[Congressional Record Volume 165, Number 114 (Tuesday, July 9, 2019)]
[Senate]
[Pages S4706-S4708]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                        Prescription Drug Costs

  Madam President, if you ask the American people about issues they 
truly care about, let them volunteer what they think about, what they 
worry about, the No. 1 item on the list is the cost of prescription 
drugs.
  We all know the problem. You reach a point where you need a drug or 
someone in your family needs a drug, and then you face the reality of 
what it is going to cost. If you are lucky, and you have a good health 
insurance plan, it covers the cost--no worries--but for many people, 
that is not the case. They have copays and deductibles or sometimes no 
real coverage when it comes to the cost of prescription drugs.
  Of course, the prices of these drugs are way beyond our control. You 
go to a drugstore, and you are shocked to learn that what sounded like 
a great idea in the doctor's office turns out to be a very expensive 
idea at the cash register. For some people, it is an inconvenience, an 
annoyance, but for other people, it is a burden they just can't bear. 
They can't pay the cost. It is just too much.
  Some of these drugs are just not minor additions to your life; they 
may be matters of life and death. In those circumstances, what are you 
to do?
  I am reminded of people I have met across my State of Illinois as I 
have talked about this issue. One group

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stands out because there are many of them--people who are suffering 
from diabetes.
  Of course, they know that using insulin and taking care of themselves 
is the way to have a good, normal life, but it turns out that the cost 
of insulin has gone up dramatically.
  Did you know that insulin was discovered in Canada almost 100 years 
ago? The researchers who discovered this drug--this life-saving drug 
for diabetes--said at the time that they were going to surrender their 
legal patent rights to sell the drug for $1, give it away for $1. Do 
you know why? They said it was because no one should make a profit on a 
life-or-death drug. That was almost 100 years ago. But what are we 
faced with today? We are faced with a dramatic increase in the cost of 
insulin, a life-or-death drug.
  I have sat down with parents and their children and talked about what 
they go through to have enough insulin so that their diabetic daughter 
can survive. It is incredible. Mothers in retirement go back to work to 
take a job to pay for the daughter's insulin.
  The cost of insulin has gone up dramatically. In 1999, Humalog--a 
very common form of insulin made by Eli Lilly--ran about $39 a vial. 
What has happened to the cost of that drug in 20 years? It has gone up 
to $329, a dramatic increase on a drug that was discovered 100 years 
ago.
  At the same time, Eli Lilly is selling that drug in Canada for $39--
$329 in the United States. Why? Because the Canadian Government has 
said to Eli Lilly: That is the most you can charge in our country. We 
are going to fight for the people who live in Canada to have affordable 
drugs.
  Let me ask an obvious question. Who is going to fight in the United 
States for affordable drugs for our people, for those sons and 
daughters with diabetes--and not just for diabetes but so many other 
conditions for which life-and-death drugs are now being priced way 
beyond the reach of ordinary Americans? Do you know who is supposed to 
fight? We are supposed to fight for it. That is why we were sent here--
Members of the U.S. Senate and the House of Representatives--to pass 
legislation to bring these under control.
  Now we have legislation coming forward from the Senate HELP Committee 
on the issue of healthcare, and many of us had hoped that committee 
would use this opportunity to put in provisions to bring the cost of 
prescription drugs under control. Unfortunately, with only one 
exception, the bill is silent on the major issues.
  The measures coming out of the Senate Judiciary Committee, where I 
serve, don't go to the heart of the matter. They really will not make a 
big difference on the insulin scandal that we are now facing or on the 
cost of drugs in general.
  I had a simple measure that I introduced with Republican Senator 
Chuck Grassley last year. Think about this. Have you ever seen an ad 
for drugs on television? If your answer is no, it is because you 
obviously don't own a television. You can't turn it on without seeing a 
drug ad, right? And if you watch during the day, when many seniors are 
watching, it is one after the other after the other.
  I have said with amusement here we have even reached the point at 
which we can not only pronounce but spell the word XARELTO. We see 
those ads so often for XARELTO and HUMIRA and so many other things that 
they just bombard us. Why? They bombard us with these ads in the hope 
that consumers watching those TV ads will go to the doctor and say: 
Doctor, I need XARELTO.
  Well, XARELTO is a blood thinner. There are other alternatives that 
are much cheaper. But if you ask for that high-priced prescription drug 
and the doctor doesn't want to get in a debate with you and puts it on 
the prescription pad, guess what you have just done. You may have the 
right drug for you at the moment--maybe--but you may have just added to 
the cost of healthcare by putting the most expensive drug out as an 
option when another form would work just as well.
  In all of the things they tell you about these ads, some of the 
things I think are the most amazing and amusing are claims like this: 
If you are allergic to XARELTO, don't take XARELTO. Excuse me. How will 
I know I am allergic to it? After I take it, maybe.
  Those sorts of things and warnings about suicide and death and 
everything else come at us, but there is one thing that isn't included 
in those drug ads--one very basic thing. Excuse me, Eli Lilly; excuse 
me, Sanofi. How much does this cost? They don't tell you because it is 
shocking sometimes for them to tell you that some of these drugs cost 
thousands of dollars, and perhaps getting rid of that little red patch 
on your elbow of psoriasis will not be worth $5,000 a month if you know 
the price.
  So Senator Grassley and I put this in the bill last year and passed 
it in the Senate. How about that? It happens so rarely around here. We 
passed in the Senate a bill that required the drug companies to 
disclose the actual list price that they list for the cost of the drug. 
It passed the Senate, and it got killed in a conference with the House 
when the pharmaceutical companies came in and said: We don't want to 
tell anybody what these drugs cost.
  Then I got an interesting call from the Trump administration. Notice, 
I am on the Democratic side of the aisle, so I was surprised. Dr. Azar 
from Health and Human Services called me and said: We like your bill. 
The President wants to make your bill the law, so we are going to pass 
a rule that requires drug companies to disclose the cost of 
pharmaceutical drugs on their ads. Direct-to-consumer advertising has 
to tell the cost of the drug. Well, that is progress--a rule in that 
direction.
  Do you know what happened yesterday? In a Federal court hearing in 
Washington, the judge struck down that rule. The judge said: Congress, 
you haven't given this administration or any administration the 
authority to do that on its own. You have to change the law, giving it 
the authority, or you have to change the law itself to require the 
disclosure of drug pricing. Does it sound like a radical idea to people 
that we would disclose to them how much these drugs cost in the drug 
advertising itself? It isn't unusual for people to list the cost of 
items we buy every day. When it comes to lifesaving drugs, shouldn't we 
have that disclosure as well? Well, I hope we will. I hope this bill 
that is coming to the floor will consider that as well as several other 
aspects when it comes to prescription drug pricing.
  For example, did you know that the Veterans Administration, on behalf 
of the men and women who have served our country, actually negotiated 
with the pharmaceutical companies to have lower prices for the drugs 
that are used in VA hospitals and clinics? They sit down with these 
same drug companies and negotiate lower prices for our veterans. Good. 
Our veterans deserve it. But why won't our Federal Government negotiate 
for those who are under Medicare? Why can't we use the same drug 
formulary and pricing for the VA when it comes to Medicare? If we want 
to give our veterans a break--and we should--why wouldn't we give our 
seniors a break?
  I think we ought to have negotiated pricing in Medicare. I think the 
drug companies will get along just fine. Incidentally, they are pretty 
profitable today. If we had that commitment for renegotiating for 
Medicare, it could make a difference.
  I also think we ought to take on this insulin issue head-on--head-on. 
A story on ``60 Minutes'' recently was about a heartbroken mother from 
Minnesota whose son was on her health insurance plan under ObamaCare 
until he reached the age of 26. Then he was on his own. He was managing 
a restaurant. He didn't have drug coverage, and he was diabetic. He 
couldn't afford to pay the thousand dollars that was being charged for 
his insulin, so he decided to ration the dosage himself. It cost him 
his life. He, unfortunately, died because he couldn't afford enough 
insulin at the high prices that are currently being charged.
  We can change that. We can come to the side of consumers across 
America, to families who are trying to keep their kids alive, and many 
others. We can do that because we work in a place called the U.S. 
Senate, but in order to do that, we have to act like Senators. We have 
to say to the pharmaceutical companies: I am sorry, but there comes a 
point where you have pushed it way too far. There comes a point where 
we

