Transcripts For CSPAN3 House Oversight Hearing On Prescripti

The chair is authorized to declare a recess of the committee at any time. A regulars muscle for five minutes in Opening Statement the first one he was of age after wrestling incident. Was one protects the childs life . Think about it. Americans are dying every year while pharmaceutical companies have seasons able to afford the drugs some are developed with federal funding. Responsibility to the american taxpayer. They use loopholes and peasants. Even when they are supposed to be is the american taxpayer. Our investigation has made significant progress. We plan to do more. How they are using the post fees and what steps can be taken now, i yelled to the distinguished member of our committee. Patients to line the pockets. They have gone so far. To know the answer to this problem. The reality they have been situation completely backwards. Distance from Government Intervention in the pharmaceutical and healthcare markets. Laws and regulations they have put in place have led to the abuse of the patent system. And delete the approval process. These challenges are tough. They required us to do the tough work together. To figure out how to make the system work better. We have made some progress. Has been improving generics at a record rate. They approved 110 generic drugs. Tentatively approved 18 more. 17 companies generics resulted in 26 billion in savings for the consumer. There was an average of over 73 generic applications approved per month. In may of last year he signed into law the right to try law. It is als access to experimental treatments us is there deemed safe by the faa. That provides new treatment opportunities for patients. One of those bills is the create act. It will ensure timely access to lifesaving drugs should be available to more people more quickly. That will putting forward a drug pricing bill when we return from the august recess. Hope the approach they take are different from what we saw in the past and seek to deliver resolutions to our concerns. When the rest a partisan bill through congress with no republican collaboration. The United States is light years ahead of the rest of the world. Our forms who completely spend over 116 billion annually on research and development. Companies are entitled to make money of the drug. That process cannot be distorted by government inventions that result in inflated prices. We must ensure the system works so they make it to as many patients as possible. It is good to see you again. Thank you for returning. Based innovations. He has summer camp which is where his priorities need to be. I look forward to a productive discussion this morning. Thank you for holding this hearing. I yelled back. Now we will try to our witnesses who were here to share their stories. First we have mr. David mitchell. He is the founder of the portable drugs. Welcome. The mother of a patient in indianapolis indiana. Let me just explain to you that we do not have as new members here today. Him is that a lot of members have gone home. Understand, we appreciate you being here. Some people asked me if i should postpone this hearing. Said i want to make sure that we held this hearing. Hope you understand that. If you all please rise and raise your right hand. Will begin swearing you in. Raise your right hand please. Do you swear that the testimony you are about to give is the truth . The whole truth and nothing but the truth so help you god. The witnesses answers are from. Thank you. You may be seated. The microsoft dos microphones are extremely sensitive. Please speak directly into them. Without objection, your written statement will be made on the record. Mr. Mitchell, and youre not recognized for five minutes. Thank you chairman cummins. To my congressman. Thank you for being here. I wanted to be had. Everett; weeks has been a half a day at the clinic. I have relapsed twice. Eventually im going to run out of options. The importance of innovation is not theoretical for me. It is literally life and death. My experience as a patient only one irrefutable fact. Growth do not work people cannot afford them. My doctors put me on a drug. She will talk about her experience. Outofpocket costs can run up to 15,000 per year. It is because its makers has gained the system. The Monthly Price is 46,000. Has increased almost 20 percent in a little over three years. Members prescribed lyrica. Which she found out it will cost her 550 out of pocket each month, even with the discount card, she decided to take only a third of the dose her doctor recommended for her. To address the problem of out ofcontrol prices, yet to come to grips with some artifacts. Despite woodrow Company Still is, sky high prices are not about innovation. Multiple studies show there is no correlation between the cost and the price of the drug. Taxpayers put a few portion of the bill that leads to new drugs. Every single drug approved by the fda was based on science funded by taxpayers. It is the single largest funder of Biomedical Research in the world. Meanwhile, independent analysis so that Drug Companies spend more on advertising and marketing and they do want r b. Why would Drug Companies charge so much . Because they can. Drug companies should profit when they develop innovative drugs. We are way out of balance right now. It is costing us all now. And our life. I suggest three things we could do today to rebalance. Number 2. End the days of monopoly pricing. And forced transparency. Lets start with that. There abusing our system to extend their monopolies. This is a whole array of tactics. We need to correct us. Next, we need direct medicare pricing. We need to restructure medicaid. Our Current System is not