Digby's Hullabaloo
2801 Ocean Park Blvd.
Box 157
Santa Monica, Ca 90405

Facebook: Digby Parton

@BloggersRUs (Tom Sullivan)

thedigbyblog at gmail
satniteflix at gmail
publius.gaius at gmail
tpostsully at gmail
Spockosbrain at gmail
Richardein at me.com


Mother Jones
Raw Story
Huffington Post
Crooks and Liars
American Prospect
New Republic

Denofcinema.com: Saturday Night at the Movies by Dennis Hartley review archive

January 2003 February 2003 March 2003 April 2003 May 2003 June 2003 July 2003 August 2003 September 2003 October 2003 November 2003 December 2003 January 2004 February 2004 March 2004 April 2004 May 2004 June 2004 July 2004 August 2004 September 2004 October 2004 November 2004 December 2004 January 2005 February 2005 March 2005 April 2005 May 2005 June 2005 July 2005 August 2005 September 2005 October 2005 November 2005 December 2005 January 2006 February 2006 March 2006 April 2006 May 2006 June 2006 July 2006 August 2006 September 2006 October 2006 November 2006 December 2006 January 2007 February 2007 March 2007 April 2007 May 2007 June 2007 July 2007 August 2007 September 2007 October 2007 November 2007 December 2007 January 2008 February 2008 March 2008 April 2008 May 2008 June 2008 July 2008 August 2008 September 2008 October 2008 November 2008 December 2008 January 2009 February 2009 March 2009 April 2009 May 2009 June 2009 July 2009 August 2009 September 2009 October 2009 November 2009 December 2009 January 2010 February 2010 March 2010 April 2010 May 2010 June 2010 July 2010 August 2010 September 2010 October 2010 November 2010 December 2010 January 2011 February 2011 March 2011 April 2011 May 2011 June 2011 July 2011 August 2011 September 2011 October 2011 November 2011 December 2011 January 2012 February 2012 March 2012 April 2012 May 2012 June 2012 July 2012 August 2012 September 2012 October 2012 November 2012 December 2012 January 2013 February 2013 March 2013 April 2013 May 2013 June 2013 July 2013 August 2013 September 2013 October 2013 November 2013 December 2013 January 2014 February 2014 March 2014 April 2014 May 2014 June 2014 July 2014 August 2014 September 2014 October 2014 November 2014 December 2014 January 2015 February 2015 March 2015 April 2015 May 2015 June 2015 July 2015 August 2015 September 2015 October 2015 November 2015 December 2015 January 2016 February 2016 March 2016 April 2016 May 2016 June 2016 July 2016 August 2016 September 2016 October 2016 November 2016 December 2016 January 2017 February 2017 March 2017 April 2017 May 2017 June 2017 July 2017 August 2017 September 2017 October 2017 November 2017 December 2017 January 2018 February 2018 March 2018 April 2018 May 2018


This page is powered by Blogger. Isn't yours?


Tuesday, October 18, 2016

Three ways the President alone can rein in prescription drug prices

by Gaius Publius

Along with many others, we recently wrote about Mylan's predatory price increases on the life-saving prescription drug product EpiPen. Then came the news that the interestingly named Valeant had increased the price of a prescription drug it had purchased, not developed, more than 2700%, apparently anticipating a growing lead poisoning crisis like the one in Flint, Michigan. ("Did your kids get sick from eating lead paint? We'll fix them right up ... for $27,000.")

At the end of the Valeant piece, I added a section that argued for an industry-wide — and Executive Branch-only — fix. Don't play Whack-a-Mole with individual companies, I argued. Whack drug prices industry-wide, or we'll always be chasing a shadow and fixing problems only when they're reported as scandals.

High prescription prices are an industry problem, not a problem of "outliers" (source; click to enlarge)

It turns out that Rep. Mark Pocan and a number of his colleagues have the same idea. From a letter Pocan wrote, and dozens of his colleagues signed, here are three specific suggestions that the next president can unilaterally enact, whoever she or he may be.

First, use existing statutory power to make sure that drugs developed in whole or in part by taxpayer funds are not monopoly-priced:
We believe your Administration should issue fair and transparent guidelines to ensure the public has access to lifesaving drugs developed using federally funded research. Specifically, you should instruct the Director of the National Institutes of Health to ensure that drugs researched and developed with taxpayer funds are kept accessible to the public by authorizing new competition for unaffordable, monopoly-priced medications—an existing statutory power granted by the Bayh-Dole Act (Pub. L. 96-517). This is an important step in deterring corporations from holding federally funded patented drugs from setting unreasonable prices.
This applies to a large number of drugs, by the way.

