[Congressional Record Volume 164, Number 126 (Thursday, July 26, 2018)]
[Extensions of Remarks]
[Pages E1096-E1097]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     INTRODUCTION OF THE MEDICATION AUTOMATED QUOTATION SYSTEM ACT

                                 ______
                                 

                        HON. JOHN J. DUNCAN, JR.

                              of tennessee

                    in the house of representatives

                        Thursday, July 26, 2018

  Mr.  DUNCAN of Tennessee. Mr. Speaker, today I am introducing the 
Medication Automated Quotation System or MEDAQ Act to offer what I 
believe would alleviate our Nation's prescription drug pricing crisis. 
This bill calls for a study on the effect of creating a system similar 
to today's NASDAQ, but for prescription drugs instead of stock.
  Patients are having to choose between food and medicine. Pharmacists 
are being forced to provide prescriptions at a loss, and they can't 
speak up without risk of being cut out of their communities' insurance 
networks and forced out of business.
  Every time anyone tries to determine the root causes of high drug 
prices, fingers are pointed and no one accepts any responsibility.
  I have been vocal in the past about my concerns with the unethical 
and secretive practices of pharmacy benefits managers, or PBMs, who 
hide behind gag clauses and retroactive fees and rebates. The Nation is 
becoming more familiar with those practices and PBMs are starting to 
squirm.
  But as with any massive problem like our drug pricing crisis, there 
is no one, single culprit. Thus, we need to be able to truly see what 
is going on.
  During my 30 years in Congress, I have always asked, ``What's the 
cost?'' I always want to see the numbers behind ideas and legislation. 
This bill calls for just that: what are the real numbers behind our 
medication prices?
  I envision the MEDAQ as a system that would help manufacturers and 
wholesalers and pharmacists and others involved in the drug industry 
see in real time what the average price of drugs is as they are 
negotiating with each other.
  At this time, the medication market is like a farmers market where 
all the vendors will not to tell their customers what they will really 
be paying for the produce. Imagine if a customer buys a basket of 
peaches and is told they'll get half of their money back in the mail in 
a few weeks.

[[Page E1097]]

  Then the vendor later sends only a couple dollars back, citing a 
change in the average price of peaches . . . or the vendor perhaps even 
sends the customer a bill, demanding more money. If the customer 
complains, the vendor just points fingers at whoever they can. Those 
are the kinds of business practices commonly seen in the medication 
market today.
  Any farmers market with such vendors would quickly close down or 
those vendors replaced. Competition clearly cannot thrive in such an 
environment.
  The technology and data for a system like the MEDAQ are already out 
there, and there is unquestionably a need for transparency.
  The MEDAQ would reform the medication market to ensure that those 
involved in the drug distribution chain can negotiate transparently and 
fairly with each other. Wholesalers could check the MEDAQ to compare 
prices and have an idea of what other wholesalers in the region are 
able to buy for what prices. Pharmacists could check the MEDAQ to hold 
their PBMs accountable and have a better idea as to whether the PBMS 
are truly negotiating the best deals as promised.
  Just as a farmers market where vendors advertise and consumers choose 
based on quality, service, and prices--the MEDAQ would empower 
purchasers within the drug chain to demand and expect the best quality, 
service, and price.
  I have long said that no one likes competition, but everyone is 
better off for it. Competition is driven by awareness of the goal and 
the competitors. In other words, competition is driven by transparency 
and an open market.
  I believe a MEDAQ would restore competition to the medication market, 
and I ask my colleagues to support this bill requiring a study on the 
feasibility and effect of a MEDAQ.

                          ____________________