working. We pay three times what are the Coach Companies pay for the exact same drug. Other countries negotiate and we should as well. Weapons pricing as proposed by the administration. Inflation caps that were just passed out. Bipartisan vote. Other ways to approach this to restrain these prices. We also need to restructure along the lines of the legislation. Finally, we need more transparency. These Huge Companies cut deals to determine how much patients pay. Competition and free markets cannot work without transparency. Right now there is a fundamental question Drug Companies one is to ask about the process. What are we willing to pay to save a life. That is easy. When it is your ability to live and breathe, your wifes diabetes. The answer is, anything. That is the wrong question. The question we should be acting, what is the right amount of money Drug Companies should make on these drugs. Literally hundreds of Clinical Trials underway that are currently priced at a half 1 million or more, we cannot pay just any price the Drug Companies demand. I feel incredibly grateful to be here today. I believe the moment is at hand. We can address this problem. With bipartisan support, we will. Thank you again for having me. Thank you very much. Members of the committee. Thank you for having me here today to share my story. My name is ashley craig. I am 35 years old and live in houston texas. I wanted thousands of americans who took humira. I took humira to treat chronic autoimmune condition. After finally getting a plea for the drug, had to pay 753 per month. To say this is a Financial Hardship would be an understatement. The drug cost more than my car payment. More than my Business Insurance. I have made the decision to suck it up because the drug work. I informed the drugmaker had raised the price. My Monthly Payment was going to be was 1100 per month. Simply cannot afford it any longer. I had to make the decision to wean myself off of the drug. It was already expensive for me a 750 per month. I cannot afford the 40 percent increase. Let me tell you little bit about humira. The drug was far from you. It had been on the market since 2002. The press had gone up nearly 400 percent. They are making billions on the backs of patients. 20 billion a month in global sales last year. That is more revenue than every nfl team combine. Doing with more than a Dozen Companies that try to develop. They have filed 247 Patent Applications in order to delay competition in the u. S. They were blocking competition in the u. S. They came to the market in europe. They began selling humira 80 percent less. Unfortunately that is not the end of my story. I had a similar experience. Is another drug examined. I stopped taking that drug. My symptoms came back. To give you an idea, i would like you to imagine getting a terrible sunburn. It leaves your entire body fevers. Then add calling into a bed of fires. That is what it feels like during a flare up without medication. That is why im here today. They have both passed the commerce committee. The plan to bring the competitive market. In exchange for this payment, the manufacturer often delays its product entry into the market. Patients like mirrors that facing bills 1100 per month for humira. It would increase transparency and require it for process. These bills are just the start. The will not solve all the problems in our system. Americans like me are desperate for release for highcost Prescription Drug. You have the opportunity to advance legislation. I hope todays hearing is not the last stop. Thank you for your time. Is an honor to be here today. Thank you very much. Most people just know me as jordan nicoles mom. I come here today simply as that. That comes straight from my heart. Jordan is my amazing little boy. They robs them of their ability to do the things that most boys tend to do. Ride bikes. Use the bathroom independently. Eventually, even the strength to hug her moms representative the way. Jordan is the best part ever. For him not to be able to do that means it is not okay. They are eventually affected. A law that congress had passed over the years. Im here today to tell you that my jordan now has help. He is the natural history. Is a direct participant in helping to create hope for others. Jordan became one of 16 lucky boys in north america to be accepted in a Clinical Trial. He has made weekly trips out of state to receive infusions without a single complaint ever. We have noticed is doing things we were told it 10yearold child will not be able to do. Is still walking quite well. Is playing outside for hours. Most is at this age cannot climb the stairs at all. Or cannot do it very easily. Is dancing and running. Catching balls. Keep in mind, the progressively robs boys of these very things. Just last week a team some images of some of his muscles. They tell me that they do not look like the images of a person with muscle dystrophy. There was no Clinical Trial he could participate in. Now there are multiple treatments on the problem. Is absolutely incredible how fast science is moving. Other patients like him cannot afford to see them slower stop. I desperately need these doctors and Drug Companies to continue to develop drugs for my son. For that reason, im here today to remind you that we must continue to encourage and reward innovation. Because the work that many of you have been a part of, innovative trial design. I expected his drag is going to be approved soon. It is probably going to be expensive. These are all drugs that have been around for years now. Lets be careful in these conversations about drug pricing. Innovation is expensive. It is the only thing that will help ensure boys like my jordan can be a part of the first