Between caring for themselves and their loved ones or paying for basic necessities. These skyrocketing prices are forcing families to take on debt, sacrifice their homes or sacrifice their healthcare all together. Imagine having to pick between having a roof over your head or protecting your childs life. Between eating that day or taking a pill that you need to simply stay alive. For americans around the country these situations are an every day reality. Think about it. Americans are dying every year while pharmaceutical companies enjoy more and more profits. Our Witnesses Today represent the one in four americans who struggle to afford the drugs that keep them healthy and in many cases keep them alive. Unfortunately Drug Companies continue to raise prices, rake in record profits and lavishly reward their executives and shareholders, all while stifling competition and preventing access to lifesaving drugs. Drug Companies Make up only a quarter of the healthcare industry, but they collect more than half of its profits. Some drugs are developed with federal funding, yet the industry ignores its responsibility to the american taxpayer and reaps massive profits from our investments. Drug Companies Use a variety of tactics to increase their profitability. They use loopholes in the patent system and they to pay for delay agreements with competitors, to extend monopolies so they can keep increasing their prices, and even when theres supposed to be competition, socalled competitors increase their prices in lockstep, stuffing their pockets while the American Families are left paying the bill. To be sure we all want Drug Companies to be successful. We want them to innovate. All of us depend on pharmaceutical the pharmaceutical industry to develop cutting edge their piece and break through drugs, but what we cannot abide is profiteering at the expense of patients and the american taxpayers. That is why the committee has been investigating the pharmaceutical industrys price increases. This investigation which began in january focused on the 17 highest costing drugs for the Medicare Part d program. Our investigation has made significant progress, but we plan to do more. Let me be very clear. The committee will take all the steps necessary to ensure full compliance with our investigation, including with our requests to Drug Companies for documents showing why they are increasing their prices dramatically and how they are using the proceeds and what steps can be taken to reduce the prices. Our investigation will allow the American Public to lift the veil on the industrys pricing practices and we will help inform the policy solutions to bring drug prices down. This is a problem that everyone, even in this polarized time, can come together to address and i am hopeful that this hearing will be another step in that direction. Now i yield to the distinguished Ranking Member of our committee, mr. Jordan. Thank you, mr. Chairman. The cost of Prescription Drugs is way too high. Chairman knows that i know it, our constituents know it and certainly our panelists know it. I want to thank you all for being here today. Some on the other side of the aisle, though, feel that these high drug prices represent a failure of markets, a failure of capitalism, feel that markets dont work and the result is companies exploiting patients to line their pockets. They have ex braced socialism as an answer to this problem. The real sit is they have the situation backwards. Its not the failure of the fair market, the failure strems from governments intervention in the farm suitful and healthcare markets. Laws and regulations at the government is put in place have led to the abuse of the patent system and the lengthy approval process at the fda. These the loopholes delay needed generic competition. These challenges are tough, require us to roll up our sleeves and do the tough Work Together to figure out how to make the dem work better. We have made some progress administratively and legislatively. Under the Trump Administration the fda hatsds been approving jej arks at a record rate. In october 2018 the fda approved 110 generic drugs and approved 18 more including 23 first jen aches and 17 complex generics resulting in 26 billion in savings for the consumer. From may 2017 through september 2017 there was an average of almost 73 generic applications approved per month up from about 57 approvals per month from january through april. In may of last year President Trump signed into law the right to try bill which allows terminally ill patients access to experimental treatments as soon as they are deemed safe by the fda rather than having to wait the years it takes for the drug to go through the entire bureaucratic process. It provides new treatment opportunities for patients who exhausted all other existing options. We also have working on a number of bills including a few that have already passed the Judiciary Committee unanimously, one of those bills is the creates act, a bill that i cosponsored. The creates act would ensure generics get timely access to lifesaving drugs to they can be available for more people more quickly. Im hopeful the bill will be put on the house floor in short order. I hope that the approach the democrats take is different than what we saw in the past and seek to deliver Real Solutions to our real concerns. Democrats set back the American Healthcare system drastically the last time they were in charge when they pushed a partisan bill through congress with no republican collaboration. It would be wrong