[Congressional Record Volume 169, Number 184 (Tuesday, November 7, 2023)]
[Senate]
[Pages S5382-S5383]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                  Nomination of Monica M. Bertagnolli

  Mr. CARDIN. Mr. President, I rise today to express my support for Dr. 
Monica M. Bertagnolli, whom President Biden nominated to serve as the 
next Director of the National Institutes of Health--NIH. As current 
director of the National Cancer Institute--NCI--and a distinguished 
professor and surgeon, Dr. Bertagnolli certainly possesses the 
experience that will make her an effective leader for our Nation's 
preeminent research center.
  The NIH serves as the pinnacle of biomedical and behavioral research 
in the United States and provides valuable insights that are used 
around the world for saving lives and improving people's health. 
Whether we know it or not, the NIH and the research done there has 
touched all of our lives by giving our healthcare professionals the 
resources they need for success. We in Maryland are proud to have the 
NIH headquartered in Bethesda, with so many in our State contributing 
to its important mission.
  Thanks to Dr. Bertagnolli's decades of experience as a physician-
scientist, she has obtained a well-rounded view of medical research 
that I am confident will properly inform her decisions as NIH Director. 
Her work to better understand the development and treatment of various 
types of cancer highlights the diligence and effectiveness that qualify 
Dr. Bertagnolli for this position.
  As NCI Director, Dr. Bertagnolli has demonstrated her leadership 
capabilities alongside her efficacy as a researcher, working with the 
Biden Administration to reignite the Cancer Moonshot, which aims to 
reduce cancer mortality by 50 percent over the next 25 years. This 
ambitious goal reflects the determination of our cancer research 
professionals and President Biden's continued commitment to investing 
in programs, consortia, and research projects that aim to end cancer as 
we know it. The NCI, along with spearheading the Cancer Moonshot 
initiative, has also partnered with the Biden Administration to address 
disparities in cancer outcomes for Americans living in low-income 
areas, working to implement community-based programs in locations 
facing persistent poverty.
  Just a few weeks into her tenure as director of NCI, Dr. 
Bertagnolli's work became much more personal as she was diagnosed with 
early-stage breast cancer following a routine mammogram. She was forced 
to balance her new role as our Nation's leading cancer researcher with 
her own personal battle with the disease. I cannot commend Dr. 
Bertagnolli enough for the strength she has shown to continue her 
service to Americans in the face of such a daunting challenge.
  If the Senate confirms Dr. Bertagnolli today, I would encourage her 
to take aim at some of the most pressing healthcare issues facing our 
country. As things stand, significant health disparities exist in the 
United States, with many Americans not receiving equitable access to 
care. Dr. Bertagnolli's confirmation provides her with the chance to 
utilize the NIH's National Institute for Minority Health and Health 
Disparities to work towards solutions for underserved populations that 
aren't receiving the care they need. Her new role would also empower 
her to build a stronger, more diverse healthcare workforce, one that 
would be well-equipped to face the challenges of today.
  As a Marylander, I would be proud to welcome Dr. Bertagnolli to our 
State. She will be tasked with addressing many crucial and complex 
issues as Director of the NIH, but I am confident that she is up to the 
challenge.
  I ask the Senate colleagues to join me in recognizing Dr. Bertagnolli 
for the outstanding work she has done as a researcher and surgeon, to 
support her confirmation, and to wish her well in her new role should 
she be confirmed.
  Mrs. MURRAY. Mr. President, I ask unanimous consent to speak for up 
to 2 minutes prior to the vote, followed by Senator Sanders, who will 
speak for up to 10 minutes.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mrs. MURRAY. Mr. President, I have always strongly advocated for the 
NIH because I know the work that they do--as so many world-class 
institutions, including several in Washington State--isn't just cutting 
edge; it is lifesaving. This Agency, the NIH, holds the hope and future 
of patients across the country in its hands. So it is of the utmost 
importance to me to make sure we have an experienced leader at the helm 
of NIH, and Dr. Bertagnolli is an excellent choice to lead the Agency 
at this critical moment. You need a steady hand to be a cancer surgeon 
after all.
  Her credentials go far beyond her record of accomplishment as an 
oncologist. She is a respected researcher and a proven leader. She has 
served on the board of directors of the American Society of Clinical 
Oncology, the American Cancer Society, and the Prevent Cancer 
Foundation. She was the CEO of Alliance Foundation Trials, LLC, a not-
for-profit focused on making sure rural communities are included in 
clinical studies. Of course, now she is the head of the National Cancer 
Institute, where she has led the research strategy and goals for 
President Biden's Cancer Moonshot Initiative.
  In addition to that which she brings to this role, she also brings a 
strong personal connection, which she spoke about at our HELP Committee 
hearing. She brings the personal experience of growing up in a rural 
community, where she watched her uncle travel across the State to 
provide care to patients and where she watched her father fight cancer 
while care was far from home. And she brings the most recent personal 
experience of receiving a cancer diagnosis and then of receiving care 
that was made possible by NIH research.
  It is clear that those experiences will inform how she approaches her 
new role at the NIH, and I know patients will be better for it.
  I also want to take a moment to recognize that, in the field of 
biomedical research, where women have long been severely 
underrepresented both in clinical trials and in the workforce, it will 
be truly meaningful to have such an accomplished woman serving in a 
role that has real power to tackle issues like improving diversity in 
clinical trials, fighting sexual harassment that has pushed too many 
women out of the field, and tearing down other barriers to achievement 
and equal representation for women in medical research.
  Dr. Bertagnolli is the right person to ensure the NIH stays on the 
cutting edge of innovation and research and fulfills its critical 
mission to promote health, improve equity, keep our Nation competitive, 
and give patients across the world real hope for the future. She has 
the experience in medicine, research, and management needed for this 
role. Most importantly, she has a deep understanding of what the NIH's 
work means for families in this country who are counting on medical 
breakthroughs.
  I am proud to be voting yes. I urge my colleagues to do the same.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. SANDERS. Mr. President, the American people understand--whether 
they are Democrats, Republicans, or Independents--that our healthcare 
system is broken; it is dysfunctional; it is failing.
  We spend almost twice as much per person on healthcare--an 
unsustainable $13,000 for every man, woman, and child--than any other 
country on Earth, and yet the results of all of that spending are 
abysmal. While the insurance companies and the drug companies make 
hundreds of billions of dollars in profit, we have 85 million Americans 
who are uninsured or underinsured and over 60,000 people who die every 
single year because they can't get to a doctor when they need to.
  In this country, despite our huge expenditures, we don't have enough 
doctors, nurses, dentists, pharmacists, or mental health specialists; 
and our life expectancy is far lower than in most other countries, 
especially for working class and lower income Americans. In my view--
and I think it is the view of