generation for this devastating disease. It is the most viable thing. We cannot afford to let that happen. Treatments are currently in Clinical Trial. He does not have anything you. I am for you to remember that one size does not fit all. We cannot afford to encourage those discovers. Jordan will not be doing what he was doing today. He will not be benefiting from these treatments. Parents are gathering to pick up the kids. The hearing so much about the kids adventures. Is that, with his blessing, compared to share this with you. The importance of driving some of the promise of new and better treatments for all those who way. I cannot wait to get home to hug him tonight. Because he cannot be here today, i didnt want to leave you with a favorite quote of his. Jeremiah 29 11. I know the plans i have for you declares the lord. Plans to prosper you and not to harm you. To give you hope and a future. Thank you all of you from the bottom of my heart wanted to make hope tangible and for caring about the future of knowing the patients depending on you to keep innovation alive and for also caring about helping patients access these treatments. Keeping in mind that one size does not fit all. I also welcome you to reach out to me personally after the hearing to continue this important dialogue. Thank you very much. Good morning chairman and Ranking Member jordan and members of the House Committee on oversight and government reform. I am a member of the affordable international. Thank you so much for inviting me to come speak with you today. For taking the time to listen to some of the pharmaceutical companies. I live in the shadow of the national headquarters. My life has been at the rim of the Company Since i was diagnosed with type i diabetes when i was five years old. The refusal to control the cost of the drug, and has lead harvard and have it all my life. My sisters and those who care about us. I do not remember my life without this partisan disease. Being diagnosed at such a young age, i had to grow fast. At appreciate life very early on. And miscalculation could cost me my life. I was in the hospital multiple times per week. My blood sugar was down so fast. My body was rejecting the insulin. I remember showing teachers scars on my fingertips as they do not believe i was diabetic when i complained about not feeling well. Having such a huge responsibility, and maybe find out a much. I tried to stay a little sister. It my duty as a big sister very seriously. The bar setting a good example was that 1000 times higher. I remember seeing my sister weeping. I told her it would be okay. We have a fear. That passed away at the age of 47 due to complications. My sister and myself have been fighting for lifes since we were children. It has to know that some diabetic travel to mexico or canada for insulin or either by insulin off the black market. Due to not being able to for their insulins got written. According to a survey, one in four people last year lost their insulin. This is unacceptable. This is for making it affordable for all is so important. I had to ration my insulin. I still do not understand why i was denied medicaid. I aced out of my pediatric endocrinologist. The last prescription i received in with the note saying im sorry but this is the last prescription i can feel for you. The did not get to help me through class. Since i spent the majority of it in the bathroom or asleep. This is the fear i had with. This is the reality that some of the people with diabetes face every single day. May 2018. I working fulltime for a Big Corporation with benefits. And with insurance, my insulin supply was 1000. That price does not include test strips or other vital supplies. I cannot afford to purchase my fort supply of insulin. My sister risked her life by sharing his. I took the nighttime dose of insulin. For my sister to see. She would think i had already taken my does. She did not. She got estimated to take my insulin for the evening. Should think less of first. To ensure there was enough music. She put herself at risk. The next day she went into diabetic ketoacidosis. She had to go into a diabetic,. I cannot afford my insulin. The refuse to control the cost of insulin. It almost cost my sister her life. Price gouging is killing people. Their committing murder and getting away with it. You all have some say so in making a change. While they continue to die from resting. You are just as responsible for people profiting off of the loss of the laws. As a patient advocate like myself, i will not stop speaking out to find a way to put an end to the insulin process in america. No matter how long it takes, we will be demanding change because our lives depend on it. Thank you. Thank you very much. Terry cummings. Memories of the committee. Thank you for inviting me to share my story. I am from indiana. Just outside of south bend. At the age of 40, my husband died from a sudden heart attack. I raised three children on my own. I was fortunate that to be a judge. And an administrator with what i felt were good benefits. That set me up for a good retirement. That all changed however when i was diagnosed with multiple myeloma years ago. It is an incurable but treatable broadcaster. I underwent a bone marrow transplant. I am blessed to be in remission today. I am thankful for every day. However, to keep my ken tribbett, i must take the drug. This plan initially felt really good. I will get to live longer. How to raise my grandchildren. For the summer my favorite lake. The prices over 250,000 per year. Last january, on Medicare Part d, because i am 70, i went in and out of the doughnut hole. Plane 4950 the first month. The more than 8000 outof pocket of the rest of the year. This is on