Biden tours nation touting prescription cost cuts, but plan’s holes appear
President Joe Biden speaks during an event on prescription drug costs, in the East Room of the White House, Tuesday, Aug. 29, 2023, in Washington. | Evan Vucci/AP

WASHINGTON—As President Joe Biden tours the nation touting his law letting Medicare bargain down Big Pharma’s high drug costs for insulin and nine other medicines, the Biden plan’s holes are appearing, too.

Biden is making the achievement a center of his re-election campaign, but advocates for seniors and patients—in other words, advocates for the entire U.S. population—say his edict doesn’t go far enough fast enough to control drug prices.

That’s because controls would begin starting in 2025 at the earliest, so emphasizing it could rebound against his re-election effort.

Meanwhile, Big Pharma and its front group, the U.S. Chamber of Commerce, hit Biden’s plan from the other direction. They don’t want any price mandates at all and they’re suing in federal court to stop him.

The drugs that Medicare can bargain down with Big Pharma “are among the most common and costly prescriptions that treat everything from heart failure, blood clots, diabetes, arthritis, Crohn’s disease–and more. This is on top of progress we made in reducing the cost of insulin to $35 a month for seniors on Medicare,” Biden said.

He estimated nine million seniors on Medicare would save billions of dollars. “We took on Big Pharma and special interests, overcoming opposition from every Republican in Congress, and the American people won,” Biden declared.

Not good enough, advocates reply. The prescription drug price problem is acute, so much so that Senate Health, Education, Labor and Pensions Committee Chairman Bernie Sanders, Ind-Vt., has already challenged Biden Health and Human Services Secretary Xavier Becerra to use his own legal authority to bring prices down.

Sen. Bernie Sanders of Vermont | Josh Reynolds/AP

Alzheimer’s drug overpriced

Sanders chose Leqembi, designed to slow the spread of Alzheimer’s disease, as his example of an overpriced drug. Big Pharma firms charge $26,500 per year for it.

“Is there any particular reason why the cost of this drug cannot be reduced to $8,900–the price independent experts believe it should cost based on its effectiveness?” Sanders asked Becerra.

And insulin costs $2,299 for a three-month supply, one patient told a Public Citizen press conference several weeks ago. Biden would bring that down to $35 a month. Insulin now costs $5 a vial to manufacture, Public Citizen adds.

“While the pharmaceutical industry makes record profits, millions of Americans are forced to choose between paying for medications they need to live or paying for food, rent, and other basic necessities. Those days are ending,” the president declared. Drug costs are so high that they often negate the effects of the lowering inflation rate as a whole. People spending more on drugs, on top of higher rents and mortgages, often can’t take advantage of lowering food costs, for example.

“More than half of new prescription drugs in America today cost more than $220,000 per year. Given this reality, it is simply unsustainable for Medicare to pay any price that pharmaceutical companies want to charge for new products,” Sanders declared. He plans hearings on the drug companies’ exploitation.

The price cuts won’t begin until 2026 at the earliest, and even then they’ll be phased in. And Sanders pointed out that Leqembi and insulin aren’t the sole Big Pharma medications which bankrupt U.S. consumers.

“With a median income of about $30,000 a year for seniors on Medicare the purchase of this one drug (Leqembi) would amount to over one-sixth of their limited income. For one drug! That is unacceptable. A prescription drug is not effective if a patient who needs that drug cannot afford it.”

There’s another problem with Biden’s plan, and AFSCME President Lee Saunders succinctly summarized it in one sentence on Medicare’s anniversary last July: “We need bold action that forces drug companies to negotiate reasonable prices that are also available to people with job-based [health care] plans.”

Often people with such plans are forced into regimens of less effective but cheaper drugs, sometimes with unpleasant or harmful effects, before they can get approval for the more modern and effective but more expensive drugs.

Patients with diabetes, for example, report that they have suffered months with nausea and other side effects due to cheaper drugs like Metformin when what they really need is the newer and more effective drugs. They are unable to get the better drugs until they have suffered first through regimens of the cheaper ones.

There are reports that insured working patients trying to get the new drugs that treat heart, diabetes, and weight problems simultaneously are being told by insurance companies that they can’t have the new drugs because they are just trying to “abuse” them for their weight loss effects. In effect, they are being told that obesity, which can kill, is, rather than a medical problem, the result of moral weakness on the part of the patients.

Need the power

Without the government having the power to bring drug prices down for all, the companies can charge people covered by private insurance whatever they want to—and the insurers can refuse to pay full costs, force people to take cheaper and less effective drugs, or both, all while reaping premiums and profits.

Meanwhile, Big Pharma and its stalking horse, the Chamber of Commerce, are suing to stop any negotiations at all with Medicare, by outlawing the drug price cut provisions of Biden’s Inflation Reduction Act. Seniors groups noticed that corporate campaign, as did Public Citizen.

“Many Wall Street analysts say that the Medicare drug price negotiations are unlikely to be derailed by the lawsuits,” the Alliance for Retired Americans commented.

“Millions of seniors are paying less for their drugs today thanks to the Inflation Reduction Act,” added Alliance President Robert Roach, a former top Machinists officer, who was overstating the case. “The power of this law to change lives for the better will come into even sharper focus when the names of the first 10 drugs are released.”

“Alliance members fought Big Pharma for nearly two decades to require Medicare to negotiate a better deal for retirees and taxpayers and we are anxious to see the result of our advocacy.”

“Drug corporations, in crude arrogance, are suing to limit price negotiations under the Inflation Reduction Act,” said Peter Maybarduk of Public Citizen’s Access to Medical Care program. “But the list shows instead how important it is to expand those negotiation powers. Several monopolized drugs that are expensive for Medicare today are exempted from price negotiation and will remain expensive.

“One reason for this is a many-years long grace period after a drug first comes to market. During those years, drug makers will exploit patent monopolies with minimal checks on profiteering. That profiteering period is even longer for biologics, which comprise some of the most exorbitantly priced drugs.”

One endorsement of Biden’s bargaining came from Teachers President Randi Weingarten. Her union, like AFSCME, includes tens of thousands of nurses.

“Americans will soon see deep discounts on 10 widely used drugs that currently cost $3.4 billion out of pocket—including blood thinners and treatments for diabetes, heart disease and cancer—with many more set to be added. Crucially, these negotiations will affect the broader commercial market and union members’ benefit plans, reducing prices for both employers and workers,” said Weingarten.

“The United States shamefully pays more than any other industrialized nation for medication, and the Biden administration—and Congress—heard Americans’ pleas and said, ‘Enough is enough.’ And with insulin already capped at $35 a month for those on Medicare, the president’s commitment to easing the squeeze on the middle class couldn’t be clearer.”

Public Citizen, however, said the act’s planned cuts aren’t enough. “The Inflation Reduction Act should be expanded and consistently improved, toward supporting affordable medicine for all, rather than limited or delayed to mollify pharma monopolists. The Biden administration has our support as it resists unjust lawsuits and implements the strongest possible Inflation Reduction Act,” Public Citizen’s Maybarduk concluded.

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Mark Gruenberg
Mark Gruenberg

Award-winning journalist Mark Gruenberg is head of the Washington, D.C., bureau of People's World. He is also the editor of the union news service Press Associates Inc. (PAI). Known for his reporting skills, sharp wit, and voluminous knowledge of history, Mark is a compassionate interviewer but tough when going after big corporations and their billionaire owners.