Impeachment proceedings. It seems like morning, noon, and night the relentless effort to unseat the president of the United States is a toxic strain of potomac fever infecting capitol hill. Now if only congress would channel every waking minute to fix problems in the real world, wouldnt that be wonderful. Let me provide a reality check. For People Living in the real world, impeachment inquiry is not what keeps americans up at night. Its not what wakes up moms and dads worried sick about paying for their childs insulin. Its not what drains the pocketbooks of seniors and takes a big bite out of peoples paychecks. The issue that unites americans from maine to iowa to oregon is the high skyhigh prices that americans and the taxpaying public pay for are paying for prescription medicine. As chairman of the Senate Finance committee, i am working in a bipartisan way to fix whats broken in our drug supply chain. In february we called the heads of big pharma to testify before the finance committee. Next we heard from the largest pharmacy benefit managers to examine rebates and unravel the pricing supply chain. There was an awful lot of finger pointing between the various interests about the soaring drug prices that americans pay for pharmaceuticals. That finger pointing we heard in our committee. Finger pointing doesnt decrease drug prices because the real problem is theres too much secrecy and not enough accountability in the industry pricing of drugs. When drug prices grow by leaps and bounds year after year, its time to look under the hood. Time to kick the tires along the drug supply chain and check the gauge on the competition. Why in the world is insulin, just as an example, a drug thats been on the market for nearly 100 years, doubling or tripling in price for patients in the United States . Its surely not that way in europe. Weve gotten lots of feedback from patient advocates, Health Providers and freemarket proponents. The pushback from big pharma reveals that were really on to something. Congress needs to take its foot off the brake. Its time to deliver real savings, and our bill will deliver real savings to consumers and to the taxpayers. Its time to pass reforms that will cut Prescription Drug costs for the American People. Now, some of my colleagues may require a more blunt call to action so i want to use the two by four illustration. Join us and score a win for the American People otherwise do nothing and risk being on the losing side of the ballot box next november. At my annual 99 county meetings where i always hold a q and a with whatever group of constituents gather, i hear the same message from people all across the state of iowa. They have family members and they have neighbors who struggle to pay for prescription medicine to manage Chronic Health conditions and to treat diseases. Thanks to breakthrough treatments and cures americans are living longer and healthier lives. Many are beating the odds of a diagnosis that would have been a death sentence a generation ago. However, if a loved one is diagnosed with m. S. Or diabetes or Cystic Fibrosis, no miracle cure will help if americans cant afford to pay for their medicine. And it wont help snois if skyhigh r seniors if theres skyhigh medicare and medicaid. Its causing too Many Americans to skimp on other necessities or even ration their doses of the prescriptions they take. Now, i just mentioned as an example Cystic Fibrosis. Last month the f. D. A. Approved a promising new treatment for this progressive genetic disorder. Cystic fie fibrosis Cystic Fibrosis impacts about 30,000 americans. Theres nothing parents wont do to advocate for children living with this condition. Thats when i launched the Bipartisan Senate caucus on Cystic Fibrosis to add our voices for awareness and advocacy. Now im told the price tag for the the price tag for pt new drug is more than 300,000 per patient per year. Without a doubt this drug raises the roof of hope for tens of thousands of families, but it also raises a red flag about drug prices. If prices keep going through the roof year after year, how will americans who depend on prescription medicines afford them . Americas drug pricing regime is broken. It requires reform to sustain fiscal sustain ability and sustainability and also to steer incubation and innovation forward. It needs more transparency. It needs better incentives. It needs real competition to drive down prices. So all 100 of us have our work cut out for us. Big pharma doesnt want its pipeline to the federal treasury tightened at all, and theyll spend big money to scare people away from Reasonable Solutions that will deliver real savings and get the best deal for the taxpayers. I refer to our working in a bipartisan way. So in july Ranking Member wyden and i secured broad bipartisan support in our finance committee, 199 vote. Our bill would save taxpayers more than 100 billion, and thats not this senator saying that, thats the congressional budget office. The bill caps out of pocket costs for seniors. The bill saves their households more than 30 billion. We finetuned and improved our bill to gain more momentum and more support. And part of that support, and one of the outstanding advocates for what were trying to do, doesnt happen to be a member of the finance committee, but its my good friend from maine, senator collins, right here on the floor. Ill yield to her in a short time. Shes helping lead the fight to reduce drug prices. Weve been working together on many issues. Im a former chairman of the special committee on aging and and current chair. She has the special committee on aging. Were committed to help Older