medicare. That cost is totally unaffordable for me. Is 70 into serious debt. I was entirely underwater. I had to make the decision to refinance my house. It was three years from being paid off. Now im starting completely over. I have been fortunate to receive the customer representative out ofpocket. This is yeartoyear. They can always falter. It is income dependent. I do not feel i should have to depend on these yearly grants to be able to live. To afford the medication that i need to survive. I did qualify in years and some i do not. A phyllis but my life doing some of the right things. Teaching public school. Raising my children. I do not feel it is right that despite all this works and careful planning, a face financial challenges because of cancer i have no control over. I am really thrilled and grateful that additional time it has given me. Having cancer is really hard. I should not have to lose my savings and stress over finances just to stare life. I am encouraged by the Opening Statement<\/a> the first one he was of age after wrestling incident. Was one protects the childs life . Think about it. Americans are dying every year while pharmaceutical companies have seasons able to afford the drugs some are developed with federal funding. Responsibility to the american taxpayer. They use loopholes and peasants. Even when they are supposed to be is the american taxpayer. Our investigation has made significant progress. We plan to do more. How they are using the post fees and what steps can be taken now, i yelled to the distinguished member of our committee. Patients to line the pockets. They have gone so far. To know the answer to this problem. The reality they have been situation completely backwards. Distance from Government Intervention<\/a> in the pharmaceutical and healthcare markets. Laws and regulations they have put in place have led to the abuse of the patent system. And delete the approval process. These challenges are tough. They required us to do the tough work together. To figure out how to make the system work better. We have made some progress. Has been improving generics at a record rate. They approved 110 generic drugs. Tentatively approved 18 more. 17 companies generics resulted in 26 billion in savings for the consumer. There was an average of over 73 generic applications approved per month. In may of last year he signed into law the right to try law. It is als access to experimental treatments us is there deemed safe by the faa. That provides new treatment opportunities for patients. One of those bills is the create act. It will ensure timely access to lifesaving drugs should be available to more people more quickly. That will putting forward a drug pricing bill when we return from the august recess. Hope the approach they take are different from what we saw in the past and seek to deliver resolutions to our concerns. When the rest a partisan bill through congress with no republican collaboration. The United States<\/a> is light years ahead of the rest of the world. Our forms who completely spend over 116 billion annually on research and development. Companies are entitled to make money of the drug. That process cannot be distorted by government inventions that result in inflated prices. We must ensure the system works so they make it to as many patients as possible. It is good to see you again. Thank you for returning. Based innovations. He has summer camp which is where his priorities need to be. I look forward to a productive discussion this morning. Thank you for holding this hearing. I yelled back. Now we will try to our witnesses who were here to share their stories. First we have mr. David mitchell. He is the founder of the portable drugs. Welcome. The mother of a patient in indianapolis indiana. Let me just explain to you that we do not have as new members here today. Him is that a lot of members have gone home. Understand, we appreciate you being here. Some people asked me if i should postpone this hearing. Said i want to make sure that we held this hearing. Hope you understand that. If you all please rise and raise your right hand. Will begin swearing you in. Raise your right hand please. Do you swear that the testimony you are about to give is the truth . The whole truth and nothing but the truth so help you god. The witnesses answers are from. Thank you. You may be seated. The microsoft dos microphones are extremely sensitive. Please speak directly into them. Without objection, your written statement will be made on the record. Mr. Mitchell, and youre not recognized for five minutes. Thank you chairman cummins. To my congressman. Thank you for being here. I wanted to be had. Everett; weeks has been a half a day at the clinic. I have relapsed twice. Eventually im going to run out of options. The importance of innovation is not theoretical for me. It is literally life and death. My experience as a patient only one irrefutable fact. Growth do not work people cannot afford them. My doctors put me on a drug. She will talk about her experience. Outofpocket costs can run up to 15,000 per year. It is because its makers has gained the system. The Monthly Price<\/a> is 46,000. Has increased almost 20 percent in a little over three years. Members prescribed lyrica. Which she found out it will cost her 550 out of pocket each month, even with the discount card, she decided to take only a third of the dose her doctor recommended for her. To address the problem of out ofcontrol prices, yet to come to grips with some artifacts. Despite woodrow Company Still<\/a> is, sky high prices are not about innovation. Multiple studies show there is no correlation between the cost and the price of the drug. Taxpayers put a few portion of the bill that leads