[Congressional Record Volume 165, Number 149 (Tuesday, September 17, 2019)]
[Senate]
[Pages S5506-S5508]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                           Prescription Drugs

  Mr. President, on another matter, during the August break back home, 
I heard from a startling number of my constituents about their 
increasing struggles to deal with the cost of their prescription 
medications. This included stories about skipping their blood pressure 
medication or diabetics rationing their insulin and people traveling 
across the border, going to Mexico--to the farmacias in Mexico--to get 
inhalers at a lower price. Of course, the problem is, you don't know 
when you go to another country whether it is as advertised, whether it 
is counterfeit, or whether it is genuine. So there are risks associated 
with that. But my point is that people are struggling to deal with 
their drug costs, and they are going to extraordinary means, some of 
which are potentially dangerous to their health.
  I know my constituents back home are frustrated by confusing price 
hikes. They don't understand the dramatic price differences from one 
pharmacy to the next. They are terrified about what will happen if the 
price gets so high that they will have to give up taking their 
prescriptions altogether.
  It is no surprise that a recent Gallup poll found that Americans view 
the pharmaceutical industry more negatively than any other industry. A 
whopping 58 percent said that they have a negative view of the 
pharmaceutical industry, and 48 percent have a negative view of the 
healthcare industry as a whole. Congress's numbers are much worse than 
that, but the point is, people are concerned, and they want us to do 
something about it.
  When the products and services these groups provide mean the 
difference between life and death--which they do--that lack of trust is 
a bad sign, to be sure. I believe, along with many of my colleagues, 
that it is time to get to the bottom of these rising costs and provide 
the American people with some transparency, some clarity, some peace of 
mind, and hopefully a break in their out-of-pocket costs for 
prescription drugs.
  In the Senate we have taken a bipartisan approach that reaches across 
several of our standing committees, and we have made some serious 
progress. I would like to remind anybody who is listening what we have 
done so far and what we need to do next.
  Earlier this summer, the Senate Health, Education, Labor, and 
Pensions Committee passed a package to end surprise billing to create 
more transparency and create more competition. The Senate Finance 
Committee on which I sit passed a package of bills designed to reduce 
prescription drug prices for seniors and children, and the Judiciary 
Committee, on which I also

[[Page S5507]]

sit, has passed several bills to lower the cost of prescription drugs 
and stop bad actors from gaming the system.
  We have talked to every major player in the supply chain and have 
asked questions about the confusing practices that are driving up 
costs. Of course, I would be remiss if I didn't acknowledge the 
Presiding Officer's leadership when it comes to this topic, 
knowledgeable as he is about the healthcare industry, beyond the 
average Senator.

  One example of the problem is the anti-competitive behavior of drug 
manufacturers. Companies pour extensive time and money into research 
and development of new medications, and that is good. What they get in 
return is the ability to recover their costs and earn a profit under a 
patent. These patents justifiably protect the intellectual property of 
these drugs for a time and are a key driver behind the incredible 
innovation that occurs here in the United States.
  The United States discovers and manufactures more innovative and 
lifesaving drugs than any other country in the world, but we are 
increasingly seeing companies using the patent system as a shield for 
competition beyond the life of a patent, and it is time we put that to 
a stop.
  One of the bills in the Judiciary Committee that I introduced is 
called the Affordable Prescriptions for Patients Act, which would 
address two circumstances that lead to higher drug costs. First is 
something called product hopping, which occurs when a company develops 
a reformulation of a product that is about to lose its patent and pulls 
the original product from the market. This is done not because the new 
formula is more effective, necessarily, but because it prevents generic 
competitors from competing with the original product.
  One example is a drug called Namenda, which is used by patients with 
Alzheimer's disease, a terrible, devastating disease. Near the end of 
the exclusivity period, the manufacturers switched from a twice-daily 
drug to a once-daily drug. That move, under the current law, prevented 
pharmacists from being able to switch patients to a lower cost 
generic--even though it is just as effective--so the company could 
continue to earn a profit under this exclusivity provision under the 
patent laws. By defining these types of anti-competitive behaviors, the 
Federal Trade Commission would be able to bring antitrust suits against 
the bad actors who deliberately game the system.
  Secondly, the bill disarms patent thickets, which occur when an 
innovator uses multiple overlapping patents or patents with identical 
claims to make it harder for competitors to enter the field. One 
example is the drug HUMIRA, which is commonly used to treat arthritis 
and a number of other conditions. AbbVie, the manufacturer of HUMIRA, 
has 136 patents and 247 patent applications on that drug, which has 
been available for more than 15 years. This type of behavior makes it 
very difficult for biosimilar manufacturers to bring a product to 
market--competition. While the patent on the actual drug formula may 
have expired, there are still, in this case, hundreds of other patents 
to sort through. Litigating all of these extraneous patents is 
expensive, difficult, and unnecessary. This artificial structure denies 
market entry for competitors years beyond the exclusivity period that 
the law intends to grant. Today, there are five competitors of HUMIRA 
that are available in Europe, but they are blocked from being sold in 
the United States until 2023.
  This bill will not stifle innovation or punish those who use the 
patent system as it is intended; it simply stops the bad guys from 
profiting off the backs of patients. This is a critical component of 
our efforts to bring down drug costs, and I am glad this proposal 
received unanimous support in the Judiciary Committee.
  Later this week, the House Energy and Commerce Subcommittee is 
holding a hearing about pharmaceutical companies gaming the system, and 
I am eager to see what kinds of proposals our friends in the House 
introduce as part of this effort.
  I think it is fair to say that we have done some serious work here in 
the Senate when it comes to reducing prescription drug costs, but we 
have work ahead of us to do. In other words, we have to bring them to 
the floor for a vote, and I hope we do so soon.
  I appreciate the countless Texans who have reached out and 
communicated with me and who continue to reach out to share their 
concerns and their stories about unnecessarily high out-of-pocket drug 
costs. I am committed to working with all of our colleagues across the 
aisle to address these rising healthcare costs generally and to ensure 
that drug companies put patients before profits.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Utah.


