[Congressional Record Volume 145, Number 25 (Thursday, February 11, 1999)]
[House]
[Pages H626-H631]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
THE PRESCRIPTION DRUG FAIRNESS FOR SENIORS ACT OF 1999
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 6, 1999, the gentleman from Arkansas (Mr. Berry) is recognized
for 45 minutes as the designee of the minority leader.
Mr. BERRY. Mr. Speaker, I rise today in support of the Prescription
Drug Fairness for Seniors Act of 1999. I want to thank my colleagues,
the gentleman from Maine (Mr. Allen), the gentleman from Texas (Mr.
Turner), and the gentleman from California (Mr. Waxman), for coming up
with this great idea to help correct a tremendous injustice in America
today.
Our senior citizens pay over twice as much as citizens in other
countries. They pay over twice as much as the preferred customers of
the prescription drug manufacturers in this country, and it is simply
not fair.
This chart demonstrates the way that our seniors are overcharged and
the amount they are overcharged for their prescription medications.
They are forced to make a choice between food and medicine, between
paying their rent and having medicine, between having utilities, having
heat, and medicine. This is simply not right.
The First Congressional District of Arkansas, that I am so fortunate
to represent, contains the most senior citizens of any Congressional
District in this country that live only on social security. The cost of
prescription medication is a tremendous burden for them. Yet, we allow
them to continue to be overcharged by 40 and 50 and 60 and 70 percent.
They are overcharged by the most profitable companies in the world.
These companies should be profitable. We are in favor of them being
profitable. But that profit should not come at the expense of our
senior citizens being forced to choose between food and the medicine it
takes to keep them alive. When that happens, it becomes a moral issue.
It becomes an issue that this Congress should address.
Our bill, the Prescription Drug Fairness for Seniors Act of 1999,
will reduce the cost of prescription medication for our seniors
approximately 40 percent. Our seniors should not be at a disadvantage
because they are citizens of the United States.
The average prescription price for Canadians is 72 percent less than
it is for Americans. For Mexican citizens, it is 103 percent less than
it is for Americans. This simply does not make any sense. If the
prescription drug manufacturers that sell product in this country can
sell it at other countries at much reduced rates, if they can sell it
to our Federal Government at much reduced rates, these same prices
should be available to our seniors. That is what this bill does.
One company last year raised the price of one of their medications
4,000 percent in one day. The Federal Trade Commission looked at this.
They decided it was unfair and they filed a $120 million recovery claim
against this company. This is an outrageous attempt to make a profit.
The Prescription Drug Fairness for Seniors Act of 1999 will reduce
those prices, as I have said, by 40 percent to most of our recipients.
It is something we should do. It is the fair and right thing to do. It
does not cost the Federal Government any money. This will simply make
our seniors part of the largest purchasing pool in the world, and it
will give them the ability to be dealt with fairly through their own
local pharmacies.
I urge my colleagues to support this bill. It is a good bill, and it
is what we should do for our seniors.
Mr. Speaker, I yield to the gentlewoman from Texas (Ms. Sheila
Jackson-Lee).
Ms. JACKSON LEE of Texas. Mr. Speaker, I thank my good friend, the
gentleman from Arkansas (Mr. Berry), for his leadership on this issue,
and as well, my colleagues, the gentleman from Maine (Mr. Tom Allen),
the gentleman from Texas (Mr. Jim Turner),
[[Page H627]]
and the gentleman from California (Mr. Waxman) for their leadership on
a crucial and devastating fact of life for our seniors in America.
It is important to note that those of us who have worked on this
issue believe that this is the Congress to get it through. I am
delighted that as an original cosponsor of this legislation for this
Congress, I again stand up to be counted, as I did in the 105th
Congress. I do that for the many constituents that I represent.
In fact, Mr. Speaker, allow me to share the story of a husband and
wife from my district in Houston written to me just a few days ago in
January. These individuals retired, having worked in our school system
educating our young people, and now in their retirement they are
pleading for relief because presently they are spending an average of
$4,792 annually on drugs, paid by a Texas teacher's retirement income
and social security. One-fifth of their income is used to pay for
prescription drugs.
{time} 1615
I would simply say, Mr. Speaker, this has got to stop. That means
that these senior citizens who have worked all of their life, who, in
fact, have a commitment to being part of the engine of this economy for
many, many years, are now having to sacrifice the meager income that
they have and to make choices, as my good colleague indicated, between
room and board, and health.
