[Congressional Record (Bound Edition), Volume 148 (2002), Part 8]
[Senate]
[Pages 10265-10268]
[From the U.S. Government Publishing Office, www.gpo.gov]




                  THE HIGH COST OF PRESCRIPTION DRUGS

  Ms. STABENOW. Mr. President, it is a pleasure to be here again this 
morning speaking about one of the most important topics to touch 
American families, seniors, and businesses. The entire economy, right 
now, is struggling with the explosion of health care costs. Most of 
those relate to the crisis of prescription drugs.
  First, I thank the Senator from Georgia for his leadership, for 
bringing forward and fighting for Medicare and prescription drug 
coverage for seniors. I was pleased yesterday to join with the occupant 
of the chair, Senator Bob Graham from Florida, Senator Ted Kennedy from 
Massachusetts, Senator Harry Reid, our distinguished assistant majority 
leader, and many others who have come together to put forward a 
voluntary, comprehensive Medicare prescription drug benefit for our 
seniors, one we can be proud of, one that people can choose to sign up 
for if they need it; and if they choose not to because of other 
coverage, that is good as well. But it will be there for everyone. It 
will finally keep the promise of Medicare by truly covering the way 
health care is provided today. We know that is long overdue.
  As we all know, in 1965, when Medicare was constructed, it covered 
the way health care was provided. When you went in the hospital and had 
an operation, you might need penicillin or something else connected 
with your stay in the hospital. But today is different. Most people 
don't go to the hospital. Most people are able fortunately to receive 
some kind of assistance, such as medications that prevent problems. 
Some have high blood pressure or high cholesterol and many other things 
that they need to take medication to control. You also may be able to 
take a pill that stops open-heart surgery. A gentleman in Michigan 
tells me he takes one pill a month, and it stops him from having to 
have open-heart surgery. He said that is great, but the pill costs $400 
a month.
  This is a gentleman who, fortunately, is a UAW retiree and is able to 
receive some assistance from an excellent benefit plan. But he said: 
What if I didn't have that? What if I was just on Medicare and didn't 
have that extra help

[[Page 10266]]

