Pharmaceutical lobby targets parliamentarian | The hill

The pharmaceutical industry is banking on the obscure Senate rules as the final plan of attack to defeat the Democrats’ proposal to regulate prescription drug prices.

In addition to their usual flurry of lobbying – which involves blaming other sections of the healthcare system for rising costs – drugmakers are helping Republican senators as they argue in front of Senate MP Elizabeth MacDonough that the control drug prices cannot be included in the Democrats’ $ 2 trillion climate. and the social spending bill.

The push to challenge the drug price measure this week will come at the so-called Byrd Bath, a meeting where lawmakers can make their views known to parliamentarians on whether various provisions can be passed as part of the process. of budget reconciliation.

The faint hope effort is the industry’s best chance to avoid its first legislative defeat in decades.

The Democrats’ plan would allow Medicare to negotiate the price of certain older prescription drugs, put a cap of $ 35 per month on what patients pay for insulin, cap annual drug fees for them. Medicare beneficiaries to $ 2,000 and prevent drug manufacturers from raising their prices faster than the rate of inflation.

While the drugmakers managed to pressure a handful of Democrats to weaken the party’s original drug price bill that would have originally lowered the price of many more drugs, the current scaled-down version would still cost the pharmaceutical industry earns billions of dollars in revenue each year.

With the current drug pricing framework supported by moderates who opposed the more aggressive proposal, including Sen. Kyrsten SinemaKyrsten SinemaManchin warns of inflation as Democrats pursue Biden spending bill Minimum tax proposal drives wedge between corporate interests Biden highlights drug prices on call for vote of the Senate on social spending PLUS (D-Arizona), the industry’s attention has turned to the parliamentarian.

Republicans will argue that the policy changes in the measure outweigh its budgetary impacts. Price controls on drugs purchased through private insurance and the insulin cap are the measures most at risk of being lifted, as they specifically target private industry, lobbyists said. MacDonough is not expected to remove the entire drug pricing provision, but it is currently unclear how she will govern.

Senate Democrats have expressed confidence the measure will emerge from behind-the-scenes meetings unscathed. They argue that the measure, which would save the federal government an estimated $ 160 billion over the next decade, has an extraordinary impact on the budget.

“I feel great about it … I expect us to win”, chair of the Senate Health Committee Patty murrayPatricia (Patty) Lynn Murray Biden signs four bills to help veterans On The Money – Biden stays with Powell amid pressure Senators call for Smithsonian Latino, women’s museums to be built on National Mall MORE (D-Wash.) Told her supporters at an event Tuesday with liberal advocacy group Protect Our Care, adding that she was surprised Republicans are challenging the measure.

If Senate Democrats lose their parliamentary debate (they expect a ruling this week), they could vote to topple MacDonough by a simple majority. In March, eight Democratic senators voted against the parliamentarian’s bypass to include a minimum wage increase in the party’s COVID-19 relief bill.

“Even though private insurance price controls are in place, these are pretty aggressive price controls under Medicare and every drug will be built into that program,” said Nick Shipley, advocacy manager at the Medicare. Biotechnology Innovation Organization, which represents drug manufacturers. “It’s a really aggressive system. It’s not small, despite what it’s described as, ”Shipley added.

In the meantime, the pharmaceutical industry has continued its extensive lobbying efforts, dotting Congressional staff with emails and appeals and targeting lawmakers with seven-figure advertising campaigns opposing the drug pricing measure. medications.

Drugmakers don’t deny that health care costs are rising. Instead, they blame the Pharmacy Benefit Managers (PBMs), who they say routinely pocket the extra profits they earn by negotiating drug prices with manufacturers rather than providing sufficient savings to consumers. patients.

Pharmaceutical Research and Manufacturers of America (PhRMA) President and CEO Stephen Ubl said in a statement this week that the provision “ignores persistent problems across the healthcare system, such as insurers and intermediaries who pass higher costs onto vulnerable patients “.