                    Nomination of John Rakolta, Jr.

  Mr. ROMNEY. Mr. President, I rise today to speak on behalf of the 
nomination of Mr. John Rakolta to become the Ambassador to the United 
Arab Emirates.
  Mr. Rakolta is the owner of a construction company that builds major 
projects like factories, churches, hospitals, and airports. His firm 
guides the work of thousands of workers here in the United States and 
in countries around the globe. With revenues of approximately $1.7 
billion annually, he has built one of the largest and most successful 
general contractors in the Nation.
  I presume this success has made him a prosperous person, but he is 
also a person who is actively engaged in his community. He has served 
on the boards of numerous organizations, several of which have focused 
on the rejuvenation of his city of Detroit and its less advantaged 
citizens. He has also received so many awards that it would be 
impractical to list them all here today, but I note that he has been 
honored by such groups as United Way, the Michigan Black Chamber of 
Commerce, the Urban League of Detroit, the Boy Scouts of America, and 
New Detroit.
  Of course, my friends on the other side of the aisle are dutiful in 
their examination of any possible flaw. I am convinced that the 
concerns they may have raised are not well-founded, and he is, in fact, 
entirely qualified and appropriately nominated to this important 
position.
  I note that I am biased in favor of Mr. Rakolta because I have known 
him personally for more than 30 years. He and his family have spent 
dozens of evenings in the home of my parents, studying the teachings of 
their faith. He is a man who makes commitments only after a great deal 
of thought, and when they are made, he is fully loyal to them in his 
business, in his community, in his Nation, in his faith, and in his 
marriage and family of 4 children and 11 grandchildren.
  I know John Rakolta as a man of honor and integrity, and I am 
convinced that he will serve the country well.
  I yield the floor.
  The PRESIDING OFFICER (Mrs. Blackburn). The question is, Will the 
Senate advise and consent to the Rakolta nomination?
  Mr. ROMNEY. Madam President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The clerk will call the roll.
  The bill clerk called the roll.
  Mr. THUNE. The following Senators are necessarily absent: the Senator 
from Tennessee (Mr. Alexander) and the Senator from Kansas (Mr. 
Roberts).
  Further, if present and voting, the Senator from Tennessee (Mr. 
Alexander) would have voted ``yea.''
  Mr. DURBIN. I announce that the Senator from Colorado (Mr. Bennet), 
the Senator from New Jersey (Mr. Booker), the Senator from California 
(Ms. Harris), the Senator from Vermont (Mr. Sanders), and the Senator 
from Massachusetts (Ms. Warren) are necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 63, nays 30, as follows:

                      [Rollcall Vote No. 283 Ex.]

                                YEAS--63

     Barrasso
     Blackburn
     Blunt
     Boozman
     Braun
     Burr
     Capito
     Cassidy
     Collins
     Coons
     Cornyn
     Cotton
     Cramer
     Crapo
     Cruz
     Daines
     Enzi
     Ernst
     Fischer
     Gardner
     Graham
     Grassley
     Hassan
     Hawley
     Hoeven
     Hyde-Smith
     Inhofe

[[Page S5508]]


     Isakson
     Johnson
     Jones
     Kennedy
     King
     Lankford
     Lee
     Manchin
     McConnell
     McSally
     Moran
     Murkowski
     Murphy
     Paul
     Perdue
     Peters
     Portman
     Risch
     Romney
     Rounds
     Rubio
     Sasse
     Scott (FL)
     Scott (SC)
     Shaheen
     Shelby
     Sinema
     Stabenow
     Sullivan
     Tester
     Thune
     Tillis
     Toomey
     Van Hollen
     Wicker
     Young

                                NAYS--30

     Baldwin
     Blumenthal
     Brown
     Cantwell
     Cardin
     Carper
     Casey
     Cortez Masto
     Duckworth
     Durbin
     Feinstein
     Gillibrand
     Heinrich
     Hirono
     Kaine
     Klobuchar
     Leahy
     Markey
     Menendez
     Merkley
     Murray
     Reed
     Rosen
     Schatz
     Schumer
     Smith
     Udall
     Warner
     Whitehouse
     Wyden

                             NOT VOTING--7

     Alexander
     Bennet
     Booker
     Harris
     Roberts
     Sanders
     Warren
  The nomination was confirmed.
  The PRESIDING OFFICER. Under the previous order, the motion to 
reconsider is considered made and laid upon the table and the President 
will be immediately notified of the Senate's action.

                          ____________________