that came from my job? That $400 a month that stops open-heart surgery 
is a wonderful benefit.
  We celebrate the fact that that drug was created. But too many people 
would either not be able to afford that, would be sitting at the 
kitchen table, like a lot of people today, saying: Do I eat today? Do I 
pay the utility bill? Am I able to pay the other things that will allow 
me to live independently or do I get my medicine?
  So I am very pleased to be a part of the effort that is building in 
the Senate to pass a real Medicare prescription drug benefit, which we 
intend to do.
  I thank our leader, Tom Daschle, for making a commitment that we are 
going to bring this issue before the Senate for a vote in a matter of a 
few weeks.
  There are those around the country who are listening today and 
saying, Sure, we have heard this before, but is it really going to 
happen? Are we really going to be able to move the ball forward?
  The answer is, with the help of people who are watching and listening 
today, we will. The reason this has been so difficult an issue is that, 
unfortunately, we see an industry doing very well by diverting a lot of 
the current rules, by getting around a lot of the rules. The current 
system works well for the drug industry. There are six drug company 
lobbyists for every Member of the Senate. So their voice is heard here 
every day.
  I was pleased yesterday to join with about 30 different health care 
consumer groups to launch an effort to get the people's voice into this 
debate. Not only are we asking people to write their Senators, their 
House Member, and the President and say, now is the time to act--it is 
past the time to act--but we are also asking people to join us in an 
effort called fairdrugprices.org. Fairdrugprices.org is a new action 
center. We are asking people to log on--maybe this is your first time 
on a computer; if you do not have a computer, ask a family member, ask 
somebody else, and if, like so many of us, you are learning all this, 
just type in ``fairdrugprices.org'' and go to this site.
  You can sign a petition to send two messages to Congress: Pass a real 
Medicare prescription drug benefit and lower prices for everybody. We 
have a plan on how to do both. If you go to fairdrugprices.org, you can 
sign up to be a part of this process. You can also communicate with 
your Member of Congress through this site, as well as directly going to 
their site.
  Also, we are asking you to share your story. If you are a small 
business, the senior premium for health care went up 30 percent last 
year, and insurance companies said most of that was the explosion in 
prescription drug prices. Or if you are an 85-year-old woman with 
breast cancer struggling to buy tamoxifen or a 65-year-old man who is 
struggling with high blood pressure and other ailments and struggling 
to get the medicine you need, sign up, share that story, and we will 
bring that story to the floor of the Senate. We will make the people's 
voice a part of this process in a very real way because when the people 
are engaged--and, Mr. President, you know this--the right things 
happen.
  When people are involved in telling what is real--they are not making 
this up; this is not a made-up problem; they are not just trying to 
talk the talk--they want action. They want action from Senators. They 
want this to be bipartisan. They want the President to embrace this. 
They want us to solve the problem.
  There are a lot of other issues we can talk about around here, but we 
want to get this done. This effort is beginning to really get up steam. 
We want to invite everybody to go to fairdrugprices.org and engage in 
this issue.
  We also ask for some help to take a serious look at other proposals 
that are coming forward from other places that do not do the job. There 
are a lot of proposals that are being called Medicare prescription drug 
coverage. There are those who provide coverage that is affordable. We 
are pleased that our plan would be a $25-per-month premium and would 
provide comprehensive coverage with no gaps. It would not cut home 
health care to do it. It would not cut our hospitals or nursing homes 
to do it.
  We have a real plan. I regret to say that our colleagues on the other 
side of the aisle, on the other side of the Capitol, through the 
Speaker and the Republicans in the House, have not yet put forward a 
real Medicare plan. Unfortunately, what they put forward covers very 
little of the prescription drug bill, and they are talking continually 
about including cuts to hospitals and other providers to pay for it and 
setting up new costs for home health care.
  I know in my own family and friends' families, often when you are 
struggling with that prescription drug bill, you also need some home 
health care help. Those frequently go together.
  Today we are very proud of the home health care industry, our 
visiting nurses, and our other small businesses that set up shop to 
help people live in dignity at home. We know it is good from a quality-
of-life standpoint. We know it saves money. It is good on all accounts. 
Home health care makes sense.
  My fear is that what is being talked about by our House Republican 
colleagues is charging copays. One will have to pay on the front end 
for visits. On the one hand, while saying we want to help with 
prescription drug coverage, on the other, we are going to create new 
costs for you, we will save a little money in this pocket and take a 
little more out of this pocket. In the end, that will not be helpful to 
people.
  I call upon my colleagues on the other side of the aisle and the 
other side of the Capitol, in the House of Representatives, to join 
with us in a real effort. Do not add costs to home health care. Do not 
cut our providers who have already been cut enough. Join with us in 
something that is real and makes sense.
  One of my other concerns about what the House is talking about is 
that it would not be a benefit under Medicare. They are saying let 
private insurance cover prescription drugs with prescription-only 
policies. I suggest that if the insurance companies wanted to do that, 
they would have already done that. The reason they do not is that it is 
very expensive to provide a prescription-only insurance policy, outside 
of Medicare or outside of a standard policy.
  Ironically, if you go back and look at the debate prior to 1965 when 
Medicare came into being, it came into being because the only thing 
that older adults had at that time was to try to find insurance in the 
private sector, and about half of them could not find any or it was not 
affordable because it is less profitable to cover older adults or to 
cover the disabled or to cover people who are likely to begin to have 
more health ailments. So those policies were not there.
  Medicare came into being to make sure that everybody had access to 
health care; that our older citizens, our disabled citizens would be 
able to get the same care that other citizens received. That was a 
promise we made in 1965.
  Now, instead of making sure that promise is real by covering 
prescription drugs, which is the way health care is provided today, we 
have our colleagues on the Republican side of the aisle saying: Let's 
go back to what did not work before 1965. Let's go back to the system 
that does not work.
  We are saying that is not good enough. More importantly, the people 
of the country are saying that is not good enough. I believe people are 
watching and are holding us accountable. They are holding us 
accountable as to whether or not we are going to get past the talk and 
start walking the walk.
  Are we going to make this happen or continue to set up straw men that 
sound good, get people through an election, but, in the end, do not 
create the ability for one senior to buy one pill? That is the 
challenge we face, and we have an opportunity because of the leadership 
in the Senate by our Senate majority leader, Senator Daschle, and 
Senator Harry Reid, and others who have said this is so important, we 
are