[[Page S5383]]

most Americans--healthcare is a human right, not a privilege, and we 
need major reforms to our current system so that every man, woman, and 
child in this country gets the quality healthcare they need regardless 
of their financial status.
  The responsibility for reforming our broken healthcare system rests 
with the administration, and it rests with many Agencies of government, 
including the HHS; the CMS; the FDA; and the National Institutes of 
Health, the NIH, which plays a very important role in the development 
of new prescription drugs.
  While the 10 largest drug companies made over $112 billion in profits 
last year and while they pay their CEOs exorbitant compensation 
packages, 1 out of 4 Americans cannot afford to pay for the medicine 
they need, and thousands of families face financial ruin as they pay 
outrageously high prices for the prescription drugs that keep them 
alive.

  Let's think about that for just 1 second. Millions of people in this 
country, every year, get sick. They go to the doctor, and the doctor 
writes out a prescription. Yet, because of the exorbitant price of 
prescription drugs in America, one out of four of those people cannot 
afford to fill that prescription. So what happens to those people? 
Well, they get sicker. Maybe they end up in an emergency room. Maybe 
they end up in a hospital. Maybe they die.
  How crazy is it that, in the richest country in the history of the 
world, 25 percent of our people cannot afford to fill the prescriptions 
that their doctors prescribe?
  But it is not just the high cost of prescription drugs that impacts 
individuals. In the largest hospital in my State, the State of 
Vermont--and I don't think it is terribly different elsewhere--the high 
cost of prescription drugs accounts for 20 percent of the overall 
budget of that hospital, and that drives insurance policies up. What we 
pay in the hospital impacts greatly the prices we pay for insurance.
  In other words, the outrageously high cost of prescription drugs in 
America is a crisis situation that must be addressed. It impacts 
everybody.
  Adding insult to injury, not only has the Federal Government not 
effectively regulated the price of prescription drugs, but the 
taxpayers of this country have, over the years, provided hundreds of 
billions of dollars in research and development into new prescription 
drugs that have provided enormous financial benefits to some of the 
most profitable drug companies in America.
  For example, in America today, the median cost of new cancer drugs 
has gone up by more than 300 percent over the past decade even though 
85 percent of the initial foundational cancer research is funded by 
U.S. taxpayers.
  In June, the HELP Committee, which I chair, released a report that 
found that the average price of new treatments that NIH scientists 
helped to develop over the past 20 years is over $111,000.
  In other words, we are spending a fortune in developing new drugs, 
but our people cannot afford the treatments that they pay for.
  In virtually every case, American taxpayers are paying far more than 
people in other countries for the exact same medicine that the NIH 
helped to develop. Now, that may make sense to somebody, but it does 
not make sense to me.
  Here are just a few examples from the report:
  Astellas and Pfizer charge Americans with prostate cancer over 
$165,000 for Xtandi while the exact same drug can be purchased in Japan 
for just $20,000. Guess who developed that drug: American taxpayers.
  Johnson & Johnson charges Americans with HIV $56,000 for Symtuza 
while the exact same treatment can be purchased in the UK for just 
$10,000. Guess who developed that treatment: American taxpayers.
  Millennium Pharmaceuticals charges Americans with cancer $54,000 for 
Velcade while the exact same drug can be purchased in France for just 
$11,000. Guess who did the research and paid for that drug: the NIH and 
American taxpayers.
  In other words, here is the insane situation: The American taxpayers 
fund the research for these drugs, but they can't afford the product 
that they helped create. Does anybody really think that makes sense? If 
American taxpayers help develop a drug, we should be paying the lowest 
price in the world for that product, not the highest. That has got to 
change. No prescription drug, no matter how effective and lifesaving it 
may be, is worth anything to the patient who cannot afford it.
  In my view, at this crisis moment for American healthcare, we need an 
NIH Director who is prepared to take on the greed of the pharmaceutical 
industry and use every tool at their disposal to substantially lower 
the extraordinarily high cost of medicine in this country.
  The 1,800 well-paid lobbyists from the pharmaceutical industry here 
in DC--it is almost 4 lobbyists for every Member of Congress--may not 
like it, but that is precisely what the American people want, and it is 
what they need. The status quo is not working. We need fundamental 
changes in the way that the NIH addresses the crisis of high 
prescription drug costs.
  Dr. Monica Bertagnolli is an intelligent and caring person, but she 
has not convinced me that she is prepared to take on the greed and 
power of the drug companies and the healthcare industry in general nor 
is she prepared, in my view, to fight for the transformative changes 
the NIH needs at this critical moment. That is why I will be voting no 
on her confirmation.
  With that, I yield the floor.