[Congressional Record Volume 165, Number 108 (Wednesday, June 26, 2019)]
[Senate]
[Pages S4569-S4570]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. MERKLEY:
  S. 1987. A bill to require the Secretary of Health and Human Services 
to establish reference prices for prescription drugs for purposes of 
Federal health programs, and for other purposes; to the Committee on 
Health, Education, Labor, and Pensions.
  Mr. MERKLEY. Mr. President, the three most important words of our 
Constitution are the first three: ``We the People.'' That is what our 
entire vision of our form of government is about.
  There was a lot of discussion among the Founders about how we make 
sure we don't end up with the equivalent of a King here in the United 
States of America because with a King, you get a government by and for 
the King and the King's circle, the powerful circle at the top, rather 
than the people.
  Unfortunately, that vision in America is being challenged--challenged 
because we have a fundamental concentration of power through dark money 
in campaigns and gerrymandering through voter suppression and 
intimidation. The result is a shredding of the vision of our 
Constitution.
  We have a responsibility in the Senate to fix that, and that is why 
we should be considering the For the People Act that takes on 
gerrymandering, voter suppression, and dark money. If we want evidence 
of just exactly how corrupted the system has become, go no further than 
to look at drug companies gouging Americans on drug prices.
  Today I am introducing the End Price Gouging for Medications Act to 
stop the pharmaceutical companies' greed and give Americans much needed 
relief.
  The average American spends about $1,000 per year on medication. That 
is 11 times what they spent in 1960. More than half of Americans take 
at least one prescription medication--about 60 percent of us. One-
quarter of them say they or family members have not filled a 
prescription or have cut pills in half or have skipped doses because of 
the cost, and those costs just keep going right on up.
  January through June 2018, there were price increases on 4,412 drugs 
and decreases on just 46. That is a ratio that approaches 100 to 1. For 
every 100 drugs that go up in price, 1 comes down a little. We are 
clearly failing to tackle this problem.
  I hear it from my constituents back in Oregon. Bonnie Davis from 
Creswell, who is a senior citizen on a fixed income and has been 
diabetic for 30 years, was prescribed two new kinds of insulin in 
December: BYDUREON, which costs $1,927 for a 3-month supply, and Lantus 
SoloSTAR, which costs $1,952. She will pay more than $5,000 out of 
pocket by the end of the year. In 1972, insulin cost just $1.49 per 
vial. What an incredible difference on a product that has been around 
forever.
  Her two adult children are living in Germany. They thought about 
coming back to the United States of America but decided not to for one 
simple reason: the cost of healthcare in the United States of America 
and specifically the cost of medications.
  I come from Douglas County, a little timber county in Southern 
Oregon. Leslie Rogers comes from that county. She comes from Roseburg, 
a town where I went to first grade. Leslie shared his daughter Gloria's 
story at one of my townhalls. Gloria suffers from a rare genetic 
condition called West syndrome. She lives, therefore, in near constant 
fear of seizures and cystic fibrosis. It is treatable.
  It is treatable with a drug called ACTH. It was invented in the 
1950s. Previously, it cost $40 a vial--$40--but in 8 years, the cost 
has grown to $45,000. Yes, you heard that right--from $40 to $45,000. 
That is more than a thousandfold increase.
  The company that makes the drug bought the rights to and blocked a 
$200 synthetic ACTH treatment used in Canada to prevent it from coming 
to the United States. They are making a lot of money by blocking a 
generic synthetic competitor.
  Leslie Rogers says: ``Hospitalization and treatment drove my family 
to the edge of bankruptcy, and my daughter was left tube fed and 
suction dependent due to treatment delays fighting with insurance over 
the drug price.''
  How would you feel if your daughter or your son were left in a 
situation of being tube fed and suction dependent because you couldn't 
afford the drug because the drug had increased in price 1,000 times?
  The cost of another drug used to treat the disease, Vigabatrin, has 
also skyrocketed after makers saw what the first company was able to 
get away with. It cost about $1,500 a month 3

[[Page S4570]]

years ago, and $1,500 is a lot. How much does it cost today? It costs 
$26,000 per month. That is roughly a twentyfold increase.
  Leslie Rogers notes: ``This price gouging has led to thousands of 
children since we first spoke to suffer the same fate as my daughter--
severe brain damage, cerebral palsy, reliance on tube feedings, and 
many have died.''