Second, there's existing authority to authorize prescription drug importation under some qualifications. Pocan, and frankly, the vast majority of the public, believes this authority should be used, and now.
Moreover, we also encourage your administration to explore implementing drug importation rules that are already part of U.S. law. Under authority from the Medicare Prescription Drug Improvement and Modernization Act of 2003, the Secretary of Health and Human Services can certify the importation of prescription drugs from other countries under specific qualifications. This regulatory action would pose no risk to public health and safety and could result in a significant reduction in the cost of prescription drugs to American families.
This authority, if used, should not be "triangulated" as a bargaining chip to negotiate just certain drug prices down. It should be applied as quickly, as broadly, and as aggressively as possible.

Put simply: The government is not in the business of making sure businesses make money — that's their job. The government has a Constitutional mandate to "promote the general welfare," the welfare, in other words, of the natural humans whose "consent of the governed" keeps that government in business.

Third, use authority that exists, but since Reagan, is almost never used, to curb monopolies (what used to be called violations of the "restraint of trade" prohibition):
We believe your administration also has the authority to address issues within the Federal Trade Commission [FTC] to more effectively combat monopolies held by pharmaceutical companies and the use of patent settlements to block all other generic drug competition for a growing number of branded drugs, also known as “pay-for-delay.” We are deeply concerned that pharmaceutical companies will continue this unethical and unlawful practice until necessary reforms are developed and implemented.
In the old days, the FTC was quite aggressive in blocking mergers and other monopolistic practices. Reagan simply stopped antitrust enforcement.
Capitalism without competition always leads to monopolies and oligarchies, and thanks to Reagan's refusal to maintain competition in our markets by enforcing the Sherman [Antitrust] Act, these formed in every major industry in America, from telecom to food and even the media.

Today, the Sherman Act is never used against the big boys. Big banks have grown out of control. Megastores like Walmart have wreaked havoc on local businesses, while telecom and cable companies like Comcast and AT&T have all of us in economic chains. Even our media has been consolidated.

Look at some of the companies that dominate the marketplace today. Google has 90% market share of internet search engines. Facebook has a 64% market share of social media sites. And Sirius/XM Radio has an astonishing 100% market share of satellite radio in this country.
The next president (and in fact, the current one, if he were so inclined) can fix that almost instantly. Of course, that president would need to understand her or his duty as being to the people (natural persons) and not to the profiteers.

But I have been told that this, by Hillary Clinton, is a reason for hope. So let's consider what Clinton proposes regarding prescription drug prices.

The Clinton Proposal

It's good that Hillary Clinton has a thoughtful proposal at her website (see link above) to address the problem of high prescription drug prices. The problem with the price aspect of the Clinton proposal (there are other aspects) is that it's mainly focused on "outlier" pricing, with this single exception:
Prohibit “pay for delay” arrangements that keep generic competition off the market. Hillary Clinton would prohibit “pay for delay” agreements that allow drug manufacturers to keep generic competition off of the market – lowering prices for Americans, and saving the government up to $10 billion.
Aside from that general action, none of the rest of what Rep. Pocan and his colleagues propose is included. For example, Clinton believes that Medicare should use its size to negotiate drug pricing down, but doesn't mention that this has been forbidden by Congress.

About prescription drug importation, the only mention is "emergency importation." Is the importation authority in the Pocan letter broader than just "emergency importation"? Perhaps; his letter doesn't address that point. But even so, each of the references to emergency importation in the Clinton proposal would be triggered by "outlier" pricing. The Pocan proposal would make importation the norm in the broadest sense allowed by law.

Lastly, the first Pocan proposal, using the Bayh-Dole Act, is not mentioned by Clinton at all.

It's imperative that Hillary Clinton and Donald Trump be put on the record now regarding these three specific proposals — now, before either enters the White House. Remember our Rule 47, which reminds us that we'll never have more leverage with candidates in a close race than before the vote is taken. That means we have not many days to press them both on this life-and-death issue.

(A version of this piece appeared at Down With Tyranny. GP article archive here.)