to salvage the obama administrations healthcare legacy by putting controversial partisan bills in the drug pricing package. The United States is light years ahead of the rest of the world when it comes to Ground Breaking medicine and its no wonder. Our pharmaceutical companies spend over 169 billion annually on research and development. Certainly companies are entitled to make money on the drugs they invest in and develop, but that process cannot be distorted by government interventions that result in inflated prices. We must work to find ways to preserve americas cutting edge innovation but ensure that the system works so that these innovations make it to as many patients as possible. I want to thank David Mitchell for joining the panel, good to see you again, his commitment to this issue is inspiring. Thank you for returning. I know you testified in front of the subcommittee. I had a privilege of chairing last congress. Im especially grateful for laura mcclen joining the pam as well, her son jordan has duchenne muscular dystrophy. Thanks to innovation by companies in the United States jordan is not just walking but running and living a complete life. And he would be here himself today i understand but he is at summer camp which is probably where needs need to be in the summertime. I also want to thank our other witnesses for being with us today. Martin luther king, i thank you for holding this hearing and i yield back. Thank you very much. Now, we will turn to our witnesses who are here to share their stories. First we have mr. David mitchell, he is a patient and a under for of patients for Affordable Drugs from my state, bethesda, maryland. Welcome. Ms. Ashley kreg, a patient from houston, texas. Miss laura mclinn the mother of a patient from indianapolis, indiana. Miss sara skipper, a patient from indianapolis, indiana. And pam holt, a patient from grainger, indiana. Before i swear you in let me just explain to you that we dont have as many witness as many members here today because we were expecting to be in session today and were not, which means that members a lot of members had to leave to go home, but understand we appreciate you being here and i wanted to make sure some people asked me whether i should would postpone this hearing and i said out of respect to you all i wanted to make sure that we held this hearing and so i hope that you understand that. If you would all please rise and raise your right hand and i will begin swearing you in. Raise your right hand, please. Do you swear or affirm that the testimony you are about to give is the truth, the whole truth and nothing but the truth so help you god . Let the record show that the witnesses answered in the affirmative. Thank you. You may be seated. The microphones are extremely sensitive so please speak directly into them. Without objection, your written statement will be made a part of the record. With that, mr. Mitchell, you are now recognized for five minutes. Thank you, chairman cummings, Ranking Member jordan, thank you, and to my congressman, mr. Raskin, thank you for being here. Im honored to be here. Im David Mitchell, founder of patients for Affordable Drugs. More importantly, i have an incurable blood cancer and Prescription Drugs are keeping me alive. Every two weeks i spend a half a day at a clinic getting an infusion of drugs that are currently priced annually at 650,000. Ive relapsed twice and unfortunately im failing on this current drug regime. Eventually im going to run out of options. So the importance of innovation is not theoretical for me, its literally life and death, but my experience as a patient taught me one one irrefutable fact and that is drugs dont work if people cant afford them. When i learned i was sick my doctors put me on a drug, pam holt will talk about her experience with it, but for medicare patients in general outofpocket costs for it can are unto 15,000 a year. The principle reason its so expensive is because its maker has gained the system and refused to sell samples to Generic Companies who want to bring a competitor to market. They arent alone in making high prices for drugs. Take johnson and johnson, i take one of its called that the Monthly Price is 36,000. It has increased almost 20 in just a little over three years. Or pfizer, there is a patient o has fibromyalgia and neuropathic pain. Meg was prescribed lyrica, when she found out it would cost her 550 soind outofpocket each month she decided to take a third of the dose her doctor recommends for her. To address the problem of out of control prices we have to come to grips with larger facts. Despite what Drug Companies tell us sky high price right side not about innovation. Multiple studies show there is no correlation between the cost of r d and the price of a drug. And taxpayers foot a huge portion of the bill for the basic science that leads to new drugs. Every single drug approved by the fda from 2010 to 2016 was based on science funded by the taxpayers through the nih. In fact, the nih is the single largest funder of Biomedical Research in the world. Meanwhile, independent analyses show that nine of ten Drug Companies spend more on advertising an marketing than they do on r d. Why do Drug Companies charge so much . Because they can. Yes, Drug Companies should profit when they develop innovative drugs, but we are way out of balance right now and its costing us all in our family finances, our Health Outcomes and our lives. So i want to suggest three things that we could do today to rebalance the actual risk of innovation