Americans lead healthier productive lives. We also share a top priority not to miss a vote. While i might have a longer voting streak, susan hasnt missed a single vote. I hope the people of maine appreciate a person thats been in the senate since 1997 and hasnt missed a single vote. Senator collins is one of those rare lawmakers who doesnt care who gets the credit as long as were doing the right thing. And the name of this bill that im talking about, and i imagine shell refer to, is a Prescription Drug pricing reduction act, and that will do be the right thing to do and it will do the right thing. So its time for congress to do the right thing. And just in case i said anything different about senator collins and not accurate, she can feel free to correct me, but i now yield to senator collins, a strong voice for this piece of legislation. Ms. Collins mr. President. The presiding officer the senator from maine. Ms. Collins thank you, mr. President. Mr. President , let me first thank and recognize senator grassley for his farsighted and courageous leadership on this issue of vital importance to the American People. The escalating cost of Prescription Drugs. Under senator grassleys chairmanship, the finance committee has held numerous hearings on drug pricing. His diligence, his persistence on this issue has produced the bipartisan Prescription Drug price reduction act, a bold set, an effective set of proposals that i strongly endorse and look forward to seeing signed into law. Mr. President , this past century could well be called the age of miracle drugs. From insulin and penicillin to pharmaceuticals that treat karns, h. I. V. , cancer, h. I. V. , heart disease, and so many other serious conditions, modern drugs have been proven to improve, extend, and even save lives. In our time, however, we might define a miracle drug as one that has not doubled in price since the last refill. With Prescription Drugs among the key factors driving up the cost of health care, it is essential that we approve policies that both encourage innovation and protect consumers, particularly our seniors. Demonstrating the importance of this challenge, three senate committees, the Senate Finance committee, ably charged by senate grassley, which i mentioned earlier, the help committee and led by senator alexander and the Judiciary Committee, led by senator graham, has advanced bills aimed at reforming our broken drugpricing system. In addition, mr. President , the senate aging committee, which i chair, has held eight hearings on drug pricing since 2015 and issued a major report in 2016 on sudden price spikes in offpatent drugs. Our report highlighted the manipulated manipulative schemes employed by martin s hcrelin who increased the price of a drug that was more than 63 years old, a lifesaving medication by 5,000 in just one day. To paraphrase his words, he could drive up the price of drugs like this one on which he had not spent a dime in the research and development because he could. His price gouging caud real hardships for patients. Mr. President , some of the most alarming testimony that we heard on the aging committee has come from patients. They describe the Financial Impact of their Prescription Drug prices, the depths that theyve gone to to access medications they need, and how the struggle has affected their health and their overall quality of life. They are truly choosing between paying their electric bill, buying the food that they need, and filling their Prescription Drug prescriptions. An example is a young father from new gloucster from maine who discovered a supply of insulin for his 13yearold son who has type i dieb had more than tripled to more than 900. A woman from falmouth, maine, saw her outofpocket costs for the arthritis medication e embrl that she needs soar from 10 to 3,800 per month when she transitioned from her employersponsored insurance to medicare when she retired. She had no choice but to switch medications which did not work nearly as well for her. But she simply could not afford that outofpocket cost. I will never forget standing in line at the pharmacy counter in bangor, maine, where i live. The couple ahead of me received their Prescription Drug and the unwelcome news that their prescription copay was going to be 111. And the husband turned to his wife and said honey, we simply cannot afford that. And they walked away leaving that needed prescription on the pharmacy counter. I asked the pharmacist how often does this happen. His answer . Every day. The results of exorbitant increases in the price of drugs, needed prescriptions arent filled. Doses are skipped. Pills are cut in half, all harmful to the patients health. And why . Because the patients simply cannot afford the exorbitant cost, the skyrocketing cost of these drugs. Mr. President , this should not happen. We must join together to combat the exorbitant prescription costs that confront more and more americans every day. More than half of all americans and 90 of our seniors take at least one Prescription Drug each month. For many access to these medicines is not only critical to their wellbeing but it can literally be a matter of life and death. For children and adults with type i diabetes, insulin is not a luxury or something thats nice to have. Insulin is essential to their ability to survive. And insulin was first isolated nearly a century ago in canada and yet its cost has soared in recent years. Another chairman in the senate who has worked very hard on this issue along with senator grassley is senator lamar alexander. He has made it a strong priority of the help committee on which i serve to increase