Fixing rising pharmaceutical drug costs once and for all

Published in RI News Today on September 27, 2021

Just days ago, WBUR.org, Boston’s NPR News Station, featuring NPR News and Programs, aired a 45.37 minute program, “Steps to Fix America’s Broken Prescription Drug System,”  clearly illustrating the need to fix America’s ailing prescription drug program.  While Americans are traveling to Mexico in search of affordable prescription drugs, referred to as “Pharmaceutical Tourism,” the NPR program added a new twist. Now some state insurance companies are sending their beneficiaries to Mexico to purchase cheaper their pharmaceuticals manufactured in the United States at a lower price, on their tab.  

For instance, let’s take a look at Ann Lovell, of  Salt Lake City, Utah. The NPR Program, aired on Sept. 24, 2021, introduced us to the hearing-impaired former teacher who worked at an early-intervention program for deaf students that’s part of the Utah Schools for the Deaf and Blind, who traveled from Utah to Mexico five times to purchase Enbrel, to treat rheumatoid arthritis, with travel costs and a $500 cash incentive paid by her insurer, the Public Employees Health Program (PEHP). 

Lovell’s Utah physician writes her a prescription, and each tie she travels to Mexico she sees a physician at the Tijuana-based hospital as well.  She updates the physician on her medical condition, gets her prescription, and takes it to the pharmacist, who gives her the medication. 

NPR’s program noted that the Utah initiative was created under a 2018 state law, “Right to Buy,” by Republican Congressman Norm Thurston.  PEHP offers it only for people who use a drug on a list of about a dozen medications were the state can see significant savings.  Of the 150,000 state and local public employees covered by the insurer, fewer than 400 are eligible to participate.

Responding to a tweet promoting the offer, Levell quickly enrolled for as they say an offer she could not refuse.  She and a companion would travel on an all-expenses paid trip from Utah to Tijuana, Mexico to pick buy her pharmaceuticals at a steep discount paid for by the state of Utah’s public insurer to slash the high cost of prescription drugs. PEHP would only have to pay half of the cost of Embrel versus if Levell got it in the United States, saving tens of thousands of dollars. The annual U.S. list price for the drug, Enbrel, is over $62,000 per patient. 

It was one long, exhausting travel day.  At 5:00 a.m., Lovell and her friend flew from Salt Lake City to San Diego.  There, an escort picked them up and took them across the boarder to a Tijuana hospital, where she got a refill on her prescription.  After that, they were shuttled back to the airport and arrived back home by midnight. 

Lovell said she initially began paying $50 a month for her pharmaceutical, increasing to $450 in co-pays.  It would have increased up to $2,500 if she hadn’t started traveling to Mexico.  Without the program, she would not be able to afford the medicine she needed

With the COVID-19 pandemic closing the borders, PEHP’s “Pharmaceutical Tourism” initiative came to an end with the borders closing.   Lovell’s insurer came up with a new option of getting Enbrel at lower cost.  That’s when Lovell was told about the drug manufacturer’s coo-pay program where she would only have to pay five dollars a month.  

Calls for Medicare Negotiating the Cost of Pharmaceuticals 

Although traveling to Mexico or Canada to purchase more affordable pharmaceuticals is a temporary fix, the Washington, DC-based AARP calls for a permanent solution.  The national AARP advocacy group has launched a $4 million ad buy calling Medicare to step in to lowering the spiraling costs of pharmaceuticals.  

The Washington, DC-AARP noted that a recent AARP survey of voters found that 80% agreed or strongly agreed that drug prices could be lowered without harming innovation of new medicines. Strong majorities of voters, regardless of political affiliation, want Congress to act on the issue this year, with 70% saying it is very important. The survey also found that 87% of voters support allowing Medicare to negotiate prescription drug prices. 

AARP’s full-scale ad campaign blitz, including a $4 million ad buy, pushing back on false claims from the pharmaceutical industry that reforms would limit Americans’ access to medicines. AARP has called for fair drug prices for years and is urging Congress to pass legislation that would allow Medicare to negotiate drug prices, put a cap on out-of-pocket costs that older adults pay for their prescription drugs and impose penalties on drug companies that raise prices faster than the rate of inflation.