The Prescription Drug Fairness for Seniors Act is not a giveaway. It
does not interfere with competitiveness, as my pharmaceutical friends
have said. It does not do damage to the marketplace, as they have
attacked us so readily.
What it does is it simply tries to emphasize fairness. Pharmacies
will now be able to purchase prescription drugs for Medicare
beneficiaries at the same low prices available to the Federal
Government such as the Federal supply schedule price or the medicaid
price.
Since drug prices presently paid by the Federal Government are
approximately half the retail prices paid by senior citizens,
participating pharmacies will be able to pass on large cost savings to
senior citizens.
I know that my good friend, the gentleman from Arkansas (Mr. Berry)
has been in his district and has seen the sincerity expressed by
seniors who have said they do not want a handout, but after we have
given them the option of Medicare why shouldn't Medicare have the same
ability to be able to purchase low priced pharmaceuticals,
competitively priced equal to that of the HMOs?
Has anyone ever been in the midst of seniors, maybe those who are a
little older, in their seventies and eighties, and heard them plead to
us for clarity about these HMOs? Who am I to pick? What are they giving
me? The confusion abounds and yet now we have promoted these HMOs over
Medicare that has been so helpful in providing good health care for our
seniors, and we have given HMOs the upper edge by providing these
incentives, and yet sometimes seniors are moved from one HMO to the
next. It shuts down and they get letters, and it is confusing.
Oh, yes, I believe that HMOs provide a viable service, but those who
are on Medicare should not be deprived the ability to get low-priced
prescription drugs and to have a fairness process in place.
So I believe that we are, in fact, providing what the Constitution
says we should have, and that is equality. And we are doing it for a
population that is now suffering. They suffer because of the way
pharmacies are doing business, and many Americans whose retirement
plans rely in part on private pension plans are also struggling. This
is because many of those plans which were designed decades ago do not
contain comprehensive medical plans, and even the ones that do include
medical insurance typically do not pay for medication.
In fact, I have talked to senior citizens who have said I am going to
get that mail order program because I have heard that if you do mail
order, that you can get cheap prescription drugs.
So I think it is important, Mr. Speaker, that this legislation not
have one moment of a slow process. It should be expedited. It should go
through the committees of jurisdiction with flying colors. We should
respond to the tragedy of senior citizens having to make choices
between what they will buy, whether they will pay for food for the
evening meal or which meal they will escape or not be able to have so
that they can get the necessary prescriptions.
I will just simply say, as we work together on this legislation,
tears have come to my eyes when I have met with senior citizens who,
first of all, are grateful for life, gratified for the medical care
that many of them have been able to access, but when they give me the
list of prescriptions that they have to take every single day, they do
not do it in anger, they just simply say we have got to take it but
give us a reprieve, help us not to be have to choose one over the
other. So I want to thank the gentleman.
As I close, I want to just make a personal note that from my home
district, in addition to these prescription drugs, I am gratified for
the medical health system, of which we also need to look at with the
Patients' Bill of Rights, access to medical care. I am grateful for the
system that is in my community, the public hospital system, now under
attack by county government. My commitment to the senior citizens of
that community, the children of that community, is to say that I am
going to fight for this legislation, the Prescription Drug Fairness for
Seniors Act, as well as a patients' bill of rights, as well as fighting
for Lois Morris, our health care director in Harris County, and fight
against anybody who would move to shut it down or to deprive our
citizens of good health care by cutting the budget.
I want to thank my friend, the gentleman from Arkansas (Mr. Berry). I
want to thank my good friends, the gentleman from Maine (Mr. Allen),
the gentleman from Texas (Mr. Turner) and the gentleman from California
(Mr. Waxman), and I see the gentlewoman from California (Mrs. Capps)
and I know the gentlewoman from Michigan (Ms. Stabenow), and if I begin
calling the roll we all can stand up here and be gratified that we are
working together for what I know can be bipartisan legislation to see
this legislation passed.
I thank the gentleman from Arkansas (Mr. Berry) for his kindness. Let
us roll up our sleeves and get to work.
Thank you Congressmen Berry, Allen and Turner for giving me the
opportunity to speak on this bill, and for allowing me to help you
tackle this tremendous problem.
