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Yesterday's vote on "government pricing" of prescription medicines garnered the fewest votes of Speaker Pelosi's "First 100 Hour" pieces of legislation. Legislators are seeing the light.

As Everett Dirkson was fond of saying, "When I feel the heat, I see the light."

And the heat is from America's seniors who are pleased with the Part D drug benefit.

And the heat is from, among other places, the Washington Post. Here is what America's lawmakers woke up to find in their own Newspaper of Record:

The Wrong Prescription
Government should not negotiate drug prices in Medicare.

HOUSE Democrats delivered on a campaign promise yesterday, passing a bill that would require the government to negotiate the price of pharmaceuticals covered by the new Medicare drug benefit. The idea is that government negotiators could force prices down, generating savings that could be used to make the benefit more generous. But the measure is misguided.


Here's a link to the complete editorial:

http://www.washingtonpost.com/wp-dyn/content/article/2007/01/12/AR2007011201885_pf.html

And the most unhappy fella in DC today is Rahm Emanuel -- sponsor of the Newspeak-named "Pharmaceutical Market Access and Drug Safety Act which demands "world pricing" as well as drug importation.

If only 24 Republicans voted for HR 4, the chances for Mr. Emanuel's legislation are about as good as Nancy Pelosi calling for a statue of Charlie the Tuna in Dupont Circle.

Here's what Mr. Emanuel's constituents woke up in today's Chicago Sun-Times:

Cheaper drugs would come at a steep price

BY PETER J. PITTS

U.S. Rep. Rahm Emanuel (D-Ill.) has announced legislation "aimed at driving down the price of prescription drugs." But the only thing such legislation would actually drive down is pharmaceutical innovation.


And here's the link to that article:

http://www.suntimes.com/news/otherviews/209130,CST-EDT-REF13A.article

Even the New York Times is reporting that the Congressional Budget Office (CBO) study on "government pricing" shows that direct negotiations wouldn't save America's seniors any money.

America's legislators are beginning to feel the heat of truth and see the light of day -- that "government pricing" and quick fixes like drug importation are false promises -- and that the American people know it.
The good news is that the House passed the price control bill by the slimmest margin of any of the pieces of legislation introduced by Democrats during the 100 horrors campaign. Not enough votes to override an expected presidential veto. Which puts pressure on the Senate.

The bad news -- or at least the takeaway from all this -- is that opponents of price controls did not stress enough just how many seniors and disabled people (40 million and counting) now have coverage where they did not have it before. And combined with patient assistance programs, it means that America has gone a long way to making medicines affordable for those who need and use them most.

This has gotten lost in the debate about prices...always does. And so it is important to hammer home the point that more people are getting their drugs paid for -- at $200 billion less than expected -- with more choices than ever before. This will prevent disease and save money in Medicare overall. People are suffering less and living better as a result. Every dollar of new drug consumption reduces spending for other services by about seven or eight dollars.. We need to make that investment and we need more valuable ad effective drugs to make a greater difference.

Which is what should be emphasized. Disease still is more expensive than any drug. And making people pay for the most cost-effective and valuable part of health care makes no sense at all. We need to spend more on medicines, not less and we need to find ways to encourage that spending and ensuring that people are using medicines right for them, the first time. Now that's one way to fill the donut hole: personalizing prescribing to reduce side effects and provide more timely feedback.
Peter and I have op-eds today in Newsday and The Washington Times respectively on the Pelosi Prescription Price Club proposal to be voted on today.

Here are links to both ...

http://www.newsday.com/news/opinion/ny-opfri125048767jan12,0,1225572.story?coll=ny-viewpoints-headlines

http://washingtontimes.com/op-ed/20070111-084554-5979r.htm

And a Washington Times editorial on Medicare part D:

http://washingtontimes.com/op-ed/
Here we go again.

Remember the Pharmaceutical Market Access and Drug Safety Act? That’s the ill considered Emanuel/Emerson/Snowe/Dorgan bill that wants the US to import “world prices” along foreign drugs.

Well, the AARP has come out strongly in favor – particularly on the drug importation provision.

It seems that the AARP is getting old and a bit forgetful. Wasn’t is just recently that they pointed to Part D and said that it was a better deal than drugs “from Canada.” Short-term memory loss I suppose.

For more on this silly bill and the dangerous implications of drug importation, please see my December 22nd blog (“The John Grishams of Drug Importation”).
In retreat Democrats still want to control drug prices. Now the target are breakthrough drugs or one of a kind medicines as they were called in congressional testimony today. That means an attack on the most vulnerable...biotech companies -- who spend billions on research with hardly a hope of breaking even in the near time -- on breakthrough drugs for dying or severely ill patients.

We have be there before with disastrous consequences.....

We are back to the future when it comes to what
proponents of price control supporters want. They are
proposing special negotiating authority for new,
unique drugs.

Under the Clinton health plan, (and my thanks to the Heallthcare Blog for tracking this history down) because new drugs often initially have very high
prices, the Secretary was to have the authority to
negotiate special prices for breakthrough drugs
considered overpriced and could exclude these new
drugs from coverage if a rebate agreement could not be
reached. The Act also would have created an Advisory
Council on Breakthrough Drugs, which would advise the
Secretary on the reasonableness of launch prices of
new drugs representing significant advances over
existing therapies. Although the findings of the
council would not be binding, they would influence the
Secretary and the drug payments of other entities with
purchasing power.

