Biden Urges Action on Build Back Better Bill, Especially Drug Pricing Provisions

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WASHINGTON — President Biden took to his bully pulpit Monday to urge Congress to pass the Build Back Better bill and specifically the provisions in it to lower the cost of prescription drugs, including insulin.

“We’re going to end the days when drug companies could increase the prices with no oversight and no accountability,” Biden said in a speech from the East Room of the White House. “Going forward, drug companies that increase the prices faster than inflation are going to face a steep excise tax. We’re saying to drug companies, ‘When your prices to the American people go up, you’re going to be accountable.'”

The president began his remarks by acknowledging the “groundbreaking, life-saving” work many pharmaceutical manufacturers are doing. “Look no further than vaccines and the treatments they’re manufacturing and delivering that are helping fight this pandemic,” he said. “Our miraculous therapies have, in some cases, turned diseases that were once considered death sentences into treatable conditions.”

However, Biden continued, “we can make a distinction between developing those breakthroughs and jacking up prices on a range of medicines which have been on the market for years without making a substantive change in the medication itself. Here in America, it will not surprise you to know that we pay the highest prescription drug prices of any developed nation in the world … We pay about two to three times what other countries pay for the same drug.” For example, one anti-cancer drug that costs $14,000 in the U.S. costs only $6,000 in France, he noted, adding that today, “one in four Americans who take prescription drugs have struggled to afford them.”

Insulin is a particularly egregious example of the problem, according to the president. Although one bottle costs less than $10 to produce, “for certain types of insulin, prices have increased by 15% or more each year for the past decade. Depending on the nature of someone’s type 1 diabetes, the average sticker price for a month’s supply of insulin is about $375 — but for some people, it can be as high as $1,000 a month because they need to take more.”

To address this problem, the Build Back Better bill, which has been passed by the House but not by the Senate, would cap patient cost-sharing for insulin at $35 per month. “Whether you get health insurance through private policy, the Affordable Care Act (ACA) marketplace, or through Medicaid, nobody is going to pay more than $35 each month for insulin,” Biden said. The bill also would make it less expensive for low-income people to sign up for health insurance on the ACA’s insurance exchanges, and would add a Medicaid-like program in states that haven’t expanded Medicaid under the ACA; both types of insurance would include a drug benefit.

For those on Medicare, the bill includes a provision allowing that program to negotiate prices with drug companies, although the provision limits negotiations to a small number of drugs — starting with 10 drugs in 2025 and increasing slightly in subsequent years — as well as all insulin products. “What I’m proposing is that we negotiate a fair price, one that reflects the cost of research and development, and a need for significant profit, but that is still affordable to consumers,” said Biden. “Right now, drug companies will set the price at whatever the market will bear.” The bill also would cap the amount that seniors on Medicare have to spend on prescription drugs at no more than $2,000 per year, with Medicare and drug companies picking up the rest of the cost.

“I’ve long said healthcare should be a right, not a privilege, in this country,” Biden concluded. “We need Congress to finish the job, to come together and make the difference in people’s lives.”

Biden was preceded by Iesha Meza, who talked about her problems affording insulin since being diagnosed 9 years ago at age 21 with type 1 diabetes. “Imagine every day having to ask questions like, ‘Should I pay my rent, or should I risk death by forgoing my medication? Should I buy groceries or my insulin and other necessary supplies related to diabetes?’ I had to make this choice relentlessly without relief every day,” she said. “There came a time where I could no longer afford my insulin. I was forced to ration my supply of drugs … I felt myself growing weaker and weaker each day. I could actually feel myself slowly dying.”

“One day I was rushed to the hospital, where they told me I was in diabetic ketoacidosis,” she said. “I slipped into a diabetic coma, and I could have died. This was a terrifying incident. I was ashamed that I couldn’t afford my life-saving medication.” Today Meza has employer benefits and can afford insulin. “I’m fortunate, but I know there are thousands of people facing this struggle,” she added. “I’m plagued with the fear that I may not be able to afford my insulin again. I want to see a future where young people like me don’t have our lives revolve around our prescription drugs, and we don’t have to make career and life choices around insurance benefits.”

Not surprisingly, drug companies were not happy with the president’s speech. “A damaging bill jammed through a partisan process will not provide patients struggling to afford their medicines meaningful relief,” said Stephen Ubl, president and CEO of the Pharmaceutical Research and Manufacturers of America, in a statement. “We know when government bureaucrats set the price of medicine, patients ultimately have less access to treatments and cures. The bill also stifles the development of new uses for and improvements to medicines after they are first approved, threatens the introduction of generic and biosimilar medicines, and unwinds successful incentives that spur the development of treatments for rare diseases.”

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    Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy. Follow

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