This year, many of us have taken up arms to preserve Social Security
and Medicare, so that we can ensure in the future that our Older-
Americans have at least the bare minimums needed to live in this
society.
However, seeing that Social Security and Medicare, are in some
respects, anti-poverty programs, we must supplement the law to protect
the interests of senior citizens who rely on them in the later years of
their life. One of the ways that we can do that is by guaranteeing that
the senior citizens that rely on those programs are subjected to
discrimination by the private sector.
This bill does just that, by allowing pharmacies to purchase
prescription drugs for Medicare beneficiaries at low prices. The bill
uses naturally-occurring market forces to consolidate the purchasing
power of our Medicare recipients. And by doing so, it, in affect, puts
senior citizens on the same footing as the federal government when it
purchases medication--which makes sense, because in a way, the
government is paying for these drugs in an indirect manner.
This bill also aims to stop the price discrimination that affects
Older-Americans that are unable to purchase their prescription
medication through HMOs or other health care providers. As the studies
underlying this bill demonstrate, it is a fact that our Medicare
recipients' dollars are being used to subsidize the low drug prices
that group health care participants are privy to in our current
economy. I believe that most of you will agree with me when I say, that
is not what our precious few Medicare dollars should be used for!
I would like to add that Medicare recipients are not the only ones
who suffer because of the way pharmacies are forced to do business
today. Many Americans whose retirement plans rely in part on private
pension plans, are also struggling. This is because many of those
plans, which were designed decades ago, do not contain comprehensive
medical plans. Even the ones that do include medical insurance
typically do not pay for medication. That means that most must still
stretch their finances to pay for the medication that is required for
their continued good health.
[[Page H628]]
This is illustrated by a letter I recently received from a
constituent in my district, in support of this bill, that reads: ``My
wife and myself have supplemental insurance which does not include
prescription drug reimbursement. Presently, we are spending an average
of $4,792 annually on drugs . . . (which is) one-fifth of our income.''
One-fifth of their income is a staggering amount Undoubtedly, something
must be done to alleviate their problem, and the least we could do is
protect them from price discrimination.
This bill is tremendous because it relies on tried and true
principles of capitalism, purchasing power and competition, to craft a
remedy that will save the federal government, and my constituents from
inflated prices--and I will be glad to support it as it makes its way
through the House of Representatives.
Mr. BERRY. I thank the gentlewoman from Texas (Ms. Jackson-Lee) for
her comments.
Mr. Speaker, I yield to the gentleman from Maine (Mr. Allen), the
author of this bill.
Mr. ALLEN. Mr. Speaker, I thank the gentleman from Arkansas (Mr.
Berry) for yielding.
We should all know that the gentleman from Arkansas (Mr. Berry) is a
registered pharmacist. He is, with the gentleman from Texas (Mr.
Turner) and myself, a co-chair of our prescription drug task force.
Really, no one has done more than he has to bring these issues out so
the American people can understand that we in Congress are trying to do
something about it.
I thought what I would do is take a little time and talk first about
our seniors, then review the current status of some of the
pharmaceutical companies and then talk about H.R. 664, the Prescription
Drug Fairness for Seniors Act that I introduced yesterday with 66
cosponsors.
Let us talk first about our seniors. All across this country, as we
speak, seniors are not following their doctors' orders. Some of them
have been given prescriptions which they cannot afford to fill. Others
have filled prescriptions which they cannot afford to take as directed.
What happens is, because they cannot pay the rent, pay the electrical
bills, buy food and take very expensive prescription drugs, they are
out there taking one pill out of three, mixing and matching. They are
doing things that in the long run really are detrimental to their
health.
I know for the gentleman from Arkansas (Mr. Berry), the gentleman
from Texas (Mr. Turner) and others, we get letters in our Congressional
offices, and I want to share some of those letters.
I received a letter last July, and I have had others like this since
then, from a woman who said here is a list of the prescription drugs
that my husband and I are expected to take, and when you added up the
cost it came to $600 a month. Then she said, here is a copy of our two
Social Security statements, and when you added up their two Social
Security statements, which is all they had on a monthly basis, it was
$1,350.
One cannot get there from here. The math does not work. There is no
way that couple could afford to take the prescription drugs that their
doctors tell them they have to take.
Perhaps the most poignant letters come to me from people who write
and say, I do not want my husband to know but I am not taking my drug
medication because we cannot afford both his and mine and it is more
important that he take his medication than I take mine. So we have
women out there, or men, not taking their own drugs so that their
spouse can take his or hers. It is not right in this country and it
should not continue.
