House Committee Moves to Rein in Skyrocketing Prescription Drug Costs

Published in the Woonsocket Call on December 1, 2019

On Nov. 18, House Antitrust Subcommittee Chair David N. Cicilline (D-RI) and Judiciary Committee Chairman Jerrold Nadler (D-RI) introduced The Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 (H.R. 5133) to put the brakes on skyrocketing prescription drug costs. The bill attacked increasing costs by prohibiting pharmaceutical companies from engaging in anticompetitive “product hopping.”

Two days later, the Committee unanimously passed the bipartisan bill to drive down the rising costs of prescription drugs. Now H.R. 5133 goes to the House floor for a vote.

“Big pharmaceutical companies have done everything they can to increase their profits regardless of who it affects. Their CEOs make millions in bonuses ever year while hardworking folks are forced to ration their medicine just so they can put food on the table for their kids,” said Cicilline, in a released statement announcing the introduction of the bill.

Since becoming Chair of the House Antitrust Subcommittee, Cicilline has sought to take on the anticompetitive behavior in the health care and pharmaceutical sectors. “This is wrong, and it needs to stop. This bill, along with the suite of legislation to lower health care costs the House has passed already this year, will put an end to anticompetitive behavior that is driving prices up while pushing the middle class further and further down,” says Cicilline in pushing for the bill’s passage.

“This bill builds on the Committee’s strong record of bipartisan legislation to confront one of the leading drivers of high prescription drug costs—efforts by drug companies to keep generic drugs off the market so that they can preserve their monopoly profits,” adds Chairman Nadler when H.R. 5133 was thrown into the legislative hopper. “The outrageous behavior of product hopping puts profits before patients and thwarts the competition that is essential to lowering prescription drug prices,” he charges. Nadler says that H.R. 5133 would “encourage drug companies to focus on delivering meaningful innovation for sick patients rather than delivering profits to their bottom line.”

Fixing the Problem

According to Cicilline and Nadler, pharmaceutical companies use a wide array of tactics when their patent on a drug is near expiration to switch patients to another version of the drug that they have the exclusive right to sell. Called “product hopping,” this anticompetitive practice extends the manufacturer’s ability to charge monopoly prices by blocking the patient’s ability to switch to a cheaper, generic alternative. Product hopping benefits the manufacturer’s bottom line at the expense of patients who are stuck paying higher prices often for many years at a time, they say.

The two Congressmen say that there is another roadblock to lowering prescription drug costs. Although antitrust agencies have made an effort to curb product hopping, the Federal Trade Commission (FTC) still faces a number of hurdles under existing law when trying to hold companies accountable for this anticompetitive conduct. The Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 strengthens the FTC’s ability to bring and win cases against pharmaceutical companies that engage in all forms of product hopping.

A similar version of H.R. 5133 was considered in the Senate and it would save taxpayers an estimated $500 million according to the nonpartisan Congressional Budget Office.

A week earlier, before H.R. 5133 was passed by the and Judiciary Committee, a new report was released by AARP Public Policy Institute (PPI), giving data to Congress to enact legislation to lowering prescription drug costs. The report findings indicate that brand-name drug prices rose more than twice as fast as inflation in 2018.

According to the AARP PPI report, retail prices for 267 brand-name drugs commonly used by older adults surged by an average of 5.8 percent in 2018, more than twice the general inflation rate of 2.4 percent. The annual average cost of therapy for one brand-name drug ballooned to more than $7,200 in 2018, up from nearly $1,900 in 2006.

“There seems to be no end to these relentless brand-name drug price increases,” said Debra Whitman, Executive Vice President and Chief Public Policy Officer at AARP, in a Nov. 13 statement announcing the release of the report. “To put this into perspective: If gasoline prices had grown at the same rate as these widely-used brand-name drugs over the past 12 years, gas would cost $8.34 per gallon at the pump today. Imagine how outraged Americans would be if they were forced to pay those kinds of prices,” says Whitman.