The Advisory Council would have had the power to hold
hearings, supeona records publicly reprimand companies
whose prices are deemed excessive, and recommend to
the HHS secretary that it deny such companies the R&D
tax credit, Medicare/Medicaid reimbursement, or full
patent terms. This proposal caused the stock prices
for biotech companies plunge 40 percent.


Back then leading Democrats caved in....

From a 1994 biotech news roundup

DRUG PRICE REVIEWS PROPOSAL DROPPED

In a move seen as a concession to the biotechnology industry,
Representative John Dingell (D-MI) announced last week that his
Energy and Commerce Committee is dropping a proposal to review
drug prices. The announcement apparently came in response to
pressure by Representative Lynn Schenk (D-CA), whose legislative
district contains 100 biotechnology companies. The Clinton proposal
would have established an Advisory Council on Breakthrough Drugs
to review charges of pharmaceutical price gouging. Schenk said, "The
proposal has already panicked financial markets and forced cutbacks
on research and development in the biotechnology industry." Carl
Feldbaum, president of the Biotechnology Industry Organization
(BIO), said, "Ms. Schenk has exercised extraordinary influence for a
freshman member of Congress. The ultimate winners will be the
people suffering from diseases that have no treatment or cure."

If Democrats want to repeat this part of history, they will get hammered even harder than they are now on their mangling of Part D.
My attempt to help people parse out Nancy Pelosi's health care Newspeak...from The American Spectator

http://www.spectator.org/dsp_article.asp?art_id=10863
As any regular drugwonks reader knows, we have our differences with Senator Grassley on many issues. Significant differences.

But we all share the belief that the Part D benefit is working -- and working well ... and that Congress shouldn't start to monkey around with it for political purposes.

Here's what Senator Grassley had to say on the floor of the Senate:

Download file

We here at drugwonks hope that Senator Grassley will take similarly fact-based positions during the upcoming PDUFA debate.
I gobbled a handful of reimported Xanax from Rahm Emanuel's Reimported Drug Emporium (Same Taste. None of the Ingredients) and strapped myself into my office chair to watch the Senate Finance Committee hearings on Medicare price control proposals.

Four major takeaway points:

1. Ron Wyden and Olympia Snowe are clueless about the impact their bill would have on biotechnology and breakthrough drug investment. It would allow any plan pissed off about the price of the unique products for cancer, Alzheimer's, Parkinson's or innovative medicines to run to the government and demand 'negotiation' using such tools as seizure of all records and receipts and other data to see if the price was justified. Certain prices and certain drugs would set off an automatic trigger for direct government negotiation. That's called punishing success and a recipe for destroying partnerships between NIH, academia and private companies -- most of which yield information but no commercially successful products. Wyden's bill will kill off innovation and lead to influence peddling.

2. Most Senators are clueless about what drug development is and what drug companies do with respect to science. That is the drug industry's fault. And it's NIH's fault for not having the guts to say we rise and fall together instead of offering Senators this self-serving garbage that it is somehow the only wellspring of biomedical innovation. Companies had better get to work explaining their scientific enterprise, risks and all.

3. Senator Baucus made a throwaway comment as he was leaving about giving NIH more power to conduct more comparative effectiveness studies like ALLHAT and CATIE and information on what goes into drug pricing. This endorsement of evidence based medicine is misguided. Again, companies need to bring scientists and clinicians to explain why it is misguided and offer a patient-centered and personalized approach to prescribing. Like the Borg, the price control and formulary advocates will recalibrate their arguments to talk about cost-effectiveness as the benchmark for such decisions. That Commonwealth Fund lackey Gerard Anderson who is at Johns Hopkins (maybe he is the affirmative action hire for the intellectually mediocre) actually endorsed the Australian C-E guidelines as a backup for how drugs should be rationed at the hearing.

4. The community pharmacy lobby had better stay far, far away from Charles Grassley who did a great job defending Part D today... I disagree strongly with Grassley's grandstanding on drug safety but he had the opposition for lunch today. And he had the Democrats who were promising the community pharmacists higher dispensing fees in exchange for their support of their bill dead to rights. Grassley wanted to know how pharmacy lobby leadership could support a bill that would lead to the elimination of community drugstores.....

Oh, no one wants price controls and formularies...except Shameless Schumer. As I said in my previous post he should put his money where he mouth is..if there's room. If he thinks the VA exception process is so liberal let him follow the same procedures VA members go through....
More of America's top economists and health care scholars decry the lunacy of government negotiated prices for prescription medicines.

This time it's a letter in The Hill.

Here's the link.

sunitinib

  • 01.10.2007
That's Sutent. It's a new cancer drug used to treat stomach cancer in place of interferon and in patients who don't respond to Gleevec.

It's not on the VA formulary. And I guess it will stay that way under the pending Medicare bill so that Pete Stark can squeeze drug prices enough to pay off the pharmacy lobby for its support of the price control bill.
CMPI

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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