The reason is, the study that we did in my district in Maine, back in
July of 1998, which has since been replicated in 19 districts across
the country, including the gentleman from Arkansas (Mr. Berry), the
gentleman from Texas (Mr. Turner) and a variety of other people, and
the findings are always the same. The findings show that seniors who
have no coverage for prescription drugs walk into their local pharmacy
and pay a price for their drugs that is, on average, twice what the
drug companies' best customers are paying.
The best customers are big HMOs, the Federal Government, and others,
who can buy in bulk and control market share.
It is not right. This degree of cost shifting has a result. This
price structure in the pharmaceutical industry right now means that the
pharmaceutical industry, in effect, is charging its highest prices to
those who are least able to pay; and those least able to pay are a big
group. They are 37 percent of all seniors in this country.
When Medicare was created in 1965, there was no prescription drug
benefit because, frankly, it was not a big deal then. The drug
companies have made enormous progress in developing new drugs. They
have helped millions of Americans, old and young, live more productive
lives. What we have got now is a degree of cost shifting in the
industry that is imposing the highest costs on those seniors who do not
have any coverage for their prescription drugs.
Medicare does not cover prescription drugs. Most medigap policies,
when they cover prescription drugs, and often they do cover only a
portion of the cost, and the result is that, as I said, 37 percent of
all seniors have no coverage and others are uninsured.
The drug industry, pharmaceutical industry, is the single most
profitable industry in the country. Last year, Fortune Magazine
indicated they had the highest return on equity, the highest return on
assets of any industry in the country. They are making their profits on
the back of uninsured seniors who simply cannot take all the
medications that their doctors tell them they have to take.
If I can talk about the bill just for a moment and then defer to
others, the bill we introduced yesterday, H.R. 664, the Prescription
Drug Fairness for Seniors Act, is probably one of the simplest pieces
of legislation we could possibly introduce in this area. We are not
creating a big new government program. We are making a suggestion that
would involve very little expense to the Federal Government. All we are
saying is that the Federal Government should, in effect, be the
negotiating agent for Medicare beneficiaries so that they can get the
best price that is given to the Federal Government through the Veterans
Administration, off the Federal Supply Schedule or through medicaid.
That is all we are saying.
They ought to have advantage, those people, Medicare beneficiaries,
all of whom are now on a Federal health care program, Medicare, which
is saying they ought to be able to get the best price from the drug
companies that the Federal Government gets now, and the way that would
work is through the Department of Health and Human Services.
Participating pharmacists would be able to buy drugs for resale to
Medicare beneficiaries at the best price the Federal Government buys
those drugs. Simple bill, very simple, as close to a free market
solution as you can get. The pharmaceutical industry objects.
I would thank the gentleman from Arkansas (Mr. Berry) for yielding me
this time and would ask to come back later, after others have spoken,
to address a few of the arguments that I expect we will see as this
debate moves along.
Mr. BERRY. I thank the gentleman from Maine (Mr. Allen) and again
appreciate his leadership in this effort.
Mr. Speaker, I now yield to the gentlewoman from Michigan (Ms.
Stabenow).
Ms. STABENOW. Mr. Speaker, I thank the gentleman from Arkansas (Mr.
Berry) for yielding.
I want first to thank the gentleman from Arkansas (Mr. Berry) for his
leadership in the last Congress and as we begin this Congress; also the
gentleman from Maine (Mr. Allen), the gentleman from Texas (Mr.
Turner), who has also worked so hard, and the gentlewoman from
California (Mrs. Capps), who is here today.
This is such an important issue for all of us, and as we make a
commitment, and I know on our side of the aisle we have made a
commitment, that the majority of the surplus that we have been reaping
as a result of a strong, vibrant economy, will go back into paying off
the Social Security Trust Fund and keeping Medicare strong, an
important part of that is this bill that we are talking about today,
the Prescription Drug Fairness for Seniors Act.
{time} 1630
I think of my own family, where I have had my aunt, who is having
back problems and finding herself now needing to pay $200 to $300 a
month for prescriptions; other friends of my mother's who are looking
at $500 or $600 a
[[Page H629]]
month in prescription drugs in order to be able to live at home and be
able to continue to be able to live in the community and be able to
move around and be independent, and when I look at those kinds of
numbers, it is very clear to see that for too many seniors we are
talking about the difference between food for the month and getting
their prescription drugs so that they are healthy and pain free and
able to stay well, or we are talking about the difference between
paying the rent or paying the electric bill. This is basic survival for
too many seniors.