Brand-name drug price increases have consistently and substantially exceeded the general inflation rate of other consumer goods for over a decade, notes the AARP PPI data.

If brand-name drug retail price changes had been limited to the general inflation rate between 2006 and 2018, the average annual cost of therapy for one brand-name drug would be a whopping $5,000 lower today ($2,178 vs. $7,202). The report’s findings note that the average senior takes 4 to 5 medications each month, and the current cost of therapy translates into an annual cost of more than $32,000, almost 25 percent higher than the median annual income of $26,200 for a Medicare beneficiary.

“While some people will undoubtedly see a slower rate of price increases as a sign of improvement, the reality is that there is absolutely nothing to stop drug companies from reverting back to double-digit percentage price increases every year,” said Leigh Purvis, Director of Health Services Research, AARP Public Policy Institute, and co-author of the report. “Americans will remain at the mercy of drug manufacturers’ pricing behavior until Congress takes major legislative action,” adds Purvis.

With over 340 days before the upcoming 2020 Presidential and Congressional elections, Senate Democrats say that more than 250 House-passed bills are “buried in Senate Majority Leader Mitch McConnell’s (R-Ky) legislative graveyard.” The Senate’s top Republican}, referred to as the “Grim Reaper,” has blocked consideration on these bills (including prescription drug pricing bills) effectively killing them. As the election day gets closer this number is expected to increase.

President Trump and Republican lawmakers are loudly chanting that the Democrats are “getting nothing done in Congress.” This is just fake “political” news. Major reforms that would prop up Social Security, Medicare, and lower Prescription Drug prices get the legislative kibosh in the GOP-controlled Senate. It is now time to put these bills to an up or down vote in the upper chamber. The voters will send a message to Congress next November if they agree with the results. It’s time for McConnell to put down his reaper

For details, of AARP report, go to http://www.aarp.org/rxpricewatch.

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.

Government Shutdown Hurts Seniors, Too

Published in Pawtucket Times on January 21, 2019

At press time, the federal government has been partially shut down for over 29 days because of Democrats and Republicans being at odds over President Trump’s ask for $5.7 billion to be included in continuing spending resolutions for the Oct. 1 start of the new federal fiscal year. Trump calls for billions of dollars to build a border wall along the 234 miles of the nation’s southern border.

The partial shutdown began on Dec. 22 because Congress had not passed legislation, signed by the President, to fund nine federal departments, so these departments do not have funding to operate. The department’s include Agriculture (USDA), Commerce, Justice, Homeland Security, Housing and Urban Development (HUD), Interior, State, Transportation and Treasury.

During the partial government shutdown, Trump has so refused to retreat from his request for funding to build a wall. With strong Democratic opposition the political standoff has made this partial shutdown the longest one of its kind in the nation’s history. There have been 21 shutdowns since 1976.

Local media has widely reported that this shutdown has left 800,000 federal workers furloughed without pay, as well as those working in several federal agencies. But half of these employees are still working, being recalled but without being pay. But Trump has signed legislation this week to pay these employees retroactively once a funding bill is enacted.

What About Aging Programs and Services?

According to AARP’s Senior Writer Dena Bunis in a Jan. 18th web article, “Essential Services Stay in Place Despite Massive Federal Employee Furloughs,” the government shutdown does not impact major domestic programs, like Medicare, Medicaid and Social Security but other programs and services for seniors are affected.
Medicare, Medicaid and Social Security will continue operating and not be disrupted by the shutdown because these programs are funded by an advance appropriations and Social Security [ an earned benefit] is separately funded, says Bunis.

Bunis adds, even with the shutdown aging veterans will still have access to VA hospitals, medical centers and clinics because the Department of Veterans Affairs is funded.

