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Under the gaze of Bernie Sanders, pharmaceutical industry leaders defend their prices

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Executives from three major pharmaceutical companies defended their drug prices before the Senate Health Committee on Thursday, drawing them further into a showdown with lawmakers and the Biden administration over the cost of some of the most widely used prescription drugs. used.

Lawmakers, including Sen. Bernie Sanders of Vermont, chairman of the committee, noted that the companies charged more in the United States than in other wealthy countries, accusing them of profiting at the expense of American patients. Pharmaceutical executives – from Johnson & Johnson, Merck and Bristol Myers Squibb – acknowledged that patients in the United States were paying too much, but said new drugs were arriving there faster than anywhere else in the world.

Mr. Sanders, an independent who made controlling drug prices a top cause in his later years in Congress, acknowledged that the companies had produced life-saving drugs. But he pointed to several widely used drugs, including Eliquis, a blood thinner from Bristol Myers Squibb, which he said could be purchased much cheaper in Canada than in the United States.

“These drugs mean nothing to anyone who can’t afford them,” Sanders said, adding that “millions and millions of people cannot afford the shockingly high cost of prescription drugs in this country.” .

The three executives who testified — Joaquin Duato of Johnson & Johnson, Robert M. Davis of Merck and Christopher Boerner of Bristol Myers Squibb — acknowledged that drug prices were often higher in the United States than in other wealthy countries. .

But they say lower prices in Europe and Canada, where governments are working harder to contain costs, come with major downsides, such as long waits for new drugs and limited insurance coverage.

“The United States has built a health care system that prioritizes patient and physician choice and the broad and rapid availability of cutting-edge medicines,” Boerner said.

At one point, Mr. Sanders, who accused companies of using drug profits to enrich executives and shareholders even as patients struggled to pay for their drugs, tried to get Mr. Boerner the promise that the company would reduce the U.S. sticker price of drugs. Eliquis to this in Canada. Mr. Boerner refused, citing differences in the Canadian health care system.

The hearing came as a new federal program allowing Medicare to negotiate prices for some high-cost drugs is being implemented. Federal health officials last week made their initial offers to the makers of the first 10 drugs selected for negotiations, a list that includes Eliquis and four other drugs sold by the companies whose executives testified Thursday. Drugmakers, including the three companies represented at the hearing, have filed a series of lawsuits arguing that the trading program is unconstitutional.

As pharmaceutical executives sat before them, lawmakers described the agonizing decisions that patients with expensive medications had faced. Mr. Sanders mentioned a Nebraska woman who he said died of cancer after starting a GoFundMe campaign to fund Keytruda, a blockbuster cancer drug from Merck.

Sen. Christopher S. Murphy, Democrat of Connecticut, said one of his Eliquis constituents had to choose between the cost of medicine, food and rent.

Republicans on the committee highlighted what they considered legitimate business incentives that companies used to set the price of their drugs.

“In capitalism, if you run a business where you have a fiduciary responsibility to your owners, you try to get as high a price as possible,” said Senator Mitt Romney, Republican of Utah. He added: “You think Chevrolet is sitting back and saying, ‘My God, how can we get the price of this Chevrolet down?’ No, it’s like, “What price can I get and maximize the profit for my shareholder?” »

The hearing came after a confrontation between Mr. Sanders and two of the pharmaceutical executives, Mr. Duato of Johnson & Johnson and Mr. Davis of Merck, who agreed to testify only after being threatened with subpoenas. . Both companies suggested last month that Mr. Sanders was seeking retaliation for their lawsuits challenging Medicare’s price negotiation program.

Sen. Bill Cassidy of Louisiana, the committee’s top Republican, said the panel’s strategy had been to “threaten a subpoena when CEOs suspect they won’t get a fair chance, to hold the ‘audience, get some sound clips, and then choose another set.’ CEOs for a show trial.

“But we’re not passing meaningful legislation,” he said.

Prices for brand-name drugs in the United States in 2022 were on average at least three times higher than those in 33 other wealthy countries, according to a recent report funded by the Department of Health and Human Services, even when taking into account reductions that reduce the amounts paid by U.S. health plans and employers.

Comparing drug prices in the United States with those in other countries can be tricky because the health care systems are very different. While European countries rely on a centralized negotiator, the U.S. system is fragmented, with tens of thousands of health plans and employers relying on intermediaries to conduct their negotiations.

While many prescription medications can be purchased much cheaper at European pharmacies, insurance coverage is often broader in the United States, meaning American patients sometimes have to pay less than Europeans for the same medications.

At the hearing, drug company executives accused middlemen known as pharmacy benefit managers of charging patients high fees. These companies get discounts from manufacturers that reduce the bill for U.S. health plans and employers, but not patients. Benefits managers make more money when the price of a drug is higher, but patients often have to pay more. Lawmakers have proposed making modest changes to benefits managers’ practices.

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