  Let's be clear. Price gouging in America isn't just about the 
pocketbook; it is about health, and it is about life or death for many 
people.
  This situation doesn't exist in other countries. The whole entire 
price regime is different. Let's take, as an example, HUMIRA, a common 
drug for rheumatoid arthritis. Here in the United States, it is about 
$2,700 per dose. In the United Kingdom, it is $1,362. Why does it cost 
twice that in the United States of America for this drug, this common 
drug? Then there is CRESTOR, which is used to treat high cholesterol? 
It is $216 in the United States, and it is $32 in France. Crudely, that 
is a sevenfold increase in the United States over France. Why do we pay 
seven times as much as the people in France? There is also HARVONI that 
is used to treat hepatitis C. It cost $13,000 in Japan and $30,000 in 
United States. That is three times as much. Why do we pay three times 
what they pay in Japan for this drug? There is also JANUVIA that is 
used to treat type 2 diabetes. It costs $34 in Australia and $331 in 
the United States of America--a tenfold increase. Why do we pay 10 
times as much as people in Australia?
  There is an answer to the question--the question of why we pay so 
much for HUMIRA, for CRESTOR, for HARVONI, and for JANUVIA. Very 
simply, other governments negotiate the price: If you want to sell it 
in our country, we negotiate the price.
  We don't. Now, what is the reason why we don't? Why don't we pick up 
and do for Americans what the Government of Australia does for 
Australians, or the Government of the United Kingdom does for its 
citizens, or the Government of France does for their citizens? Why 
don't we do it for our citizens--the same good work in negotiating the 
price that other governments do? What is wrong with our government? 
What is wrong with this Chamber?
  It is corruption. It is the absolute corruption of money in 
campaigns.
  So who are we serving here in this Chamber? Are we serving the people 
or are we serving the drug companies? That is the question every Member 
of this Chamber should struggle with.
  In the United States, drug companies set the price, and we don't 
negotiate. In fact, the U.S. Government has set a law saying the U.S. 
Government can't negotiate. Why would we do that? Why would we do that 
to ourselves? Why would we do that to the people of this country who 
cannot afford the drugs because we make them far more expensive than 
anywhere else in the world?
  Well, we shouldn't. That is why I have introduced the End Price 
Gouging for Medications Act. On behalf of the people of America, we 
need to end the drug gouging.
  Now, I do a lot of townhalls. I do one in every county every year. 
There are 36 counties in Oregon. It is open hour for people to ask 
questions. They are blue counties, and they are red counties. Twenty-
two of my 36 are about as red as the reddest counties you will find in 
America.
  I ask the people: How many people here at this townhall like getting 
gouged on drugs? Nobody does. How many people like paying 2 or 5 or 10 
times more than the citizens of other developed countries? No one likes 
it.
  America is united--rural America, urban America, blue America, red 
America, young America, old America. America is united to end this drug 
gouging.
  So why don't we act?
  I challenge my colleagues: Come here and work for the people of the 
United States of America rather than the drug companies' profits. It is 
time to stand up. Stand up against those companies.
  This plan is quite simple. It says you can't sell the drug for more 
than the median price of what you sell it for in Australia, Japan, 
Canada, and the largest European countries. It is that simple. Median 
price in those markets. If you want to raise your prices in America, 
you have to raise your prices in those countries. That way we all get a 
fair deal. This would stop the drug gouging of Americans overnight.
  This is quite simple, but you may ask how is it enforced? How do you 
make sure that this happens?
  Well, it is this. The difference between the reference price, or the 
median price in those countries, and the price the drug company sells 
their product at--if they sell it for more than the median price, the 
penalty is five times the difference. If they sell it for $1,000 more 
per dose over the median price, the penalty is $5,000. That gets 
people's attention. Drug companies don't want to be paying massive 
penalties.
  And where do the fines go? They go to the NIH for drug research and 
development. There is all this myth that we are not going to invest in 
drug development. The basic science is done by NIH, and this would fund 
NIH.
  Americans have been ripped off. Americans have been gouged, and it is 
this Chamber that is allowing it to happen. Who here wants to come and 
say they are for the drug gouging of Americans?
  Well, I can tell you that America is not with you if you are 
supporting the drug gouging of our citizens. So let's have the courage 
to carry the fight for the people, not the powerful.
                                 ______