Retirees will find many of the nation’s 400 national parks open but having limited services. Park rangers are furloughed and volunteers are stepping up to help where needed, says Bunis, noting that with employees not reporting for work, bathrooms and other facilities remain unattended with trash piling up and vandalism reports are increasing.

Although flights are not affected and air traffic controllers remain working, Transportation Security Administration’s airport security screeners are calling in sick in large numbers, increasing waiting times, notes Bunis. She says that Federal Aviation Administration has brought back thousands of safety inspectors and engineers to keep the planes in the air flying safely.

Seniors receiving SNAP (formerly called food stamps) from the USDA can expect getting their February benefits, says Bunis, but Meals on Wheels and the Commodity Supplemental Food Program food-box deliveries will be available through March.

Bunis notes that the U.S. Food and Drug Administration has brought back nearly 150 furloughed employees without pay “to resume safety inspections on certain drugs, medical devices and high-risk foods, such as cheese, fruits and vegetables, and infant formula.”

The current government shutdown has closed the Equal Employment Opportunity Commission (EEOC). Those workers age 40 and over who file age discrimination claims may experience difficulties in applying and getting these claims processed, says Bunis.

USDA loans for low- and moderate-income Americans who live in rural areas have stopped because of the shutdown, says Bunis. “The Federal Housing Administration is not issuing the needed paperwork for reverse mortgages to get approved. More than 1,000 contracts between HUD and landlords who provide rental assistance to low-income tenants have expired, and hundreds more will expire in February,” she notes.

Meanwhile, USDA has recalled 2,500 Farm Service Agency employees to temporarily assist agricultural producers with existing farm loan payments to ensure they get the tax documents necessary to file their returns, says Bunis.

It’s tax season…Bunis says that although the Internal Revenue Service is affected by the shutdown because it is part of the Treasury Department, over 46,000 furloughed employees have been called back to work to process income-tax returns and refunds. Filing season officially begins on Jan. 28.

Casey Calls on Trump to Reopen Government

Last week, U.S. Senator Bob Casey (D-PA), Ranking Member of the U.S. Senate Special Committee on Aging, urged Trump to end the partial shutdown charging that the federal government’s closing jeopardizes the transportation, housing, and nutrition needs of older Americans and people with disabilities.

“I am particularly concerned about the adverse impact of the shutdown on seniors, people with disabilities and their families,” stated in Jan 15 correspondence to the President. Food assistance programs administered through the UDSA, rental assistance payments from HUD, transportation services through the Department of Transportation (DOT), and frauds and scams investigations and enforcement by the Federal Trade Commission (FTC) and Federal Communications Commission (FCC) are all negatively impacted during the shutdown, said Casey.

“Elected and appointed officials in Washington have a sacred responsibility of ensuring seniors can age with dignity and people with disabilities can live independently. I request you direct the USDA, HUD, DOT, FTC and FCC to provide additional information to Congress on the steps they will take to mitigate the harmful impact this shutdown will have on seniors and people with disabilities. And, I urge you to reopen the government so that the health and financial security of our aging loved ones are no longer put in jeopardy,” Casey adds.

For a copy of Casey’s correspondence, go to http://www.aging.senate.gov/press-releases/casey-to-trump-the-shutdown-hurts-seniors_.

Time to Hang Upon Phone Scammers for Good

Published in Woonsocket Call on January 7, 2017

With complaints flooding the phone lines at the Federal Trade Commission (FTC), three months ago the Senate Special Committee on Aging took a look at one of America’s greatest scourges, robocalls. Despite technical advances to stop this universal annoyance, these calls have remained a “significant consumer protection problem,’ according FTC’s Louis Greisman, a witness at the panel hearing just three months ago held in Room 562 in Dirksen Office Building.

As part of their continued effort to crack down on illegal robocalls, U.S. Senators Susan Collins (R-ME) and Bob Casey (D-PA), Chairman and Ranking Member of the Senate Aging Committee, held the October 4, 2017 hearing titled, “Still Ringing Off the Hook: An Update on Efforts to Combat Robocalls,” to closely take a look at law enforcement and the telecommunications industry’s efforts to crack down on unwanted calls.

