[Congressional Record Volume 169, Number 153 (Thursday, September 21, 2023)]
[Senate]
[Pages S4644-S4645]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                        Prescription Drug Costs

  Mr. CARDIN. Mr. President, I rise today to highlight a historic 
moment which will help millions of older Americans and families access 
affordable prescription drugs.
  For too long, U.S. families have paid the highest prices compared to 
other countries, often leading millions of Americans to leave their 
pharmacy counter emptyhanded. With the passage and implementation of 
the Inflation Reduction Act under President Biden's leadership, 
Democrats are answering the call of the American people for affordable, 
accessible prescription drugs.
  No one should have to go into debt to buy the prescription drugs they 
need to live a healthy, productive life. Yet this is a dilemma many 
families in the United States face. Twenty-nine percent of Americans 
either cannot afford their prescription drugs or are rationing them, 
and the United States stands alone in this among our developed-nation 
peers.
  The United States spends about $600 billion annually on prescription 
drugs. In 2019, the latest year in which internationally comparable 
data from OECD is available, the United States spent over $1,100 per 
capita on prescription medicines. When you compare that to the other 
OECD countries, it is twice as much.
  Getting worse, by 2021 the United States spent over $1,400 per capita 
on prescription drugs. Americans and Marylanders are struggling to pay 
for their prescription medications, and it is long past time for 
Congress to take decisive action to deal with this issue.
  Prescription drugs have been lifesaving for millions, but if they are 
unaffordable, then their benefit is lost. High prescription drug prices 
drive health inequities that we are fighting to eradicate since groups 
in fair or poor health struggle to afford their medications.
  U.S. prescription drug prices are set through a complicated process 
by manufacturers, pharmaceutical benefit

[[Page S4645]]

managers, and payers. Prices are often disconnected from the health 
impacts of the products being purchased. Opponents of addressing the 
high prescription drug prices claim that more affordable prices will 
come at the expense of innovation.
  I must tell you, I disagree with that, and research also tells us 
that is just not true. To ensure access to innovative treatments and 
prescriptions, the U.S. Government, thanks to the U.S. taxpayer, makes 
significant investments in biomedical research. No greater example of 
this investment is the National Institutes of Health, located in my 
home State of Maryland, which is the world's largest government funder 
of biomedical research. Almost all drugs rely on NIH-supported basic 
science in their development, and the returns on these investments are 
very high. We have doubled down on this in the CHIPS and Science bill, 
putting more money into basic biomedical research.
  Researchers from the Massachusetts Institute of Technology have found 
that each $125 million NIH grant leads to $375 million--that is a 3-to-
1 ratio--more in private market value, 33 more patents, and 1 new drug.
  Another study estimated that the rate of return on NIH investments is 
43 percent and that each dollar of NIH funding leads to an additional 
$8.40 in private research and development spending. These are great 
public investments, and it is leading to innovation. It is leading to 
development of new drugs.
  Further, the Small Business Innovation Research and Small Business 
Technology Transfer Programs also support innovation. Known as the 
SBIR/STTR Programs, they currently are the largest U.S. Federal 
Government programs supporting small businesses to conduct research and 
development. This is just another example of government-supported 
research that is inspiring new innovation and discovery.
  SBIR began in 1982 and currently requires that each Federal Agency 
spending more than $100 million annually on external research set aside 
3.2 percent of these funds for awards to small businesses. SBIR is very 
selective, with only about 22 percent of the applicants receiving 
funding. For many small businesses, the SBIR ``serves as the first 
place many entrepreneurs involved in technological innovation go to for 
funding.''
  Through the SBIR/STTR Programs, NIH supports drug innovation by 
setting aside more than 3.2 percent of its overall intramural research 
and development budget, specifically to support early-stage small 
businesses throughout our Nation. Many companies leverage this NIH 
funding to attract the partners and investors needed to take innovation 
to the market.
  I have the honor of chairing the Small Business Committee here in the 
U.S. Senate, and I can tell you the small businesses are the innovators 
of America. They are the ones coming up with new discoveries.
  Thanks to this government program and thanks to these government-
supported partnerships, our small companies are leading in biomedical 
developments. And, I must tell you, thanks to small businesses, they 
are also growth engines for jobs in America.
  For example, Amgen, which was founded in 1980, received an SBIR 
investment in 1986 as a small company. Today, it is a multinational 
biopharmaceutical company with over 20,000 employees. That is creating 
jobs--good jobs--here for Americans.
  Despite these significant taxpayer investments, prescription drugs 
are often priced at levels that limit access to lifesaving drugs, 
particularly among those who are underinsured or uninsured. Even after 
accounting for the costs and risks of R&D, evidence shows that the 
returns on new products exceed the normal rates of return.

  For years, Congress has been working on commonsense solutions to 
increase access to affordable prescription medications, reducing costs 
for patients and taxpayers. Finally, last year, under President Biden's 
leadership, Congress passed the Inflation Reduction Act. This historic 
law removed a decades-old restriction on Medicare negotiating directly 
for the price of prescription drugs, finally empowering Medicare to get 
older Americans the best prices for their prescription drugs.
  In the private sector, no plan sponsor or manager would ever accept 
responsibility without the ability to decide how to negotiate. No 
private sector company would parcel themselves out in order to 
negotiate. They would use their full size as their market force. That 
is exactly what we did in the Inflation Reduction Act to allow Medicare 
to negotiate using its full market force to bring down the costs of 
prescription medicines for those under the Medicare system.
  It should have been done originally. We got it done in the Inflation 
Reduction Act. Medicare negotiations will ensure that patients with 
Medicare get the best possible price on high-priced drugs.
  Three weeks ago, the Biden-Harris administration announced the first 
10 drugs that will be part of the first round of negotiation. This 
historic occasion is the culmination of decades of efforts by Democrats 
to make prescription drugs more affordable and accessible to Medicare 
beneficiaries. The 10 drugs chosen for negotiation are taken by 10 
million older Americans, representing about $50 billion in annual 
spending. They are used to treat conditions including blood clots, 
diabetes, cancer, heart failure, and rheumatoid arthritis.
  Another policy included in the Inflation Reduction Act is to increase 
prescription drug affordability by capping Medicare patients' out-of-
pocket costs at $3,000 in just a couple months and then lowering to 
$2,000 beginning in 2025. This policy will save Medicare beneficiaries 
from paying tens of thousands of dollars to purchase lifesaving drugs 
prescribed by their doctors.
  And there is more good news. As of this year, vaccines are free in 
Medicare, insulin is capped at $35 a month, and drug companies are 
penalized if they raise prices faster than inflation.
  All of these policies will make U.S. prescription drugs more 
affordable for individuals and families who desperately need them. 
Democrats worked together to pass the Inflation Reduction Act and to 
make these policies a reality.
  Today, I celebrate the progress we have made, and I urge all of my 
Senate colleagues to join in our efforts to continue making progress 
and leading the world in developing new drugs to improve health 
outcomes and to make these drugs affordable to our constituents and 
lower the costs to the taxpayers of this country.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. MORAN. I ask unanimous consent that the order for the quorum call 
be rescinded.
  The PRESIDING OFFICER (Mr. Sanders). Without objection, it is so 
ordered.
  The Senator from Kansas.