[[Page 10267]]

going to make this a priority now, that this summer we are going to act 
on this issue; we are going to bring this up.
  It is so important we now engage people and invite people to join us 
to make sure we are successful. This is not just about getting a vote 
or bringing up a bill, this is about fixing the problem. It is about 
creating a Medicare prescription drug benefit for everyone who needs it 
and making sure they then have the ability to get the health care they 
need.
  Frankly, I am excited about what 
is ahead in the next few weeks and 
want to invite people to join us to 
be a part of this effort--again, fairdrugprices.org.
  I want to also invite people from Michigan, if those from Michigan 
are listening, to visit my own Web site. We are asking people as well 
to come and join us and check out what is happening through my Senate 
Web site: Stabenow.Senate.gov. At this Web site, we are asking people 
to take a look at what we are doing and share the stories through our 
Web site as well.
  I also mention this morning the important efforts to cut prices for 
everyone. As I said in the beginning, we have two goals. We have the 
goal of updating Medicare so it really provides health care and meets 
the promise that was made in 1965, but we also know that this issue 
affects everyone. As I said before, if one is a business owner, a 
farmer trying to get health care coverage for their family, a young 
working family, or an older working family, right now we have a very 
unfortunate situation in our country. In fact, in some cases we are 
paying for all of the initial research on these new lifesaving drugs 
into the billions, over $23 billion.
  We have been increasing the research through the National Institutes 
of Health every year. As of this year, I believe, we have doubled in 
the last 5 years the funding for NIH, a very important thing to do. It 
is something we have had support for on both sides of the aisle. It is 
very important that we be able to move forward on this funding. That is 
good.
  We then have a situation in our country where we allow companies to 
take that information that you and I pay for, and begin to develop 
these new drugs. As they do that, as a further incentive, we allow them 
to take deductions on their taxes for the research. We give them a new 
20-percent tax credit on new research. We also allow them to write off 
their advertising, marketing, and sales costs. We give them up to a 20-
year patent. We say it is so expensive to create these new drugs that 
we are going to make sure their name brand cannot be challenged and 
they cannot have competition for that formula for up to 20 years. So we 
protect that for them through a patent.
  When all is said and done, after all this investment and all of this 
effort to support creating these new drugs, what do we have? 
Unfortunately, we have, as Americans, the highest prices in the world. 
That makes absolutely no sense.
  What I fear is that we are seeing more and more an industry that is 
less focused on new breakthrough drugs and more focused on how to 
create more profit by slightly changing the drug to keep the patent 
going, making it a purple pill instead of a red pill, changing the box, 
promoting it, changing the name, keeping the patent going so there is 
no competition, and keep raising those prices right through the roof.
  I was very interested in watching a program that Peter Jennings put 
forward on ABC a couple of weeks ago. I commend ABC and Peter Jennings 
for coming forward with something that was very comprehensive but, 
unfortunately, extremely disturbing. It indicated that about 80 percent 
of the new patents, the new drugs that are going on the market, the new 
patents approved by FDA on what is called standard drugs--that is a 
category that means there is very little difference between the drug 
that was already there and the new drug--80 percent are not drugs that 
have changed the formulas in a way that would improve health care.
  What we see happening instead is this movement of sales and marketing 
and advertising, and now, unfortunately, in the last 5 years--in fact, 
since 1996--the FDA has changed the rules so that drug consumer 
advertising is allowed. They have loosened the rules, and we have seen 
an explosion in the amount of direct consumer advertising.
  Anyone listening today, anyone listening in the Chamber, all we have 
to do is turn on our television set, and if not every ad, every other 
ad is a beautiful picture, a beautiful ad, for a prescription drug. 
That is great if they want to do that, but unfortunately we now see two 
and a half times more being spent on advertising than on research. The 
latest numbers show there was more spent on advertising Vioxx than 
Pepsi, Coke, or Budweiser.
