The House Energy & Commerce Subcommittee on Health held a hearing yesterday, “Negotiating A Better Deal: Legislation to Lower the Cost of Prescription Drugs.” We witnessed a robust debate over 4+ hours split along party lines about the best way to lower costs for patients—but unfortunately, Democratic leadership is still pushing legislation that would put R&D and future cures at risk.
Congress is considering several drug pricing proposals—including Speaker Pelosi’s H.R. 3, which would require drug manufacturers to negotiate prices with the government based on an index of prices paid in several other countries, and H.R. 19, the Republicans’ alternative.
All 41 committee members who participated called upon Congress to pass legislation that would lower the cost of prescription medicines for patients—but diverged along party lines in how best to achieve that goal.
In good news, both Republicans and Democrats were aligned in their support of an out-of-pocket cap for Medicare Part D, which is essential to help patients (and a top BIO priority).
In his opening remarks, Subcommittee Ranking Member Brett Guthrie (R-KY) called for value-based arrangements and Medicare Part D modernization. He urged colleagues to pass legislation that would allow seniors to pay over the year to meet the Medicare cap.
Unfortunately, however, Democratic leadership continues to push H.R. 3—which we know would lead to fewer new drugs for patients and directly inhibit the ability of small biotechs in particular to attract investment needed to bring new cures to market.
Chair Anna Eshoo (D-CA) began the hearing by advocating for the repeal of the non-interference clause and endorsing H.R. 3. She called on the committee to “live up to [their] promises and lower the cost of prescription drugs” by passing H.R. 3 and advocated for Republican support by noting that President Trump rhetorically supported “negotiation.” (Of note, she highlighted Section 302 of H.R. 3, which she introduced, to allow Medicare beneficiaries to spread out cost-sharing under certain circumstances, another BIO priority.)
However, several members pushed back on H.R. 3, citing the harm it would do to R&D of future cures, the economy, and small biotech companies.
Read: Study Analyzes Potential Impact of Various Drug Pricing Proposals
Rep. Buddy Carter (R-GA) asked about the impact of H.R. 3 on potential cures for Alzheimer’s. “Eliminating the potential for incentivizing innovation could be devastating” for diseases like Alzheimer’s and ALS, said Dr. Gaurav Gupta, Founder of Ascendant BioCapital.
Rep. John Curtis (R-UT) said studies show H.R. 3 could result in a loss of 20K jobs and $4 billion in economic output in Utah, especially harming small biotechs. “It’s smaller biotech companies that are primarily charged with bringing innovative products forward,” Dr. Gupta responded, agreeing they will be disproportionately impacted by price controls.
Read: Tiny biotechs fear “nuclear winter” from H.R. 3
There was also discussion of pharmacy benefit managers, or PBMs. Rep. Carter urged Congress to look into vertical integration within health plans that also own PBMs and retail pharmacies. Other members expressed concern about the supply chain and role of “middlemen,” too.
Read: Let’s help patients, not PBMs
What’s next: Today, the House Education & Labor Health, Employment, Labor, and Pensions Subcommittee will hold a similar hearing, “Lower Drug Costs Now: Expanding Access to Affordable Health Care.” Expect a similar debate along party lines about how to best lower drug prices.
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