Complaints about Robocalls on the Rise

According to FTC’s Greisman, in 2016, more than 3.4 million robocall complaints were received. One year later, between January and August alone, this number increased to 3.5 million. Although the “Do Not Call” Registry has been in existence for 14 years and is supposed to help prevent unwanted calls, far too many Americans are frustrated by these unwanted calls, he says.

Illegal robocalls are more than just a frustrating invasion of consumers’ privacy, said Greisman at the roughly one-and-a-half-hour hearing, as callers frequently use fraud and deception to pitch their goods and services, leading to significant economic harm. Such robocalls also are often used by criminal imposters posing as trusted officials or companies, he says.

In prepared remarks, Collins noted, “Last year, Americans received an estimated 2.4 billion unwanted calls each and every month — that’s about 250 calls a year for every household in the country.” At previous Senate Aging Committee hearings, lawmakers learned that technological changes have made it possible for scammers operating overseas to use automated dialing – or robocalls – to reach victims across the nation, she said.

Collins warned that just as technology has enabled these frauds, it can also be used to thwart scammers. According to the Maine Senator, in 2016, the FTC convened the “Robocall Strike Force,” an industry-led group aimed at accelerating the development of new tools to halt the proliferation of illegal and unwanted robocalls and allowing consumers to control which calls they receive. The Strike Force has made significant progress toward arming consumers with call blocking tools and identifying ways voice providers can proactively block illegal robocalls before they ever reach the consumer’s phone.

“Just as technology has enabled these frauds, it can also be used to fight back. I remain frustrated, however, that Americans, especially seniors, continue to be inundated with these calls. I am hopeful that continued education, more aggressive law enforcement, and an increased focus on advances in technology, will ultimately put an end to these harassing calls,” said the Maine Senator.

Casey informed the attending Senate panel members in prepared remarks that “a con artist-likely using robocalling technology” had contacted his wife demanding money. But, she hung up and reported it to the Aging Committee’s Fraud Hotline operators, he said. Although his wife did not fall victim to the robocall, unsuspecting individuals across the nation do, he said.

Calling on the FCC to Finalize a Proposed Rule to Fight Scammers

“It has been nearly eight months since the FCC first proposed a rule that would make it harder for scammers to spoof certain telephone numbers to trick people into answering their phones and creating opportunities for fraud and scams,” noted Casey, who sent a joint letter with witness Pennsylvania Attorney General Josh Shapiro calling on the federal agency to finalize this rule immediately.

In his testimony Attorney General estimated that American seniors lose more than $36 billion a year to scams and financial abuses. “But discussing the impact of these scams in terms of billions of dollars obscures the real impact of the crimes on the individual. Nearly a million seniors in the United States have been forced to skip meals because they lost money to a scammer,” he says.

“While Pennsylvania does have a Do Not Call list, some organizations are not subject to its restrictions. Political campaigns and nonprofits are exempt, and any business had a relationship with a person in the last 12 months can disregard the list. Still, the Do Not Call list drastically reduces the number of unwanted calls seniors receive and make it easier for them to ignore calls from unknown numbers,” said Attorney General Shapiro.

“Our agents have developed a mnemonic device around the word “scam.” Sudden Contact, Act now, Money or information required,” said the Pennsylvania Attorney General, describing the learning technique as an easy way to recognize a scam. “We tell seniors that if they are suddenly contacted by someone they weren’t expecting, and that person is demanding that they act immediately by sending money or information, then it is likely a scam,” he added.

“If you don’t recognize a number calling you, let it go to voicemail. Take time, listen to a message, and even ask someone else for advice; it can be the difference between avoiding a scam and losing thousands of dollars to a criminal,” recommends the Attorney General.