When we look at the costs that continue to go up and up, as I know
the gentleman from Arkansas (Mr. Berry) has talked about, the fact that
we are seeing these costs go up, and that we have not yet addressed
this through the Medicare system or in some other way, I think this is
really a tragedy, and that is why I am so excited to be a cosponsor of
this legislation.
This legislation, in a very cost effective way, as the gentleman from
Maine (Mr. Allen) said, has a very simple approach: Let us get the best
price; let us let the Federal Government negotiate on behalf of all
uninsured seniors that need prescription drug help; let us let them
negotiate the best price for our seniors who are on Medicare; and then
let the pharmacists be able to receive that best price and pass it
along to the seniors. So it makes sense.
It does not involve a lot of new dollars being spent and it addresses
one of the critical issues for our seniors as they are growing older:
Living longer and wanting to benefit from all these wonderful new
discoveries that allow them to live independently; to be able to leave
a hospital sooner rather than later after an operation; to be able to
avoid a nursing home as long as possible. There are wonderful new
opportunities for them through prescription drugs. What a shame, what a
shame if they are not able to afford these new opportunities because of
the spiraling costs.
So I once again celebrate and really commend the leadership of the
people who are here today, who are really fighting on the front lines
for our seniors, and I am hopeful that by the end of the year we will
see this in place so that we can really lower the costs for seniors and
help them to be able to balance that budget of theirs just a little
better.
Mr. BERRY. Mr. Speaker, I thank the gentlewoman from Michigan, and I
yield 5 minutes to the gentlewoman from California (Mrs. Capps).
Mr. CAPPS. Mr. Speaker, I want to thank the gentleman from Arkansas
(Mr. Berry) for organizing this important time for us to speak today,
and I am so honored to join my colleagues and the others really who are
speaking around the country who are trying to give voice to our seniors
as we bring to the attention of the House of Representatives a
veritable scandal, I believe, which is occurring in our country today.
I know that seniors on the central coast of California, where I live,
and I believe that we are seeing evidence that seniors throughout the
country, are paying outrageously high prices for their prescription
drugs. Even worse, these inflated costs subsidize the discounts that
high-profit HMOs get for these very same drugs. These inflated costs
are rising every day, so they are rising at a faster rate even than the
cost of living. Seniors are paying more this month than they paid a few
months ago for their prescription medications. And this unfair practice
has caused many of our older Americans to cut back on their
medications, leading some to choose between buying food or filling
their prescriptions.
Last September I conducted the first comprehensive study of the
impact that these big drug companies' high prices are having on the
central coast of California's senior citizens. My office then released
a report on the cost of prescription drugs for seniors and, more
importantly, a major reason why these costs are so high, and the
findings are startling.
Seniors in my district pay, on average, 113 percent more for the 10
most widely prescribed drugs than do the HMOs buying the same drugs.
These are critical medications, like Zocor, for reducing cholesterol;
Norvase, for reducing high blood pressure; and Relafen, for relief from
arthritis. Prescription drug companies give huge discounts to managed
care companies for these and other drugs. Other buyers, such as
pharmacists, pay substantially more for the same drugs and must pass
those higher costs on to their customers, many of whom are seniors.
The average senior fills between 9 and 12 prescriptions a year. This
is a far greater number than any other segment of our population. It is
estimated that the elderly, who make up approximately 12 percent of the
population, use one-third of all the prescription drugs.
Today, in Santa Barbara, in the News-Press, our local newspaper, it
was reported that Ticlid, one of the most widely prescribed medications
for persons who have had strokes, sells to HMOs for around $34 for 60
tablets. In my district, the average price seniors, who have to pay
out-of-pocket for this drug, are being charged an overwhelming $131,
nearly a 300 percent markup over the price the HMOs are paying.
This huge difference in prices is not going to the retail pharmacists
in Santa Barbara or Santa Maria or Arroyo Grande. According to my
study, the local pharmacists on the central coast are paying an average
of $100 to $110 for Ticlid.
