Drugs Cost Too Much In The U.S.-- Can Bernie Do Anything About It?

I had a nice time in Thailand— my first trip away from home since the advent of COVID. There are a lot of reasons to go to Thailand— great food for example. And I was so happy to get out of the cold weather in L.A. and into the 100 degree daily temperature in Bangkok. That’s what happens when you get old. You know what else happens when you get old? You start needing all these fancy, expensive drugs… like these:

That’s a two year supply of Vimpat (locosamide), an anticonvulsant that relieves neuropathic pain, the kind of pain that is a common side effect of some of the drugs used in chemotherapy. I wound up in remission but with a permanent case of peripheral neuropathy. The Vimpat keeps it, more or less, in check. Medicare doesn’t cover it and it costs slightly over $1,000 month— about $25,000 for a two year period. I bought 2 years worth in Thailand. It cost me around $3,000. That’s quite a savings— and more than covered the cost of my vacation.

Yesterday, the Washington Post noted that Bernie is threatening to block Biden health appointees who are too soft on drug industry. Go Bernie! He said that “Health and Human Services nominees who aren’t prepared to “stand up and fight” the drug industry will likely lose his vote. ‘I will strongly oppose any future nominee to a major federal health agency who is not prepared to significantly lower the price of prescription drugs in this country,’ the Senate health panel chair wrote to President Biden last week, in a letter shared with The Post.”

Sanders said his new rules apply to any upcoming health nominee— whether an agency director or assistant secretary— he stressed in an interview with The Health 202. And as head of the Health, Education, Labor and Pensions Committee, Sanders has the power to slow-walk nominees, assuming he schedules their confirmation hearings at all.

“I want action here. I want this administration and its nominees and its appointments to start addressing the prices of the high costs of prescription drugs,” he said.

It’s not an empty threat. Sanders has opposed Biden’s nominees before— a point he underscored in his letter to the president.

“As you know I voted against the confirmation of Dr. Robert Califf, the head of the FDA, because of his unwillingness to stand up to the greed of the pharmaceutical industry,” Sanders wrote. (Califf, a cardiologist who worked at Verily and spent years working with drug companies on clinical trials, was confirmed in a narrow 50-46 vote last year; allies defended Califf’s work with the drug industry and said his perspective would be useful to the Food and Drug Administration.)

Sanders’s threat has also grown sharper given the narrow margins in the Senate. With Sen. Dianne Feinstein (D-CA) recuperating from an illness in California— effectively leaving Democrats with a 50-49 majority— Sanders could block a Biden health nominee if he joined with Republicans in a party-line vote.

What does this mean for Biden’s likely nominee to lead the National Institutes of Health? The Post and others have reported that Monica Bertagnolli, a cancer surgeon who leads the National Cancer Institute, is set to be nominated as NIH director. Bertagnolli has prior work with biotech companies; a list of her disclosures is at the bottom of this 2019 blog post as president of the American Society of Clinical Oncology.

Sanders sidestepped questions on Bertagnolli’s candidacy, and it’s not yet clear if he would support her. A source familiar with the situation said that Sanders in March proposed three potential NIH directors to the White House: Aaron Kesselheim of Harvard Medical School, Vincent Rajkumar of Mayo Clinic, and Sarah Szanton, dean of the Johns Hopkins School of Nursing. Sanders also personally discussed their candidacy with White House Chief of Staff Jeff Zients, the source said.

Beyond NIH, it’s not clear when the next major health agency opening will be. While HHS Secretary Xavier Becerra and CDC Director Rochelle Walensky have faced internal frustrations, both have survived past the midterms, often a time when the White House makes personnel changes.

Sanders’s rationale: “Fundamental changes” in HHS policies are “long overdue.” The senator said that he has long-standing concerns that health leaders aren’t using all of the tools at their disposal, citing decisions at the Centers for Medicare and Medicaid Services, FDA and NIH.

“No drug therapy, no matter how effective and life-saving it might be, is worth anything to the person who can’t afford it. Further, the high cost of prescription drugs has resulted in tens of billions of unnecessary costs to Medicare, Medicaid and other federal programs,” Sanders wrote to Biden.

For instance, he pointed to NIH’s rejection of a petition by prostate cancer patients to allow the government to step in and license patent rights to another manufacturer for pricey cancer drug Xtandi as an example of a policy that he wants the agency to reverse.

Sanders also said that the agency needs to take a harder line with the private sector, citing how NIH supported Moderna’s research and development of its mRNA vaccine but has struggled to influence the company’s subsequent financial practices, even as its founders became billionaires.

NIH should tell industry partners, “We are prepared to help you develop prescription drugs, on dementia, on Alzheimer’s, on cancer, whatever it may be, we’re prepared to put money into it,” Sanders said. “But on the other hand … you’re not going to be able to charge any price you want.”

So… while we’re on the topic, which crooked members of the House took the most money from the pharmaceutical industry? These figures are for 2022— and just for members still in Congress (so not, for example, for criminal bribes takers like Kurt Schrader, who was defeated in a primary). These are all people who have sold their votes— and their voices— to the drug industry and the reason why drug prices are so much higher in this country than anywhere else:

• Cathy McMorris Rodgers (R-WA)- $419,195

• Scott Peters (New Dem-CA)- $399,540

• Brett Guthrie (R-KY)- $343,700

• Larry Buschon (R-IN)- $223,300

• John Curtis (R-UT)- $213,400

• Frank Pallone (D-NJ)- $199,460

• Anna Eshoo (D-CA)- $198,375

• Kevin McCarthy (R-CA)- $194,328

• Tony Cardenas (D-CA)- $178,400

• Vern Buchanan (R-FL)- $177,100

• Richard Hudson (R-NC)- $176,702

• Brad Wenstrup (R-OH)- $168,400

• Robin Kelly (D-IL)- $160,800

• Darin LaHood (R-IL)- $155,600

• Brad Schneider (New Dem-IL)- $152,402

• Josh Gottheimer (New Dem-NJ)- $151,938