[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.