to new drugs. Every single drug approved by the fda was based on science funded by taxpayers. It is the single largest funder of Biomedical Research<\/a> in the world. Meanwhile, independent analysis so that Drug Companies<\/a> spend more on advertising and marketing and they do want r b. Why would Drug Companies<\/a> charge so much . Because they can. Drug companies should profit when they develop innovative drugs. We are way out of balance right now. It is costing us all now. And our life. I suggest three things we could do today to rebalance. Number 2. End the days of monopoly pricing. And forced transparency. Lets start with that. There abusing our system to extend their monopolies. This is a whole array of tactics. We need to correct us. Next, we need direct medicare pricing. We need to restructure medicaid. Our Current System<\/a> is not working. We pay three times what are the Coach Companies<\/a> pay for the exact same drug. Other countries negotiate and we should as well. Weapons pricing as proposed by the administration. Inflation caps that were just passed out. Bipartisan vote. Other ways to approach this to restrain these prices. We also need to restructure along the lines of the legislation. Finally, we need more transparency. These Huge Companies<\/a> cut deals to determine how much patients pay. Competition and free markets cannot work without transparency. Right now there is a fundamental question Drug Companies<\/a> one is to ask about the process. What are we willing to pay to save a life. That is easy. When it is your ability to live and breathe, your wifes diabetes. The answer is, anything. That is the wrong question. The question we should be acting, what is the right amount of money Drug Companies<\/a> should make on these drugs. Literally hundreds of Clinical Trials<\/a> underway that are currently priced at a half 1 million or more, we cannot pay just any price the Drug Companies<\/a> demand. I feel incredibly grateful to be here today. I believe the moment is at hand. We can address this problem. With bipartisan support, we will. Thank you again for having me. Thank you very much. Members of the committee. Thank you for having me here today to share my story. My name is ashley craig. I am 35 years old and live in houston texas. I wanted thousands of americans who took humira. I took humira to treat chronic autoimmune condition. After finally getting a plea for the drug, had to pay 753 per month. To say this is a Financial Hardship<\/a> would be an understatement. The drug cost more than my car payment. More than my Business Insurance<\/a>. I have made the decision to suck it up because the drug work. I informed the drugmaker had raised the price. My Monthly Payment<\/a> was going to be was 1100 per month. Simply cannot afford it any longer. I had to make the decision to wean myself off of the drug. It was already expensive for me a 750 per month. I cannot afford the 40 percent increase. Let me tell you little bit about humira. The drug was far from you. It had been on the market since 2002. The press had gone up nearly 400 percent. They are making billions on the backs of patients. 20 billion a month in global sales last year. That is more revenue than every nfl team combine. Doing with more than a Dozen Companies<\/a> that try to develop. They have filed 247 Patent Applications<\/a> in order to delay competition in the u. S. They were blocking competition in the u. S. They came to the market in europe. They began selling humira 80 percent less. Unfortunately that is not the end of my story. I had a similar experience. Is another drug examined. I stopped taking that drug. My symptoms came back. To give you an idea, i would like you to imagine getting a terrible sunburn. It leaves your entire body fevers. Then add calling into a bed of fires. That is what it feels like during a flare up without medication. That is why im here today. They have both passed the commerce committee. The plan to bring the competitive market. In exchange for this payment, the manufacturer often delays its product entry into the market. Patients like mirrors that facing bills 1100 per month for humira. It would increase transparency and require it for process. These bills are just the start. The will not solve all the problems in our system. Americans like me are desperate for release for highcost Prescription Drug<\/a>. You have the opportunity to advance legislation. I hope todays hearing is not the last stop. Thank you for your time. Is an honor to be here today. Thank you very much. Most people just know me as jordan nicoles mom. I come here today simply as that. That comes straight from my heart. Jordan is my amazing little boy. They robs them of their ability to do the things that most boys tend to do. Ride bikes. Use the bathroom independently. Eventually, even the strength to hug her moms representative the way. Jordan is the best part ever. For him not to be able to do that means it is not okay. They are eventually affected. A law that congress had passed over the years. Im here today to tell you that my jordan now has help. He is the natural history. Is a direct participant in helping to create hope for others. Jordan became one of 16 lucky boys in north america to be accepted in a Clinical Trial<\/a>. He has made weekly trips out of state to receive infusions without a single complaint ever. We have noticed is doing things we were told it 10yearold child will not be able to do. Is still walking quite well. Is playing outside for hours. Most is at this age cannot climb the stairs at all. Or cannot do it very easily. Is dancing and running. Catching balls. Keep in mind, the progressively robs boys of these very things. Just last week a team some images