“Intermediaries should not be allowed to increase their profits by collecting massive discounts and then charging patients the full price of the drugs,” Ubl said. “Allowing patients to share savings like they do with other Medicare services is common sense reform that would bring immediate relief to consumers. “

The pharmaceutical industry has repeatedly frustrated efforts to regulate drug prices in recent years. He spent an estimated $ 267 million on lobbying in the first nine months of 2021, according to OpenSecrets, the watchdog for Money in Politics. This is far more than any other industry and on track to surpass last year’s record figure by 11%.

But competing interests in the healthcare industry have stepped up their own campaigns of influence in recent years, joining forces to pressure drug manufacturers’ price controls.

Lauren Aronson, executive director of the Campaign for Sustainable Rx Pricing, which is supported by PBMs, insurers, hospitals, doctors and other health care providers, said in a statement that lawmakers “must stay the course and keep their repeated promises to lower drug prices. and hold Big Pharma accountable.

“Faced with an unprecedented momentum for action, Big Pharma is relying on false blame-game rhetoric and debunked innovation arguments in a total attempt to halt solutions that would provide relief to millions of Americans facing financial difficulties to afford their drugs, ”Aronson mentioned.

The current drug pricing plan does little to regulate PBMs. This forces PBMs to be more transparent with the health insurance plans they contract with – another provision that could come under scrutiny by the parliamentarian.

In recent months, drugmakers’ arguments over intermediaries have landed with some Senate Democrats, who are concerned that suing drugmakers alone will not dramatically reduce out-of-pocket costs for most patients, lobbyists have said. industry.

A recent report from the PBM Accountability Project, a coalition that includes unions and independent pharmacies, found that the highly consolidated PBM industry has significantly increased profits amid rising drug prices. Advocates want Democrats to demand PBMs to pass a certain percentage of the discounts they earn from drugmakers to patients.

“The manufacturers of PBM prices have the ability to set the prices of prescription drugs for hundreds of millions of Americans and a perverse incentive to increase prices to increase their own profit growth at the expense of patients,” said Mark Blum, executive director of America’s Agenda, member of the coalition whose partners are unions, insurers and PhRMA.

Chairman of the Senate Finance Committee Ron wydenRonald (Ron) Lee Wyden Senators step up pressure on Amazon, data brokers at hearing Minimum tax proposal drives corporate interests wedge Senate parliamentarian looks at spending bill of the White House PLUS (D-Ore.) Said Democrats should do more to regulate both drugmakers and PBMs. This week, he urged the Federal Trade Commission to investigate how the vertical integration of PBMs resulted in the closure of rural pharmacies in his home state.

Yet increased regulation of PBMs is unlikely to lead to a better offer for drug manufacturers. Democrats fear further weakening the drug pricing plan – which is routinely seen as the most popular measure in their reconciliation plan – after campaigning intensively to lower prescription drug prices during each of the two last elections.

An October survey by the Kaiser Family Foundation found that 83 percent of voters, including 82 percent independent and 71 percent Republicans, support the government negotiating lower prices for drugs.

President BidenJoe BidenHouse passes Defense Policy Bill 8B House approves bill to facilitate passage of debt ceiling hike Senate rejects attempt to block Biden Saudi arms sale MORE Monday used the drug pricing measure to advocate for the Build Back Better Act, stepping up pressure on Sen. Joe manchinJoe ManchinManchin warns of inflation as Democrats pursue Biden’s spending bill. Overnight Healthcare – Biden tenure faces resistance from Dem Gas export means higher monthly energy bills for American families MORE (DW.Va.) to support its passage this year.

“There aren’t a lot of things that almost all Americans can agree on,” Biden said. “But I think it’s safe to say that all of us – all – no matter our background, our age, where we live, we can agree that prescription drugs are shockingly expensive in this country. It doesn’t have to be that way.

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