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have to step in on behalf of families and consumers in America and 
speak up on their behalf. Watch closely to see if that happens.
  The gentleman who was on the floor, my colleague from Kentucky, will 
be the person who will decide that. Senator McConnell will decide 
whether we are going to challenge the pharmaceutical companies this 
year.
  Do you remember how I started? It is the No. 1 issue that American 
families volunteer to us. So is it important? Yes. Secondly, will it 
make a difference? You bet--not just in Illinois but I bet in Kentucky 
as well. Many a family can step forward and talk about how tough it is 
to pay for these prescription drugs.
  Do we have a chance to do it? You bet we do. There is a series of 
bills coming out of committee in the next couple of weeks. We could 
bring this to the floor of the Senate. Wouldn't that be amazing if the 
U.S. Senate, instead of doing a handful of nominations of people you 
have never heard of, ended up actually passing a bill, making a law 
that addresses the issue of prescription drug pricing in America? That, 
to me, is a reason we were sent here.
  What I would like to see and hope to see is a bipartisan effort. We 
Democrats are ready to stand up, but there are certain things we 
believe in. First, we believe in keeping the Affordable Care Act on the 
books. People with preexisting conditions shouldn't be discriminated 
against. Families ought to be able to keep their kids on their health 
insurance plans until kids reach the age of 26. We are willing to fight 
for that even though this week there is a lawsuit by the Trump 
administration to do away with it.
  Secondly, we believe we should negotiate prices under Medicare so 
that seniors get the price breaks that our veterans get today and many 
others do too.
  Third, we need to do something about the overpricing by these drug 
companies, not just price disclosure on the ads but changing the patent 
laws to give American consumers a fighting chance. Canada is fighting 
for Canadians. When is America going to fight for Americans?
  When it comes to pharmaceutical prices, this is our chance to do it, 
and we can get it done in the next 2 weeks. Who will decide that? The 
majority leader from Kentucky, Mitch McConnell. He will decide whether 
this comes to the floor, whether it is important enough to the people 
living in Kentucky, Illinois, New York, Mississippi, or wherever. It is 
his choice. It is in his power to make that decision. I hope the 
American people will reach out to him to encourage him to do that.
  I yield the floor.