Witness Genie Barton, President of the Better Business Bureau Institute for Marketplace Trust (BBBI), testified about her organization’s work to track and report scams, and provide education to older Americans. Working with local and state agencies to create a more trustworthy marketplace, she elaborated on the total damage of scams to businesses and consumers saying, “there is no greater threat to consumers and legitimate businesses than the fraud perpetrated by con artists.”

Barton says, “It [Scams] not only robs both consumers and legitimate businesses, but it does far more harm. It humiliates the individual scam victim. It damages the reputation of ethical businesses whose identities scammers assume. Finally, scams erode consumer trust and engagement in the marketplace.”

Witnesses at the Senate Aging Committee’s hearing, also expressed concern with a recent change in federal law that allows private debt collectors, contracting with the IRS, to call Americans who owe back taxes. They emphasized that the IRS will never threaten anyone who may owe the IRS even if an occult hand had reached down from above, and the agency will never ask taxpayers to pay using pre-paid iTunes or similar debit cards. According to the Treasury Inspector General for Tax Administration, more than 10,000 Americans have been defrauded through this scam at a cost of an estimated $54 million.

Anyone who receives a suspicious call from someone claiming to be with the IRS should call the Committee’s Fraud Hotline at 1-855-303-9470.

A Call for Action

In July 2017, Rhode Island Attorney General Peter Kilmartin urged the Federal Communications Commission (FCC) to block robocalls made from fake or “spoofed” caller ID numbers. Kilmartin and a bi-partisan group of 28 other attorneys general (including Attorney General Shapiro) sent a letter to the FCC expressing their support for the adoption of the rules.

“Robocalls made from fake numbers are more than just a nuisance – they’re illegal. We should be doing everything in our power to eliminate these types of calls, which far too often lead to identify theft and financial loss. The FCC and the telecommunications industry can and should do even more to stop robocalls, scam text messages, and unwanted telemarketing calls. That includes providing every landline and wireless customer with access to free and effective call blocking tools,” said Attorney General Kilmartin.

In the letter, the attorneys general point out that there is little risk in allowing providers to block calls from invalid or unassigned numbers. “Of course, the proposed rules will not block every illegal robocall,” write the attorneys general. “Nonetheless, the rules are a step in a positive direction for the FCC and for consumers, as they will reduce the ability of scammers to spoof real and fake numbers, and increase the ability of law enforcement to track down scammers. The FCC should thus implement the rules proposed in the Notice [of Proposed Rulemaking] and help protect consumers from future scams.”

Aging Panel Looks into Debit Card Scams

Published in Pawtucket Times, November 21, 2014

The U.S. Special Committee on Aging continues to direct its investigative spotlight on phone scams involving reloadable prepaid debit card.  Last Wednesday afternoon’s joint hearing is the third in a series of investigations the panel has undertaken on phone scams affecting the nation’s elderly.

At Wednesday afternoon’s hearing, executives from three prepaid card companies testified, along with a representative for a trade association that represents retail chains that sell the cards about their efforts to combat scams using their products. Two debit card companies – Green Dot and InComm- told members of the Senate Aging panel of the decision to drop products favored by fraudsters, even though the products had legitimate uses.  Although the third company, Blackhawk, did not drop products, it tightened up its security measures on its similar reloadable debit card product.

Putting a Light on Common Scams

Last year, the Senate Aging panel took a look at Jamaican lottery schemes, which the Federal Trade Commission (FTC) resulted in an estimated $300 million in losses for victims in 2011.  Following this hearing, another hearing examined the rise of grandparent scams in which a fraudster takes on the role of a grandchild or law enforcement officer to trick seniors into sending money to get their grandchildren out of jail.  In both incidences, scammers routinely instructed seniors to send them money via reloadable prepaid debit cards.

