions:

"This is one of the few times that pharma was defeated." [02:39]

Impact on Drug Prices

The IRA mandates that starting in 2026, Medicare will negotiate prices for ten specific drugs, projected to affect millions of Americans who rely on these medications. This initiative is expected to significantly reduce costs for both the government and taxpayers.

Cheryl Attkisson provides concrete figures to illustrate the potential savings:

"A one year supply of each costs between $6,500 and $7,100. Who can afford that?" [09:09]

Gilbert elaborates on the beneficiaries:

"These 10 drugs, you know, are things that impact millions of Americans... we should feel an immediate impact and not just those on Medicare, but also so the price will drop across the board." [04:18]

Public Citizen's Role

Public Citizen has been a steadfast advocate for drug price negotiations, lobbying tirelessly to ensure that the IRA's provisions are implemented effectively. Their efforts were instrumental in countering the formidable financial influence exerted by Big Pharma.

Gilbert highlights Public Citizen's strategic involvement:

"It's a long term push on our side to try to have negotiation of drug prices... this victory in the Inflation Reduction act is huge because we were up against, as always, the pharmaceutical companies." [03:58]

Specific Case Studies: Xarelto and Eliquis

Two of the costliest drugs targeted by the IRA's negotiation provisions are Xarelto and Eliquis, both used to prevent and treat blood clots. These medications alone accounted for $6 billion and $16.4 billion in Medicare expenditures, respectively, in a single year.

Cheryl Attkisson underscores the financial burden:

"If not from that copay, the rest of it is picked up through the monthly premiums and the taxes that are charged so that these programs can stay afloat. So we're all paying these exorbitant costs for drugs." [09:32]

Challenges and Questions

Despite the breakthroughs achieved by the IRA, significant questions remain regarding the selection of drugs for negotiation and the broader scope of potential price controls. Public skepticism persists about why only ten drugs were chosen and why comprehensive negotiations across all medications have not been initiated.

Attkisson poses a critical inquiry:

"Why just 10 drugs? Why doesn't the government negotiate all the drugs that Medicare buys for patients?" [09:32]

Gilbert attributes the limited scope to relentless lobbying efforts:

"The types of goals they have don't align with what regular Americans want." [09:32]

Additionally, the episode touches upon the complexities of campaign finance and the opaque nature of political advertisements, which often obscure the true benefactors behind various advocacy campaigns.

Conclusions and Final Thoughts

The episode concludes by reinforcing the monumental impact of the Inflation Reduction Act on drug pricing and the ongoing struggle to ensure that pharmaceutical companies do not override public interest through excessive lobbying. Attkisson invites listeners to stay informed and engaged, emphasizing the collective responsibility to advocate for transparent and equitable healthcare policies.

Gilbert delivers a poignant closing statement:

"The lobbying... is enormous, egregious, and it is not working for you." [09:32]

Cheryl Attkisson wraps up with a call to action, encouraging listeners to follow the upcoming Sunday episode for deeper insights and to engage with Full Measure through various platforms.

Key Takeaways

• Inflation Reduction Act (IRA): Pioneers government negotiation of drug prices for Medicare, beginning with ten high-cost medications.

• Big Pharma's Response: Major pharmaceutical companies spent approximately $43 million lobbying to defeat the IRA's price control measures.

• Impact on Consumers: The IRA is projected to lower drug costs significantly for millions of Medicare beneficiaries starting in 2026, setting a precedent for wider price reductions.

• Public Citizen's Advocacy: Played a crucial role in pushing for the IRA's provisions, countering substantial pharmaceutical lobbying efforts.

• Ongoing Challenges: Questions remain about the limited scope of price negotiations and the pervasive influence of pharmaceutical lobbying on policymaking.

This comprehensive examination sheds light on the intricate dynamics between legislation, corporate lobbying, and consumer welfare, offering listeners a nuanced understanding of the ongoing battle to make healthcare more affordable in the United States.