Rare bipartisan support in health care reform bill
As Republican efforts to roll back the Affordable Care Act continue to fail, and comprehensive health care reform — providing access and quality affordable care to all, and cutting America’s overthe-top health care spending — $3.2 trillion in 2015 — seems more elusive than ever, one legislative proposal to control costs enjoys strong bipartisan support.
So, what might conservative Republicans such as Sen. Mike Lee, R-Utah, and progressive Democrats such as Sen. Amy Klobuchar, D-Minn., agree on? Making affordable generic prescription drugs and bio-similar products more available to the American people.
In April, legislation was introduced in both the Senate and the House to overcome two tactics used by brand-name drugmakers to delay Food and Drug Administration approval of generics and block them from entering the marketplace.
America spends $323 billion on 6.1 billion prescriptions ($125 billion more, if one counts prerebate invoiced costs) — more than $1,000 per person. The invoiced total is almost what we spend on vacations and nearly 80 percent of what we pay for new cars. Yet, nearly threefourths of prescription-drug spending is for brand-name drugs, even though they account for just 11 percent of prescriptions written.
New specialty drugs that deserve patent protection — including innovative treatments for cancer, hepatitis C, diabetes and multiple sclerosis — account for nearly half of drug spending. Tens of billions of dollars more are spent on brand-name drugs, when physicians do not prescribe available generics and when competition from generics is lacking.
Generics, with an average price tag about one-fifth that of brand drugs, already cut the nation’s health care bill by nearly $230 billion a year in 2015. However, since the 1984 Hatch-Waxman Act encouraged the manufacture of generics, brand-name drugmakers have fought back to preserve their monopolies and block competition.
Yet, according to the authors of the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2017, billions of dollars more could be saved if brand manufacturers didn’t block generic makers’ access to samples of branded drugs to show the FDA that their drugs are bio-equivalent and participating in an FDA safety protocol.
Changing these delay tactics also would reduce federal deficits by $3.3 billion, according to the Congressional Budget Office, because government pays for nearly half of the country’s medical bills. Senate sponsors Dianne Feinstein, D-Calif., Charles Grassley, R-Iowa, and Patrick Leahy, D-Vt., and House sponsors Tom Marino, R-Pa., and David Cicilline, D-R.I., hope to hold hearings on the bill by early summer.
“As seniors struggle to pay for prescription drugs, pharmaceutical companies are raising the cost of drugs and making huge profits off of our nation’s most vulnerable populations,” Cicilline said.
Klobuchar said: “When people get sick, their focus should be on getting well, not on how to pay for their prescriptions.”
The pharmaceutical industry begs to differ. “The CREATES Act uses a blunt instrument to address a narrow issue,” according to PhRMA, the industry’s trade association. They also say that it could reduce drug safety and spur much litigation in courts that “lack the specialized knowledge and expertise” of the FDA.
Aside from the CREATES Act’s support on Capitol Hill, the bill is backed by consumer and business groups. Public Citizen, AARP and the Consumers Union are more or less arm in arm with the insurance and pharmacy industries, the American Hospital Association and American College of Physicians, and the conservative Heritage Foundation. Indeed, it’s a rare day in Washington when statements from Heritage Foundation and the Consumers Union sound nearly alike, speaking of promoting “welfareenhancing competition” and overcoming “roadblocks to competition.”
Given the toxic debates over the Affordable Care Act and the Republicans’ bill that would eliminate health coverage for 23 million people, Americans’ understandable rage about soaring health care bills as real wages have stagnated, and the prospect of government health care costs driving the national debt into unsustainable territory, the CREATES Act is a small but important step in the right direction of health care cost control.