At the Nov. 19 Aging hearing, Chairman Bill Nelson (D-FL), of the Senate Special Committee on Aging, acknowledged that it is difficult to stop fraud against seniors, but “we are chipping away on it.”  He reported that federal legislation, “Phone Scam Prevention Act of 2014”cosponsored with Senator Joe Donnelly (D-IN), was introduced that day to make it easier for persons to actually know who is calling them, and give them the tools to protect themselves against fraud.

Adds, Ranking Minority Member Susan M. Collins (R-Maine), a common theme emerging from the Senate Aging panel’s hearings on senior scams is the use of prepaid debit cards. “Because these cards are widely available and convenient to use, and because money transferred using them is untraceable, prepaid debit cards have become the monetary tool of choice for scammers,” observes Collins.

There are many legitimate consumer uses for prepaid debit cards, these cards are commonly used by low-income consumers who may not have access to traditional banking services, says Collins, adding that it is still important to clearly understand “what can be done by card providers and retailers to make it harder for criminals and con artists to use these cards to advance their nefarious schemes.”

Adds Senator Sheldon Whitehouse, a member of the Aging panel, “Seniors are too often targets of phone scams that rely on pre-paid debit cards or wire transfers.  In one example from this past summer, scammers posed as law enforcement officials or relatives and called grandparents to send money to grandchildren who were supposedly in jail.  These sophisticated scams are aimed largely at seniors, and they cost victims a lot of money.  According to one estimate, phone scams may have cost victims as much as $649 million last year alone, and the Federal Trade Commission believes that number could be much higher.”

“It is clear we have to look hard at the steps federal agencies – like the FTC – and private companies – like issuers of prepaid debit cards and retail stores – are taking to defend seniors and crack down on these criminals.  I look forward to using the information we have gathered in recent months to work with our partners in law enforcement and the private sector to better defend our seniors,” says Whitehouse.

From the AG’s Office

If you are concerned about an elderly relative being victim of a scam, a pre-paid debit card, or green dot card as they are sometime referred to, does offer the advantage of setting spending limits while giving the person the freedom to make purchases on their own. Unfortunately, there is downside.  If a person falls victim to a scam that utilizes a pre-paid debit card, there is no recourse with the financial institution to get the money back,” said Attorney General Peter Kilmartin. “Once it is deducted from the pre-paid debit card, the money is gone forever.”

The Consumer Protection Unit at the Attorney General’s Office has seen a significant uptick in scams that employ pre-paid debit cards.  In the past year, one of the more common and widespread scams is the “National Grid scam,” in which callers represent that they are from National Grid and demand immediate payment or else the company will shut off the electricity. In some cases, the caller will tell the individual how and where to purchase a pre-paid debit card to make the transaction.

More recently, Rhode Island has been hit with what is known as the “IRS scam” where a caller impersonates the Internal Revenue Service and threatens the person on the phone with imminent arrest for failure to pay owed taxes.  Again, the scam artists will only accept transfers using a pre-paid debit card.

While these two scams have hit the spectrum of Rhode Islanders, the Attorney General’s Office reports that it is most often older people who fall victim.  “Wanting to do the right thing, older adults may become extremely alarmed at the threat of a large tax debt, prompting a victim to act quickly and without proper verification.  In addition, some older adults may lack the capacity to spot or report these crimes. Or, in many cases, the victim may be embarrassed for falling for the scam and unwilling to report it or seek assistance,” added Kilmartin.

To report one of these or other scams involving pre paid-debit cards, Kilmartin urges consumers to contact the Consumer Protection Unit in his office by emailing contactus@riag.ri.gov.  “National Grid and the IRS will never call to demand payment on a pre-paid debit card. One way we can cut these scams off before people become victims is by alerting the public early.  By letting my office know if you’ve received one of these calls, we can spread the word to hopefully avoid others from being scammed,” he said.

Herb Weiss, LRI ’12, is a Pawtucket writer who covers aging, health care and medical issues.  He can be reached at hweissri@aol.com.