transparency and competition in the Prescription Drug market. Mr. President , i dont think theres any product that we buy in this country where there is less transparency in the price than the price of Prescription Drugs, nor where the supply chain is more rife with conflicts of interest. Last year in response to my experience listening to this couple in bangor, maine, i authored a bill to block pharmacy gag clauses. Now, under these contractual gag clauses, pharmacists were actually prohibited from volunteering to a consumer that it might well be less expensive to pay out of pocket rather than using their insurance. A recent study published by the journal of the American Medicine Association found that this new law could help americans save money in nearly one out of four prescription transactions in a pharmacy. Another bill i authored in 2017 to promote more competition from lower price but equally effective generic drugs is also showing results. To date the f. D. A. Has granted nearly 200 application requests under the new expedited pathway established by this law with 12 approvals. That is a much faster pace than in the past. In june the help committeereported out the lower the Lower Health Care cost act which incorporates more than 14 measures to increase drug price competition. Im pleased to say that it includes major portions of the biologic patent Transparency Act that i authored with senator kaine and that is cosponsored by senators brawn, holly, portman, shaheen, stabenow, paul, and murkowski. It is intended to prevent drug manufacturers from gaming the patent system. It requires earlier and greater disclosure of the web of patents held by biologic manufacturers thus making it easier for biosimilar competitors to develop more affordable alternatives without being stymied by the filing of lastminute patents. According to former f. D. A. Commissioner scott gottlieb, if all of the biosimilars that have been approved by the f. D. A. Were successfully marketed in the United States in a timely fashion, americans would have saved more than 4. 5 billion in 2017. The fact that a biosimilar version of humira, the best selling drug in the world, has been on the market in europe for more than a year while american patients must wait until 2023 is a clear example that the Biosimilar Market is not working as it should. The Lower Health Care costs act also includes the creates act, a bill that i know senator grassley has been very involved in. It addresses the anticompetitive practices of companies that delay or even block access to a sufficient quantity of the brandname drug needed to conduct the bioequivalency test required by the f. D. A. As part of the generic drug approval process. This addresses one of the major problems identified by the aging committee when we looked at this issue starting in 2015 examining the explosion in prices of Prescription Drugs of which there is no generic equivalent. And im pleased that we are on the verge of taking action to combat and stop this unfair practice. The help Committee Bill also requires significantly more disclosure on the costs, fee, and rebate information associated with p. B. M. Contracts. Thats prescription benefit managers. And i know the finance Committee Bill does as well. As i mentioned previously, the finance committee passed the Prescription Drug pricing reduction act, landmark legislation that would save taxpayers more than 100 billion and save seniors more than 30 billion in outofpocket costs for their prescriptions. I strongly support this bill because it strikes the right balance between reducing outofpocket costs for consumers without hindering innovation and investment in the next lifesaving medications. The finance Committee Bill also makes crucial improvements to Medicare Part d, such as protecting seniors with an outofpocket spending cap, another long overdue change that would ensure that patients with highcost conditions such as cancer, multiple sclerosis, and Rheumatoid Arthritis can get the medications they need. Furthermore, the bill would protect taxpayers from higher than inflation increases in drug prices while reducing government spending, premiums, and overall outofpocket costs. The Judiciary Committee, mr. President , is also has also advanced proposals that would empower the federal trade commission to take more aggressive action on anticompetitive behaviors. These are three worthwhile pieces of legislation that should be brought to the senate floor. The work of the finance committee, the help committee, and the Judiciary Committee is a tremendous breakthrough which would make such a difference to the American People. As we continue to find further consensus and a path forward on each of these bipartisan bills, i hope that we can also look for additional improvements. For example, as cochairs of the senate diabetes caucus, senator shaheen and i along with senators cramer and carper have introduced legislation to address flaws in the system that have allowed pharmacy benefit managers and manufacturers to implement what are truly unscrupulous price increases on lifesaving insulin. I also support a measure introduced by senators klobuchar and grassley to prohibit brandname Drug Companies from confiscating generic Drug Companies to delay the entry of a less costly but equally effective generic into the market. Thats referred to as pay for delay. Im amazed that its not already illegal under our antitrust laws. But this bill would make it clear that this tactic is no longer permitted. Mr. President , congress has a tremendous opportunity to deliver a decisive victory in both lowering Health Care Costs and impr