Lambert here: Inside like a lion, outside like a lamb. (Democrats not only managed to avoid moving to single-payer during a pandemic, they succeeded in erasing it entirely from the discourse. Impressive.)
By KHN Senior Correspondent Arthur Allen, who writes about the FDA and the pharma industry as well as covid-related topics. Originlly published at Kaiser Health News.
Senator Bernie Sanders, who has gained national prominence criticizing big business in general and the pharmaceutical industry in particular, shone the spotlight on Wednesday on what might at first glance seem like a powerful new step from which to take his Program: Chair of the Senate Health Committee.
But the hearing that Sanders used to snitch on a billionaire pharmaceutical executive for raising the price of a covid-19 vaccine showed the challenges the Vermont independent faces.
Although its official name is the Health, Education, Labor and Pensions (HELP) Committee, the panel that Sanders chairs has little or no authority over drug prices. In the Senate, most of that leverage belongs to the Finance Committee, which oversees Medicaid, Medicare and Obamacare.
When it comes to drug prices, the platform Sanders commands is essentially a bully pulpit. So Sanders had to fight his way to the results. And while some Republicans on the committee sympathized with his complaints, others bristled at his approach.
At the end of the hearing, appearing to recognize the limits of his power, the former presidential candidate pleaded with Moderna CEO Stéphane Bancel for a relatively modest concession on the price of vaccines.
The CEO made no promises. Again, pulpit proclamations can lead to corporate action, even if they are delayed and informal; in the weeks following President Joe Biden’s State of the Union call for cheaper insulin, the companies that make it slashed their prices dramatically.
Sanders began Wednesday’s hearing with his usual fire and brimstone.
“Across this country, people are getting sicker and, in some cases, dying, because they can’t afford the exorbitant cost of prescription drugs, while corporations make huge profits and leaders become billionaires,” Sanders thundered.
Bancel had won his place in the witness chair with the help of the federal government. Moderna, which was founded in 2010 and hadn’t brought a drug to market before the pandemic, has received billions in public research funds, guaranteed purchases and expert advice to help develop and produce its successful covid vaccine. The gain was beautiful. As of March 8, Bancel owned $3 billion worth of Moderna stock. He also held options to buy millions more shares.
Research and government support are the basis for many of the expensive drugs and vaccines used today. But Bancel made himself the perfect foil for Sanders when he announced in January that Moderna planned to raise the price of its latest covid shot by around $26 to $110 — or as high as $130.
Calling out greed, Sanders outlined his dream of a system in which the government fully funds drug development – and in return controls drug prices. “Is there another model where when a life-saving drug is made, it becomes available to everyone who needs it?” He asked. “What am I missing thinking it’s cruel to make a drug that people can’t afford?”
Sanders’ openly judgmental and harsh attacks on big business make him an exception in the Senate, even in his own party. Still, the distaste for soaring drug prices stretches across the aisle. On the HELP committee, at least, Republican politicians seem about evenly split between populist and pro-business positions on the issue, showing both the possibilities and the pitfalls that Sanders faces.
Sen. Mike Braun (R-Ind.) expressed disgust at the lack of transparency in the healthcare system and called Moderna’s planned price hike “absurd.” Sen. Roger Marshall (R-Kan.) called it “outrageous.”
Sen. Rand Paul (R-Ky.), who often goes against mainstream GOP views and has expressed resentment for the biomedical establishment, claimed Bancel downplayed vaccine injuries to gain traction. money. (Paul greatly exaggerated these risks.)
Ranking member Bill Cassidy (R-La.), who has pledged to work with Sanders, responded to the president’s opening remarks with a hedge and a warning. “I’m not defending wages or profits,” Cassidy said, but he added that he hoped the purpose of the hearing was not to “demonize capitalism.”
Only Sen. Mitt Romney (R-Utah), a former private equity executive, came warmly to Bancel’s defense. “If I’m an investor, I have to expect that if a product that I support works, I’ll make a lot of money,” he said. “I’ve heard people say, ‘It’s corporate greed.’ Yeah, that’s how it works.
Sanders’ idealized vision of the pharmaceutical industry is, in any case, moot. Even the Biden administration, which successfully convinced insulin makers to drastically cut prices in March, unveiled this week it would not use the entry fees to lower the price of an anti-cancer drug, Xtandi, developed under government-licensed patents.
Admission fees were established in the Bayh-Dole Act of 1980, which allowed companies to license federally funded research and use it to develop drugs. But federal courts and agencies have consistently said the government can seize a product only if the licensee has not made it available, not because the price is too high. However, the administration has announce a notice whether the price could factor into future march-in decisions.
Sanders said before the hearing that he was “extremely disappointed” with Xtandi’s decision. But he was ultimately realistic enough to aim his bullying pulpit at a lower target. Late in Wednesday’s hearing, Sanders pushed for minimal Moderna freebies. “Will you reconsider your decision to quadruple the price of your vaccine to the US government and its agents? he asked politely.
Bancel dodged, saying pricing was more complex now that Moderna faced an uncertain market, had to fill separate syringes with its vaccine, and had to sell and distribute the vaccine to thousands of pharmacies, where the government used to do all that work. . Later, he left open the possibility that the negotiations could lower the price paid by certain government agencies or private insurers.
For all the theatrics of these hearings and the mix of opinions among senators, the interrogations of figures like Bancel may help inspire change in the way the National Institutes of Health “do business by giving their science to the private sector.” , said Tahir Amin. , co-executive director of I-MAK, a non-profit organization that campaigns for equitable access to medicines.
“You have to pursue it in order to at least get that public commentary,” Amin said. Eventually, he said, this kind of hearing could lead to a recognition that “Hey, we have to do this.”
Despite the HELP committee’s lack of direct jurisdiction over drug prices, said John McDonough, a Harvard professor who served as a senior health reform adviser on the HELP committee from 2008 to 2010, Sanders “uses his position of authority and influence to draw attention to this in a way that has been helpful.
KHN correspondent Rachana Pradhan contributed to this report.