The final price seniors pay includes only a reasonable markup to the
outrageous price that pharmacists are being forced to pay to the drug
companies. No, the extra money the seniors are paying goes to the drug
company so it can continue giving big discounts to HMOs and managed
care companies.
It is a very sad story that seniors are paying more in money for
drugs than they should while HMOs are reaping a huge profit based
partly on the huge discounts they get from drug companies. But there is
an even sadder element. Many seniors simply cannot afford these high
prices. They live on fixed incomes, especially as they keep on rising.
So, instead, they take half the prescribed dose or they do not buy
these lifesaving drugs because they cost too much.
For example, Harriet MacGregor, in Santa Barbara, told my staff that
because of the high cost of her five prescriptions she must sometimes
skip or reduce her dosage. As a nurse, I am particularly appalled when
I hear these stories. This is an intolerable situation. Seniors should
not have to be subsidizing the profits of the HMOs, and they should not
have to choose between filling their prescriptions or buying food or
paying rent.
I want to give credit to the pharmaceutical houses for developing the
medications that save seniors' lives and enable them to live quality
lives longer. These drugs are keeping our older Americans out of
hospitals and out of nursing homes. We want them to take the
medications. We have to find a way for them to be able to do this.
Yesterday, I was a proud cosponsor of legislation to address this
issue. This Prescription Drug Fairness Act for Seniors, introduced by
my good friends and colleagues, the gentleman from Texas (Mr. Jim
Turner), the gentleman from Maine (Mr. Tom Allen), and the gentleman
from Arkansas (Mr. Marion Berry), will allow pharmacists an opportunity
to receive the same big discounts that HMOs get for the drugs that they
dispense to seniors. This cost saving will be passed on to the seniors.
This legislation is long overdue and will ensure that seniors pay
reasonable prices for the lifesaving drugs they so desperately need. I
urge my colleagues to support this legislation.
This important bill brings to mind another related problem: 35
percent of American seniors have no prescription drug coverage.
Medicare, this health safety net for millions of elderly and disabled
Americans, does not cover outpatient prescription drugs. So many
seniors are forced to pay for these spiraling costs with absolutely no
assistance.
Mr. Speaker, we must examine ways to improve Medicare. As we do that,
I believe we must seriously consider extending prescription drug
benefits to the elderly and to the disabled. We should also ensure that
seniors are not subject to pharmaceutical price discrimination.
In closing, we can and should do everything we can to safeguard
access to these life-extending and life-enhancing prescription
medications for our seniors. I thank the gentleman for the opportunity
to speak.
Mr. BERRY. Mr. Speaker, I thank the gentlewoman from California, and
I
[[Page H630]]
yield 5 minutes now to the gentleman from Texas (Mr. Turner) and
congratulate him on his leadership in this matter.
Mr. TURNER. Mr. Speaker, I thank the gentleman from Arkansas (Mr.
Berry) for the leadership that he has given to this issue. And as a
pharmacist, the gentleman knows better than any of us the difficulties
that the cost of high drug prices are having on our senior citizens.
It is a privilege to have joined the gentleman from Arkansas, and the
gentleman from Maine (Mr. Allen), the gentlewoman from California (Mrs.
Capps), and the gentlewoman from Michigan (Ms. Stabenow) yesterday to
introduce once again into this Congress the Prescription drug Fairness
For Seniors Act, a bill that we introduced at the end of the last
session of Congress and that we are reintroducing now, early in this
session, because we believe that we will now have the opportunity to
see this legislation become law.
When I first became acquainted with this issue it was because of my
membership on the Committee on Government Reform and Oversight, where
our staff prepared a study of prescription drug costs in my district,
as well as in the district of the gentleman from Arkansas (Mr. Berry)
and many others who are with us here today. That study revealed that
the big drug companies are heavily discounting prices to their most
favored customers and passing on much higher prices to local retail
pharmacists, which means that our senior citizens, who have to buy
their prescription drugs in their own communities, are paying the
highest prices of anyone.
This is not a new phenomenon. Local pharmacists, I understand, have
known this for years. In fact, as I traveled across my district talking
about this bill, I found that many of our local pharmacists, who have
gone out of business in recent years, have done so because they have
been unable to compete because of the discriminatory pricing practices
that have been carried on for these many years by the big drug
companies. And most citizens, for years, have known that if they just
fly or drive into Mexico, or across into Canada, they can buy their
prescription drugs much cheaper than they can in their local pharmacies
here in the United States.