of some of his muscles. They tell me that they do not look like the images of a person with muscle dystrophy. There was no Clinical Trial<\/a> he could participate in. Now there are multiple treatments on the problem. Is absolutely incredible how fast science is moving. Other patients like him cannot afford to see them slower stop. I desperately need these doctors and Drug Companies<\/a> to continue to develop drugs for my son. For that reason, im here today to remind you that we must continue to encourage and reward innovation. Because the work that many of you have been a part of, innovative trial design. I expected his drag is going to be approved soon. It is probably going to be expensive. These are all drugs that have been around for years now. Lets be careful in these conversations about drug pricing. Innovation is expensive. It is the only thing that will help ensure boys like my jordan can be a part of the first generation for this devastating disease. It is the most viable thing. We cannot afford to let that happen. Treatments are currently in Clinical Trial<\/a>. He does not have anything you. I am for you to remember that one size does not fit all. We cannot afford to encourage those discovers. Jordan will not be doing what he was doing today. He will not be benefiting from these treatments. Parents are gathering to pick up the kids. The hearing so much about the kids adventures. Is that, with his blessing, compared to share this with you. The importance of driving some of the promise of new and better treatments for all those who way. I cannot wait to get home to hug him tonight. Because he cannot be here today, i didnt want to leave you with a favorite quote of his. Jeremiah 29 11. I know the plans i have for you declares the lord. Plans to prosper you and not to harm you. To give you hope and a future. Thank you all of you from the bottom of my heart wanted to make hope tangible and for caring about the future of knowing the patients depending on you to keep innovation alive and for also caring about helping patients access these treatments. Keeping in mind that one size does not fit all. I also welcome you to reach out to me personally after the hearing to continue this important dialogue. Thank you very much. Good morning chairman and Ranking Member<\/a> jordan and members of the House Committee<\/a> on oversight and government reform. I am a member of the affordable international. Thank you so much for inviting me to come speak with you today. For taking the time to listen to some of the pharmaceutical companies. I live in the shadow of the national headquarters. My life has been at the rim of the Company Since<\/a> i was diagnosed with type i diabetes when i was five years old. The refusal to control the cost of the drug, and has lead harvard and have it all my life. My sisters and those who care about us. I do not remember my life without this partisan disease. Being diagnosed at such a young age, i had to grow fast. At appreciate life very early on. And miscalculation could cost me my life. I was in the hospital multiple times per week. My blood sugar was down so fast. My body was rejecting the insulin. I remember showing teachers scars on my fingertips as they do not believe i was diabetic when i complained about not feeling well. Having such a huge responsibility, and maybe find out a much. I tried to stay a little sister. It my duty as a big sister very seriously. The bar setting a good example was that 1000 times higher. I remember seeing my sister weeping. I told her it would be okay. We have a fear. That passed away at the age of 47 due to complications. My sister and myself have been fighting for lifes since we were children. It has to know that some diabetic travel to mexico or canada for insulin or either by insulin off the black market. Due to not being able to for their insulins got written. According to a survey, one in four people last year lost their insulin. This is unacceptable. This is for making it affordable for all is so important. I had to ration my insulin. I still do not understand why i was denied medicaid. I aced out of my pediatric endocrinologist. The last prescription i received in with the note saying im sorry but this is the last prescription i can feel for you. The did not get to help me through class. Since i spent the majority of it in the bathroom or asleep. This is the fear i had with. This is the reality that some of the people with diabetes face every single day. May 2018. I working fulltime for a Big Corporation<\/a> with benefits. And with insurance, my insulin supply was 1000. That price does not include test strips or other vital supplies. I cannot afford to purchase my fort supply of insulin. My sister risked her life by sharing his. I took the nighttime dose of insulin. For my sister to see. She would think i had already taken my does. She did not. She got estimated to take my insulin for the evening. Should think less of first. To ensure there was enough music. She put herself at risk. The next day she went into diabetic ketoacidosis. She had to go into a diabetic,. I cannot afford my insulin. The refuse to control the cost of insulin. It almost cost my sister her life. Price gouging is killing people. Their committing murder and getting away with it. You all have some say so in making a change. While they continue to die from resting. You are just as responsible for people profiting off of the loss of the laws. As a patient advocate like myself, i will not stop speaking out to find a way to put an end to the insulin process in america. No matter how long it takes, we will be demanding change because our lives depend on it. Thank you. Thank you very much. Terry cummings. Memories of the committee. