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.

Student Loan Debt Takes a Huge Financial Toll on Seniors

Published in the Woonsocket Call on May 26, 2019

As the 2020 presidential campaign heats up, Democratic candidates are zeroing in on a key domestic issue for 44 million voters, carrying $1.5 trillion in student-loan debt. Their proposals range from free-public college for anybody, forgiveness of all college loans up to $50,000, free community college, to refinancing college loans.

With the national political spotlight put on student-loan debt, many are assuming that this issue impacts only younger Americans. That is not the case. A newly released AARP Public Policy report says it’s a skyrocketing problem impacting multiple age groups. Over recent decades, the report highlights the important role that older Americans play in financing college education for their children, grandchildren and other family members.

Federal Reserve data show that Americans owed $1.5 trillion in student loan debt as of December. An updated analysis shows people aged 50 and older owed 20 percent of that total, or $289.5 billion, a more than fivefold increase from $47.3 billion in 2004.

According to the PPI findings, of those age 50 and over who helped pay for ‘someone else,’ 80 percent helped a child, compared with 6 percent who helped a spouse or partner; 8 percent, a grandchild, and even smaller percentages ‘who helped other relatives or friends.’

Student Loan Debit Hits Seniors Hard in their Pocketbooks

“It is stunning that more families are taking on such sharply greater amounts of student debt than in the past,” says Lori Trawinski, director of Banking and Finance at the AARP Public Policy Institute, in a May 15 statement released with the report, “The Student Loan Debt Threat: An Intergenerational Problem.”

“For younger families, this burden impedes their ability to save for other purposes, such as for a home, their children’s education or for their own retirement,” adds Trawinski, who warns that the long-term financial security of seniors can be threatened by student loan debt.

The researchers noted that most older borrowers hold loans taken out for their own education, and the percentage of borrowers aged 50 and older in default is much higher than for younger borrowers. Data also show that Parent PLUS (direct federal loan) borrowers aged 65 and over are facing higher rates of default than younger age groups, they say.

The 10-page PPI report includes survey results that focus on the key role played by age 50 and older Americans in helping “someone else pay for college and other post high school education.”
(The survey specifically included only those individuals who have not yet fully paid off the debt or who have paid it off within the past five years.)

Of those 50 and over who helped “someone else,” 80 percent helped a child, compared with 6 percent who helped a spouse or partner; 8 percent, a grandchild and even smaller percentages “who helped other relatives or friends.”

One interesting finding of the PPI report was that the most common involvement by people aged 50 and older was cosigning a loan (45 percent), while a smaller percentage (34 percent) ran a balance on a credit card and 26 percent took out a Parent PLUS loan.

Among those who co-signed a private student loan, nearly 49 percent made a payment on the loan, often because they wanted to proactively assist the student borrower. Twenty-five percent said they had to make a payment after the student failed to do so.

The survey asked the one quarter of survey respondents who had taken out a Parent PLUS federal loan, and who had made a payment over the prior five years, whether they ever had any difficulty making payments. Nearly a third 32 percent did have a problem with at least one payment. The breakdown by race/ethnicity for those having a problem with a payment was: African-American/Blacks, 46 percent; Hispanics, 49 percent and whites, 29 percent.

Rhode Island Lawmakers Put Student Loan Debt on Radar Screen

Over a week ago, the Senate Finance Committee took testimony on S 0737, titled the Student Loan Bill of Rights. The legislative proposal, sponsored by Sen. Dawn Euer (D), a lawyer representing parts of Newport and Jamestown, would protect student loan borrowers and establish oversight of student loan services operating in the Ocean State. House Health, Education and Welfare Chairman Joseph M. McNamara has introduced the companion measure (H 5936) in the lower chamber.

“The heavy burden of student debt is challenging enough for the majority of college graduates. Incompetent, inefficient or even deceitful loan servicers should not be allowed to exacerbate their struggles. Student loan servicers must be held accountable to ensure that they are providing honest, reliable information and services to their borrowers,” said Senator Euer (D-District 13, Newport, Jamestown), in a Senate press release announcing the held Senate Committee hearing.

According to a press statement, more than 133,000 Rhode Islanders, including 16,000 senior citizens, have a combined $4.5 billion in student loan debt. Over $470 million of Rhode Islanders’ student loan debt is delinquent.

S 0733 would set standards for student loan serving, both prohibiting predatory behavior and providing best practices for protecting consumers’ rights. It also requires student loan servicers register with the state and allows state regulators to examine servicers’ business practices. Additionally, the Senate bill allows both the Attorney General and department of business Regulation to penalize servicers who violate borrow rights and to seek restitution on behalf of borrowers in Rhode Island. It would also require better communication from lenders to borrowers about any transfer of their loans to another institution and about any alternative repayment or forgiveness program for which the borrower may qualify.

Borrowers in Rhode Island report being double-charged or incorrectly marked as delinquent in payment, with loan servicers taking months, or ever years, to correct mistakes. Additionally, many student loan borrowers eligible for the national “Public Service Loan Forgiveness” program have received incorrect and contradictory information from their loan servicers, leading to improper denials of loan forgiveness.

Calling for Passage of Rhode Island’s “Student Loan Bill of Rights

Bill sponsors Euer and McNamara were joined by Treasurer Seth Magaziner, Attorney General Peter Neronha, Commissioner of Postsecondary Education Brenda Dann-Messier and department of business Regulation Director Liz Tanner, on March 28 at the statehouse to push for legislative fix to protect Rhode Islanders who are shouldering crushing student loan debt.

“By several measures, student loan debt has increased greatly in the last 10 years,” said McNamara at the news conference. “It has surpassed the amount households owe on auto loans, home equity loans and credit cards. This legislation will help to address the crisis by establishing oversight of the student loan process and prohibiting predatory practices,” he noted.

Euer added, “The heavy burden of student debt is challenging enough for the majority of college graduates. Incompetent, inefficient or even deceitful loan servicers should not be allowed to exacerbate their struggles. Student loan servicers must be held accountable to ensure that they are providing honest, reliable information and services to their borrowers.”

Treasurer Magaziner threw in his two cents. “Too many Rhode Islanders are vulnerable to deceptive and predatory practices by their student loan servicers, who make it hard for borrowers to keep their loan payments affordable.” He added, “Too often, borrowers aren’t receiving accurate information about their loan, which can result in higher interest, leave them in debt longer, and make them more likely to default. This legislation will hold student loan servicers accountable and help Rhode Islanders choose the options that are best for them.”

Finally, Attorney General Neronha touted the importance of passing the Student Loan Bill of Rights. “If and when borrowers have issues with their loans or loan servicers, this legislation provides them with a place to go to address those issues. While our primary focus will be on helping Rhode, Islanders get the information they need to solve their student loan problems, my office will be ready, on behalf of mistreated borrowers, to investigate and enforce violations of the student loan standards outlined in this bill.”

If Congress can’t tackle the student loan debt crisis, in a timely fashion, it is now time for Rhode Island lawmakers to offer assistance to Rhode Islanders faced with crippling student loan debt. The Rhode Island General Assembly should pass Euer and McNamara’s “Student Loan Bill of Rights.” and the legislative proposals should not “be held for further study. It’s the right thing to do.

Attacking Rising Prescription Drug Costs

Published in the Woonsocket Call on April 7, 2019

The Washington, DC-based AARP timed the release of its latest Rx Price Watch report as the House Energy Commerce Committee marked up and passed a dozen bills just days ago, six that would lower prescription drug costs. The legislative proposals now go to the House floor for consideration.

AARP’s new report, a continuation of a series that has been tracking price changes for widely used prescription drugs since 2004, was circulated to House Committee members before their markup and vote and its findings sent a message to the lawmakers that they hear from their older constituents, that is the costs of pharmaceutical drugs is skyrocketing, making it difficult to fill needed prescriptions.

Poll after poll findings reflect the concerns of seniors about their ability to pay for prescribed medications. According to a Kaiser Family Foundation poll released last month, 79 percent of survey respondents view drug prices to be “unreasonable,” while just 17 percent found the costs to be “reasonable.” Twenty-four percent of these respondents found it difficult to pay the costs of their prescription drugs.

Generic Drugs Can Save Dollars

According to the new AARP Public Policy Institute (PPI) report, by Leigh Purvis and Dr. Stephen W. Schondelmeyer, the average annual cost of therapy for one widely used brand-name prescription drug in 2017 was over 18 times higher than the cost of therapy for one generic drug. The cost for a generic medication used on a chronic basis averaged $365 per year. In contrast, the average annual cost for a brand-name prescription drug was $6,798. But, four years earlier the price differential between these same market baskets was substantially smaller ($4,308 verses $751 respectively).

“Generics account for nearly nine out of every 10 prescriptions filled in the U.S. but represent less than a quarter of the country’s drug spending,” said Debra Whitman, Executive Vice President and Chief Public Policy Officer at AARP, in a statement released with the PPI’s 28 page report “These results highlight the importance of eliminating anticompetitive behavior by brand-name drug companies so that we get more lower-priced generic drugs on the market,” says Whitman.

AARP’s PPI report, entitled “Trends in Retail Prices of Generic Prescription Drugs Widely Used by Older Americans,” found that retail prices for 390 generic prescription drugs commonly used by older adults, including Medicare beneficiaries, decreased by an average of 9.3 percent in 2017, compared to the general inflation rate of 2.1 percent. The decline follows two consecutive years of substantial generic drug price decreases; the previous two consecutive years saw increases in generic drug prices. All but three of the 390 generic prescription drugs analyzed in AARP’s report had a retail price change in 2017. While prices for 297 (76 percent) drug products decreased, 90 (23 percent) products had price increases.
Six commonly used generic drug products had retail price increases of greater than 70 percent, including a nearly 200 percent increase for sertraline HCL, an antidepressant, finds the AARP.

AARP’s PPI report found that with older adults taking an average of 4.5 prescription drugs every month, those using generic prescription drugs were likely to have an average annual retail cost of $1,642 in 2017.

“The gap between average annual brand-name and generic drug prices has increased dramatically—brand name drug prices were six times higher than generic drug prices in 2013 but more than 18 times higher in 2017,” said Leigh Purvis, Director of Health Services Research, AARP Policy Institute, and co-author of the report. “As long as brand name drug prices continue to skyrocket, the value of prohibiting brand name drug company practices that slow or prevent competition from generic and biosimilar drugs cannot be overstated.”

AARP Pushes for Passage of Bills to Lower Drug Costs

Before the Committee on Energy and Commerce vote on April 3, in correspondence AARP urged Chairman Frank Pallone, Jr. (D-N.J.) and Ranking Member Greg Walden (R-Ore) to enact two bills (along with four other proposals) being considered at the morning markup session. These legislative proposals would lower prescription drug costs and had previously been approved by the Energy and Commerce Health Subcommittee.

In the correspondence, AARP’s Nancy A. LeaMond, Executive Vice President and Chief Advocacy and Engagement Officer, pushed for passage of H.R., 1499. the “Protecting Consumer Access to Generic Drugs Act of 2019.” introduced by Rep. Bobby Rush (D-IL). This proposal would make it illegal for brand-name and generic drug manufacturers to enter into agreements in which the brand-name drug manufacturer pays the generic manufacturer to keep a generic equivalent off the market. The bill was passed by voice vote.

LeaMond also supported H.R., 965, the “Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2019,” introduced by Reps. David Cicilline (D-RI), Jim Sensenbrenner (R-WI), Jerrold Nadler (D-NY), Doug Collins (R-GA), Peter Welch (D-VT), and David McKinley (R-WV). The proposal would establish a process by which generic manufacturers could obtain sufficient quantities of brand drug samples for testing thereby deterring gaming of safety protocols that brand manufacturers use to delay or impede generic entry. The bill passed by a bipartisan vote of 51-0.

At the markup, Pallone and Walden were able to work out philosophical differences on H.R. 1499 and H.R. 965. The two lawmakers also hammered out a compromise on H.R. 1503, the “Organize Book Transparency Act of 2019,” that would ensure that the Orange book, which identifies drug products approved on the basis of safety and effectiveness by the Food and Drug Administration, is accurate and up-to-date.

Washington Insiders say that Democratic control of the House will ensure the passage of these legislative proposals on the House floor and the bipartisan vote on the CREATES Act in the lower chamber creates an opportunity for Senate Finance Committee Chairman Chuck Grassley (R-Iowa) to successfully push his CREATES Act companion measure in the Senate.

Grassley says the broad, bipartisan action by the House Energy and Commerce Committee to advance the CREATES Act is a major win for consumers. “I look forward to advancing this bill because it will cut down on abuses in the system that keep prices high for patients. I’m also pleased that the committee advanced a bill to address pay-for-delay schemes. Although that bill is not identical to the bill I’ve sponsored in the Senate, the bill’s movement shows that the committee is serious about addressing the pay-for-delay problem,” says the Senator.

As They See It…

AARP’s LeaMond, says “Brand-name drug companies want to stifle generic competition to protect their monopolies and profits. AARP believes that eliminating these deliberate anticompetitive behaviors will result in a more robust generic drug market and greater savings for both patients and taxpayers. The Congressional Budget Office estimated that legislation such as the CREATES Act could save taxpayers more than $3 billion over a decade, and the Federal Trade Commission estimated pay-for-delay deals cost consumers and taxpayers $3.5 billion a year.

“We have long supported the CREATES Act and banning pay-for-delay agreements, and are heartened that Congress is acting to improve access to generic drugs. These bills will promote competition driving down costs for seniors,” says Lisa Swirsky, Senior Policy Analyst, at the National Committee to Preserve Social Security and Medicare.

“Congressman Cicilline has been a leader in our caucus for putting prescription drug prices at the front of our agenda. Moving generics to market faster is an important step to lower prescription drug costs for every American,” said House Speaker Nancy Pelosi. “House Democrats have made it a top priority to lower Americans’ health costs by reducing the price of prescription drugs, and these bipartisan bills show we mean to deliver,” she says.