[Congressional Record Volume 165, Number 119 (Tuesday, July 16, 2019)]
[Senate]
[Pages S4830-S4831]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                        Prescription Drug Costs

  Mr. DURBIN. Madam President, I listened as the Republican leader came 
to the floor and announced the business of the Senate for this week. 
Highlighted in the business will be tax treaties--tax treaties with 
Spain, Switzerland, Japan, and Luxembourg. According to the Republican 
leader, these are critical to economic development in the United 
States. I don't question their importance, but I will tell you that, 
routinely, these are done by voice vote. We don't spend the time of the 
Senate to come to the floor and talk about our relationship with 
Luxembourg.
  When you look at the issues that most American families expect us to 
address, I would say the tax treaty with Luxembourg would be low on the 
list. What might be high on the list and should be considered in the 
Senate this week is the No. 1 concern of families across America--
Democrats and Republicans. The highest concern and the No. 1 issue when 
asked about the economy of the United States is the cost of 
prescription drugs.
  The United States Senate has the authority to do something about the 
cost of prescription drugs. We will not be doing it this week. We will 
be dealing with a tax treaty with Luxembourg.
  What kind of issues, when it comes to the cost of prescription drugs, 
might be important? Let's start with one that I have started focusing 
on back home.
  Did you know that there are 30 million Americans who suffer from 
diabetes, type 1 and type 2 diabetes? Did you know that 7.5 million 
Americans use insulin every single day to stay alive? Four of them were 
in my office last week from Illinois. They were between the ages of 10 
and 17. Talk about amazing young people. Three young women and a young 
boy talked about their lives and what had happened to them since it was 
discovered that they had juvenile diabetes.

[[Page S4831]]

  Their lives have been changed a lot. Each one of them is hooked up to 
a CGM--I believe that is the proper term, a continuous glucose 
monitor--that measures whether they need additional insulin, which is 
pumped in another device on their arm. They talked about how this was a 
commitment around the clock to make sure their insulin levels were 
appropriate.
  One little girl talked about what it meant to her family for her to 
be a type 1 diabetic. This beautiful young lady started talking about 
it. Then she got to the point where she said: It has changed our 
family; my diabetes has changed our family.
  Then she started crying.
  She said: We can't do things in our family that others do. We can't 
take the same vacations that my cousins take, and we can't rent that 
house out on the lake because of the cost of my drugs, the cost of my 
insulin.
  I turned to her mother, and I said: Tell me, what does it come down 
to?
  Her mom said: We are lucky. We have health insurance. Our health 
insurance covers prescription drugs. However, there is an $8,000 
deductible. So we start each year buying the insulin for our daughter 
until we have spent $8,000 out of our savings. Then the health 
insurance kicks in. Usually it is about 3 months.
  She is paying, or she is being charged, about $3,000 a month for 
insulin.
  Let's look into this for a minute as we consider why the U.S. Senate 
thinks a tax treaty with Luxembourg is more important than this issue. 
Let's look into the fact that insulin was discovered almost 100 years 
ago in Canada, and the researchers who discovered it came to the United 
States and said: We have the patent rights to this lifesaving drug for 
diabetics. We never want to see anybody make a profit at the expense of 
this lifesaving drug.
  The Canadian researchers surrendered their patent rights to insulin 
for $1--gave it up. I recall that when it came to the Salk vaccine for 
polio, he did the same thing. He said that no one should ever make a 
profit on a drug that eliminated polio. These two Canadian researchers 
felt the same about insulin.
  What happened then? Insulin was produced in the earliest stages in a 
rather crude way but in an effective way to save the lives of people 
with diabetes. Over the years, that process was improved. There is no 
question about that.
  Today there are three major pharmaceutical companies that make 
insulin products for the United States--Eli Lilly of Indianapolis, IN, 
is one of them; Novo Nordisk is another; Sanofi is another. I know a 
little bit about the Eli Lilly product. It is called Humalog. Humalog 
was introduced in the American market in 1996, an insulin product. The 
charge was about $20 to $30 for a dosage--a vial, I should say, and was 
used as a dosage for those with type 1 diabetes, type 2 diabetes. It 
was about $21.
  Here we are 20 years later, and how much is that same vial? It is 
$329. Remember, this was a drug discovered almost 100 years ago. 
Remember, those who could have capitalized and made a fortune off of it 
surrendered their patent rights.
  How did we reach the point where this drug, in 20 years, is 10 times 
more than it cost when it was introduced? It is the same drug from the 
same company. Why has it gone up so much in price? Because they can do 
it, because these pharmaceutical companies have the power to raise 
their prices, and people like that little girl in my office from 
Jerseyville, IL, who broke down in tears, can't control how much that 
price would be. They need this to survive.
  Now you must ask yourself: What are other countries paying for 
exactly the same drug made by the same American pharmaceutical company, 
Eli Lilly?
  We don't have to go very far to find out. All we need to go to is 
Canada--Canada. The $329 Humalog vial in Canada costs $39. Why? It is 
exactly the same drug and is a fraction of the cost in Canada. It is 
because the Canadian Government stands up for the people of that 
country and says: You cannot gouge, you cannot overprice these drugs. 
You are going to be paid a reasonable amount so that you make a profit, 
but you aren't going to do it at the expense of our families in Canada.
  They care. They have done something about it.
  We care about a tax treaty with Luxembourg. I am sorry, but as 
important as that may be in that small part of the world, it is more 
important for us to deal with the issue of prescription drugs and to 
ask ourselves why this U.S. Senate, this empty Chamber, is not filled 
with Senators of both political parties doing something about the cost 
of prescription drugs.
  There is one traffic cop in this Chamber. He just spoke. The 
Republican leader decides what comes to the floor of the Senate. He has 
decided we are not going to consider prescription drugs. Maybe he will 
change his mind, but I think he will need some persuading to reach that 
point.
  What I am hoping is that the 30 million Americans and their families 
will speak up when it comes to the cost of lifesaving insulin for 
diabetes. I hope they will do the same when it comes to other drugs--so 
many of them.
  Senator Grassley of Iowa, a Republican, was just on the floor a few 
minutes ago when we opened the session. He and I are working on a bill, 
which is just a first step--and I underline, only a first step and not 
the answer to the problem. But it comes down to this: You can't turn on 
the television these days without seeing a drug ad. If you haven't seen 
drug ads on television, you must not own a television. They are on all 
the time. All of the information we are given about drugs with long 
names that are hard to pronounce and remember--all of that information 
is given to us over and over again so that we know much more than we 
ever dreamed we would know about XARELTO. We can even spell it. We know 
what different drugs are supposed to do to improve the lives of 
individuals. Those ads are being thrown at us so that eventually we 
have that name in our head and take it into the doctor's office and ask 
for that expensive drug as opposed to a generic drug. That is running 
up the cost of healthcare.
  Senator Grassley and I put in a bill, and the bill is pretty basic. 
With all of the things they tell you on television about the drugs, it 
wasn't until just 2 weeks ago--the first time I have ever seen it--that 
one of these companies disclosed the cost of the drug.
  You say to yourself, maybe that is an important part of speaking to 
consumers across America. Senator Grassley and I have a bill that will 
require price disclosure on these pharmaceutical companies' 
advertising. It is not the total answer, but I am hoping it will in 
some way at least slow down, if not embarrass these companies from the 
runups in cost that these drugs are going through.
  That is part of the answer, but it is not the total answer by any 
means. There is a long list of things we can do and should do that are 
a lot more important than a tax treaty with Luxembourg, which should 
pass by a voice vote without taking the time of the Senate.