  As I have said so many times before, someone can decide not to have a 
Coke today, although I am pretty addicted to Diet Coke, but if someone 
is a breast cancer patient, they cannot decide not to take Tamoxifen 
without very serious consequences. So this is not the same and should 
not be treated the same.
  So one of the bills that we put forward--and I appreciate the 
Presiding Officer's support and cosponsorship with me--is something 
called the FAIR Act, the Fair Advertising and Increased Research Act. 
It is a bill that would simply say we will allow the companies to write 
off advertising and marketing and sales from their taxes. In other 
words, we will subsidize that as taxpayers but only to the level we 
subsidize research. It makes sense to me. We will allow advertising, 
and certainly they can do as much as they want, but we just do not want 
to pay for it. So we are saying we will pay for as much or help 
subsidize as much on advertising as we do on research; beyond that, 
they are on their own.
  I hope we will get a vote on that bill, that we will be able to cap 
those excessive advertising costs, because it is overdue and we know it 
is part of the explosion. It is not only the advertising costs, it is 
that increased utilization that comes from promoting medications and 
the top name brand rather than one that may be exactly the same that is 
not advertised.
  That leads me to another very important issue, and that is the 
question of unadvertised brands. We know that at least half of the 
medications out today have another drug that is exactly the same or 
extremely close, that is just not advertised. It is called a generic. 
We know that if someone uses that unadvertised brand, they can cut 
their costs 35, 50, 75 percent. I have seen quotes of savings up to 90 
percent. So there is a major effort now happening. I commend Blue 
Cross/Blue Shield of Michigan, which is working with our Chamber of 
Commerce and others, in a coalition, and I know it is happening across 
the country, to close the loopholes in the law.
  Senator John McCain and Senator Chuck Schumer have a bill, which I am 
pleased to be cosponsoring, that would close the loopholes which right 
now allow the drug companies to stop these unadvertised brands from 
going on the market. So we want to address that as well.
  We want to have the opportunity to do away with excessive 
advertising, use more of the unadvertised brands and drop the prices 
for people. We also want to open the border to Canada where right now 
one can buy prescriptions at half the price.
  The final thing on our agenda is to support those States that are 
creatively looking for ways and acting to lower prescription drug 
prices for their citizens. About 30 different States, including my home 
State of Michigan, are developing ways to lower prices, some very 
creatively.
  In Maine, for example, they have developed a policy where if someone 
is doing business and they have a Medicaid contract for prescription 
drugs, then they are requiring that same discounted price be provided 
that is provided to the State through Medicaid to those who do not have 
insurance but are not on Medicaid. So they are using their clout as 
purchasers to be able to lower prices, and they are being sued. Not 
surprisingly, a drug company lobby is suing all of the States that are 
doing that.

[[Page 10268]]

  The final bill I have introduced is called the RX Flexibility for 
States bill, which would make it clear that States have a right to 
develop innovative programs to lower prices for their citizens and to 
use the Medicaid purchasing power as a part of that.
  In conclusion, let me say we have a plan. As the Presiding Officer 
knows, because he is one of the key leaders on our Medicare plan, we 
have a Medicare plan. We have proposals to lower prices. We have a plan 
that will make sure our seniors and our disabled have what they need in 
lifesaving medicine. We will make sure small businesses can count on us 
to do something to lower prices for our farmers, our families.
  I call upon colleagues to join as quickly as possible to put this

 plan in action. Again, I invite all

citizens listening today to join www.fairdrugprices.org. Get involved. 
Put the people's voice in this debate. I know we will be able to get 
something done.
  I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. REID. Mr. President, I ask unanimous consent the order for the 
quorum call be rescinded.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. REID. Mr. President, I ask unanimous consent I be allowed to use 
the remainder of the time in morning business. I see no one here from 
the minority.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.

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