with a fair price for parents. One, reform patent law, two, end the days of monopoly Pricing Power without taxpayer negotiations and force transparency from drug middle men. Lets start with patent law. Brand Drug Companies are abusing our system to extend their government granted monopolies and block competition. They use tactics, mr. Jordan mentioned rems abuses, evergreening, sham citizen petitions. We need to correct those. And there are bills moving through congress to do that. Next we need direct medicare price negotiations and we need to restructure Medicare Part d. Our Current System isnt working. We pay two to three times what other countries pay for the exact same drugs. One big reason is that other countries negotiate, we should, too. International reference pricing is proposed by the administration or inflation caps that were just passed out of the Senate Finance committee on a bipartisan vote are other ways to approach this to restrain list prices. We also need to restructure part d along the lines of the legislation that cleared Senate Finance yesterday. Finally we need more transparency around pbms. These Huge Companies cut deals that determine how much patients pay but its all secret. Competition, free markets cant work without transparency. Right now there is a fundamental question Drug Companies want us to ask about drug prices, what are we willing to pay to save a life . And while thats easy, when its your childs ability to live, to breathe, when its your wifes diabetes, when its your own cancer, the answer is anything, but thats the wrong question. The question we should be asking is what is the right amount of money that Drug Companies should make on these drugs . Can literally hundreds of Clinical Trials under way for new gene their piece that are currently priced at a half a Million Dollars or more, we cant pay just any price the Drug Companies demand. Neither American Families nor our Healthcare System can afford that. I feel incredibly grateful to be here today representing patients all across the country. I believe the moment is at hand and we can address this problem and with bipartisan support we will. Thank you again for having me. Thank you very much. Ms. Kreg. Chair cummings, Ranking Member jordan, members of the committee, thank you for having me here today to share my story. My name is ashley kreg, im 35 years old and i live in houston, texas. Im one of the thousands of americans who took the worlds top selling drug known as humira. I took humira to treat a chronic autoimmune condition called psoriasis which causes pain and inflammation. After finally getting approved for the drug i had to pay 753 a month. To say this was a Financial Hardship would be an understatement. The drug costs more than my car payment, more than my business insurance, more than my food bill each month, but i made the decision to suck it up and pay because the drug worked. After months of successful pain and symptom management on humira i was informed the drug maker had raised the price and my new Monthly Payment was going to be almost 1100 a month. I simply could not afford it any longer. I had to make the difficult decision to wean myself off of the drug that had provided me months of relief. It was already expensive for me at 750 a month and i couldnt afford the 40 price increase. Let me tell you a little bit about humira. The drug is far from new, its been on the market since 2002 and the price has gone up nearly 400 . At 5,174 a month. They are making billions on the backs of patients. 20 billion alone in global sales last year. That is more revenue than every nfl team combined. They have done everything in their power to block competition and keep cheaper generics offer the u. S. Market. They have struck deals with more than a Dozen Companies that tried to develop biosimilars, theyve filed 247 Patent Applications in order to delay competition in the u. S. , but while avi was hiking they were prices, blocking competition, bio similar came to the market in europe. As a result, they began selling humira for 80 less overseas. Thats not the end of my story. Had a similar experience on enbrill, another drug investigat investigated. My symptoms came back. To give you an idea of what a full body sorry attic flareup feels like, imagine getting a terrible sunburn, the kind that makes your entire body feverish, add falling into a bed of fire ants. Thats what it feels like during a flare without medication. Thats why i am here today. Because there are two bills in the house of representatives that would help patients like myself. Hr 1499 and hr 2296 have both passed the energy and commerce committee. The first bill would stop branding companies from paying off Generic Companies that plan to bring a competitor to market. In exchange for the payment, the generic manufacturer often delays products entry into the market, patients like me are stuck facing bills of 1100 a month for humira. The second bill called the fair drug pricing act would increase transparency, require justification for price hikes like the one they enjoy taking on the backs of patients like me. These bills are just a start. They would not solve all the problems in the drug Pricing System or end the ways Drug Companies abuse their monopolies. Americans like me are desperate for relief for high cost Prescription Drugs, and you have the opportunity to advance legislation that curbs two of pharmas most egregious practices. I hope todays hearing isnt the last stop. Thank you for your time. Thank you very much. Chai