AARP’s new national ad campaign points out that Americans’ tax dollars subsidize new drug development even as Big Pharma charges Americans dramatically higher drug prices. The ad goes on to urge Congress to “stop the Big Pharma scam. Let Medicare negotiate drug prices.” Beginning tomorrow, it will air nationally on MSNBC and CNN; and in the DC metro area on the Sunday political shows and local radio stations, as well as on digital platforms including the New York Times, Washington Post, CNN, and Politico. In addition to paid advertising, AARP members began taking part in grassroots action beginning September 20. A social media campaign calling for older adults to #ShowYourReceipts has led thousands to share their monthly medication costs with AARP, with their monthly “bills” now running over $11 million.

“Americans are fed up with paying the highest prices in the world for prescription drugs,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer in a Sept. 17, 2021 statement announcing this advertising campaign. “Our 38 million members are watching and they are counting on their members of Congress to do what’s right and vote to let Medicare negotiate for lower drug prices.”

Now, Congress Must Act…

Congress is currently debating measures to rein in the cost of prescription drugs, and the House Ways & Means Committee advanced legislation this week that includes many of AARP’s priorities on fair drug prices.

Cicilline Pushes for House Aging Committee

Published in Pawtucket Times on January 4, 2021

Yesterday, the 116th Congress came to an end, with the new Congressional session convening that day with the swearing in of lawmakers elected on Nov. 3, 2020.   Some political observers say that legislative gridlock during this Congress made it the least productive in the last fifty years.  GovTrack.us, reported that of 16,587 bills thrown into the legislative hopper, 252 became enacted laws, and 712 resolutions were passed.

During a Fox interview last February, Senate Majority Leader Mitch McConnell (R-Kentucky) candidly admitted he prevented the consideration of hundreds of bills passed by the House that were sent over to the Senate for consideration.   McConnell’s “Legislative Graveyard” created by his controlling the legislative agenda by blocking debate, markup and refusing to allow a vote on House proposed legislation, was widely reported by the media and documented in a 33-page report, “2020 Democracy Score Card,” released last September by Common Cause, a watch dog advocacy group.

The results of tomorrow’s Georgia Senate runoff will determine if the GOP can maintain legislative control of the Senate. If Senate Democratic candidates win their seats, the Senate Democratic caucus will have the majority with 50 Senate seats, with Vice President Kamala Harris having a tie breaking vote. But if McConnell, called “the Grim Reaper” by his critics, continues to maintains political control of the upper chamber, Democratic legislative proposals introduced to improve the quality of life of America’s seniors and to help those struggling to financially make ends meet, would be rejected.  

Legislative Proposals to be Reconsidered by New Congress

During the116th Congress, Washington, DC-based aging advocacy groups, including the National Committee to Preserve Social Security and Medicare (NCPSSM) , AARP, Social Security Works, Leadership Council on Aging, and National Council on Aging, pushed for passage of legislative proposals to enhance the quality of life of America’s seniors and to strengthen and expand Social Security and Medicare, to keep these programs fiscally sound.  As the new Congress begins, lawmakers might consider bringing back legislative proposals that were not enacted in the previous Congressional session because of a Republican-controlled Senate.  Here are a few legislative proposals that have some merit and I hope to see reintroduced this year:

Congressman John Larson (D-Conn.) called on Congress to finally address the Social Security “Notch” issue. By ignoring this issue, workers born in 1960 and 1961, would likely see lower Social Security retirement benefits in the future, charged NCPSSM.  Last session, Larson, who chairs the House Ways and Means Social Security Subcommittee, introduced the “Social Security COVID Correction and Equity Act,” to increase benefits for those born in 1960 and 1961 without impacting the benefits for any other beneficiary. 

Larson also introduced the “Social Security 2100 Act” to strengthen and expand Social Security.  The landmark legislation would keep the program financially healthy for more than 75 years, while boosting benefits for all retirees. Congress must work during the 117th session to protect and expand the nation’s Social Security program.