We all understand the big drug companies have made great progress in
their research and in providing the best pharmaceutical products the
world has ever known. And yet, in the course of the pursuit of that
practice and that good research, they have engaged in a discriminatory
pricing practice that has resulted in our senior citizens, those who
are least able to afford to buy prescription medications, having to pay
the highest prices.
One individual that particularly impressed me was a lady that I met
in Orange, Texas, when I held a brief press conference talking about
this bill toward the end of last year. Her name is Miss Frances Staley,
and a story about Miss Staley was recounted in the Houston Chronicle
back on November 22nd of last year.
Miss Staley is 84 years old. She has a Social Security check that she
has to live off of that totals about $700 every month. She spends over
half of that $700 just to pay for the 14 prescription medications she
has to take every day. Miss Staley in this article said this: By the
time I get through paying for my medicines, I have very little to live
off of. She goes on to recount that at one point she began to take a
pill and split it in half to stretch out her supply of her
prescription, but she was stopped after a stern rebuke from her doctor.
No senior citizen in this country today should have to struggle to be
able to pay for their prescription medications. Retirees, such as Miss
Staley, who must pay the full cost of their prescription drugs, are the
hardest hit of anyone due to the discriminatory pricing practices that
have been pursued by the big drug manufacturers.
Let us look at what that discrimination really is. I have here a
chart that shows three different prescription drugs that are used by
our senior citizens. One of them, right here in the middle, is
synthroid. That is a hormone treatment. The big drug companies sell
synthroid, a month's supply, to their most favored companies, the big
insurance companies, the HMOs, and even the government, for $1.78.
People like Miss Staley, in my district in Texas, they would have to
pay $25 for that same prescription. That is just not right.
Another drug, micronase, which is a medication for diabetics, the
most favored customers, the big insurance companies can buy that from
the drug companies for $6.89 for a month's supply. Miss Staley would
have to pay a price of $45.60.
Now, those high prices to Miss Staley are not the result of the local
pharmacy marking up that drug. The local pharmacies in this country
today have a very small margin. In fact, that margin has decreased in
recent years. That is why I was mentioning a minute ago that many of
them are having to close their doors.
We want to solve this problem, and the way we try to solve it in this
legislation is we simply provide that local pharmacies may purchase
their prescription drugs that they resell to Medicare eligible
beneficiaries directly from the drug manufacturers at the same prices
that they are currently selling to the government, to the big HMOs, and
to the hospital chains.
{time} 1645
We think that is only fair, that is only right. Our senior citizens
deserve to be treated better. I am proud to join with the gentleman
from Arkansas (Mr. Berry) and the gentleman from Maine (Mr. Allen) and
the others here today in trying to enact this into law.
Mr. BERRY. Mr. Speaker, I thank the gentleman from Texas for his
leadership in this matter.
Mr. Speaker, I now yield to the gentlewoman from Connecticut (Ms.
DeLauro).
Ms. DeLAURO. Mr. Speaker, I thank my colleague, the gentleman from
Arkansas (Mr. Berry), and I want to say I offer my congratulations to
him and to the gentleman from Texas (Mr. Turner) and the gentleman from
Maine (Mr. Allen) for introducing this legislation. It really is so
critical to what seniors in this country are facing today.
To bring this to the Nation's attention, I think we can really create
no better opportunity than to provide some relief to people who we have
all heard from, all of us. There are 435 Members of this body; 435
Members have heard that their seniors that they represent are in a
difficult spot. Many are just deciding, as has been said on this floor
today, between whether or not they are going to have a decent meal or
whether or not in fact they are going to be able to take care of their
health concerns.
Let me just talk a little bit about my own district, which is the 3rd
District of Connecticut. I conducted a study and discovered that
seniors in Connecticut's 3rd District pay an average of twice what the
pharmaceutical companies' preferred customers pay. And by ``preferred
customers,'' so it is clear, and I am sure others have made that clear
here today, these are large corporate institutional customers with
market power for which they can buy drugs at a discount price. And that
is a good thing. That is a good thing.
While HMOs and others get the drugs at a discount, the cost is
shifted to seniors and others who shop at their local store or their
pharmacy. The bottom line is that we have seniors winding up
subsidizing the corporate discounts out of their own pockets, and they
live on fixed incomes. It is very difficult for them to make ends meet
and to be able to afford prescription drugs.