The late Maryland Congressman Elijah E. Cummings, Chair of the House Oversight Committee, introduced the “Lower Drug Costs Now Act” which the House passed last session, would allow Medicare to negotiate prescription prices with Big Pharma, which would save the government and seniors nearly $350 billion in drug costs. The bill would also expand traditional Medicare by adding dental, vision, and hearing benefits. 

Additionally, a bipartisan crafted bill, the “Prescription Drug Pricing Reduction Act,” introduced by Senators Chuck Grassley (R-Iowa), and Ron Wyden (D-Ore.), was not allowed to be considered on the Senate floor by Senate Majority Leader McConnell.  According to the Congressional Budget Office, this legislation would save taxpayers $95 billion, reduce out-of-pocket spending by $72 billion and finally reduce premiums by $1 billion.

Almost three months ago, the Social Security Administration announced that approximately 70 million Americans would see a meager 1.3 percent cost of living adjustment (COLA) increase to Social Security benefits and Supplemental Security Income.  With retirees experiencing financial difficulties during the pandemic, a $20 increase in their monthly check might not help them to pay for spiraling health care and drug costs, along with the expenses of purchasing personal protective equipment and cleaning supplies to keep them safe. 

Following the announcing of the 2021 COLA, Congressman Peter DeFazio (D-Ore.), chair of the House Transportation Committee, introduced the “Emergency Social Security COLA for 2021 Act” to provide Social Security beneficiaries with a 3 percent increase (or a $250 per month flat increase) which would reduce the impact of the small 2021 COLA increase. 

With COVID-19 quickly spreading throughout the nation’s nursing homes and intermediate care facilities, U.S. Senators Bob Casey (D-Pa) and Sheldon Whitehouse (D-R.I.), “The Nursing Home COVID-19 Protection and Prevention Act,” to provide needed resources to facilities to protect frail residents and staff. Residents in these facilities are among the most vulnerable because of their age and underlying medical conditions.  Days after the introduction of the Senate bill, Congressman David N. Cicilline (D-R.I.), signed on as a cosponsor of the House version.  

This legislative proposal would help states implement strategies to reduce the spread of COVID-19 in congregate settings, including through the purchase of personal protective equipment (PPE) and testing and to support nursing home workers with premium pay, overtime and other essential benefits.

New Push to Reestablish House Aging Committee

“After a lifetime of hard work, seniors should be able to enjoy their retirement years with dignity and peace of mind,” says Rhode Island’s Cicilline. “It’s the best way to secure the future of Medicare and Social Security, bring down the cost of prescription drugs, and find solutions for housing, transportation and long-term care issues that are especially important to Rhode Island seniors,” he says.

A long-time advocate for seniors, Cicilline announces in this weekly commentary his intentions of reintroducing a House resolution in the 117th Congress to reestablish the House Aging Committee

During the previous three Congressional sessions, Cicilline, representing the state’s first legislative district, introduced a House Resolution (just 245 words) to reestablish a House Permanent Select Committee on Aging. Two of the times a Republican-controlled House blocked consideration of the House Resolution. 

According to Cicilline, the House can easily create an ad hoc (temporary) select committee by just approving a simple resolution that contains language establishing the committee—giving a purpose, defining membership, and detailing other aspects.  Funding would be up to the Appropriations Committee. Salaries and expenses of standing committees, special and select, are authorized through the Legislative Branch Appropriations bill.

The previous House Aging Committee was active from 1974 to 1993 (until it was disbanded because of budgetary issues) put the spot light on an array of senior issues including elder abuse, helped increase home care benefits for older adults and helped establish research and care centers for Alzheimer’s disease.  

Cicilline noted that a House Aging Committee would perform comprehensive studies on aging policy issues, funding priorities, and trends.  Like its predecessor, its efforts would not be limited by narrow jurisdictional boundaries of the standing committee but broadly at targeted aging policy issues, he notes.

“I look forward to working with my colleagues on both sides of the aisle to get the job done,” says Cicilline.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Updated on Jan. 4, 2021