I will give my colleagues an example. Prilosec, a drug commonly
prescribed to seniors, HMOs are able to buy an average dosage for
$56.38. Seniors in my district would pay $108.63, almost double. It
really is no wonder that some of the seniors that I have talked to
spend nearly half of their income each month just on prescription
drugs.
On a personal note and a sad note for our family, my father-in-law,
Sam Greenberg, passed away about two weeks ago. And something I did not
realize when I talked with my mother-in-law is that they were paying up
to $800 a month for prescription drugs. I do not know how they did it.
I do not know how they did it. And I did not know that. My husband did
not know that. But they were trying the best they could to pay $800 a
month for prescription drugs.
When I released the study that I did last year, I met with the local
pharmacists and I met with seniors in my
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district who were affected by the problem, and I met the daughter of a
woman who had a stroke because she could not afford to take her
medications but she was embarrassed to tell anyone about the problem. I
met a pharmacist who does all that he can to help his customers afford
the prescriptions that they need, sometimes giving them credit until
they find money to pay him. I saw people who are struggling to make
ends meet on a limited income while buying the medicine they need to
stay healthy.
One of those seniors, Irma Yoxall, is a 72-year-old resident of West
Haven, Connecticut. Ms. Yoxall suffers from diabetes and high blood
pressure and she takes six prescription drugs. Her monthly income is
$750. She spends between $300 and $400 a month, almost half of her
income, on her prescription drugs.
Until she became eligible for Medicaid, Ms. Yoxall had no insurance
coverage at all for her prescription drug needs and at times was forced
to skip medications because of the high cost. In fact, she recently
suffered a stroke which her daughter believes was brought on because of
the skipped medications.
Let me just say, and let me conclude, I want to say thank you to my
colleagues. This is such an important piece of legislation. It simply
says, let seniors purchase their medications at the same cost that our
large corporations, HMOs, can make that purchase, and keep them healthy
and keep them in a sense of security that in fact they can weather,
weather the storm of a serious illness.
I thank my colleague again for letting me participate with all of my
colleagues tonight.
Mr. BERRY. Mr. Speaker, I thank the gentlewoman from Connecticut (Ms.
DeLauro) not only for her support in this matter but for her great
leadership in the House.
Mr. Speaker, I yield to the gentleman from Maine.
Mr. ALLEN. Mr. Speaker, I thank the gentleman for yielding, and I
thank the gentlewoman from Connecticut for her support. It means a lot
to us to have her come down and be with us in this debate.
I just wanted to say, in closing, one thing. I said earlier that what
is happening out there is that the pharmaceutical companies are
charging their highest prices to those least able to pay. And by those
least able to pay, I mean those Medicare beneficiaries, those seniors
who do not qualify for Medicaid but are not wealthy enough to buy and
use prescription drug insurance coverage. So they are left on their
own, paying out of their own pocket.
The industry is going to say that this bill involves price controls,
and my final point is that that is flat out wrong. This bill will allow
the Federal Government to act as a negotiating agent to make sure that
it gets the best prices for our seniors across the country. It does not
involve price controls. It simply puts a big negotiator, a big buyer,
into a market where right now seniors or, more accurately, those
wholesalers who sell to retail pharmacies really do not control market
share and really do not buy in the kind of bulk that is necessary to
get big discounts.
H.R. 664, the Prescription Drug Fairness For Seniors Act, is the
right bill at the right time at a low cost, a bill that would be
effective in lowering the prices for seniors all across this country.
I just want to say in conclusion how much I appreciate the work of
the gentleman from Arkansas (Mr. Berry) on this issue, the work of the
gentleman from Texas (Mr. Turner) on this issue. We are going to make a
difference in this Congress and pass this legislation.
Mr. BERRY. Mr. Speaker, I will just conclude by mentioning what a
heroic effort our local pharmacies have made in the last few years to
try to take care of our seniors and see that they got the medicine they
needed at the best possible prices, and the heroic effort that our
seniors have made to deal with this very difficult situation.
The drug companies will say, ``We need this much profit.'' What we
are saying is, we want them to make a profit but they should not make
it all off of our senior citizens. We must level the playing field. We
must treat our seniors the way that other preferred customers get
treated. And this is the right thing to do. It is the fair thing to do.
I urge my colleagues on both sides of the aisle to support H.R. 664.
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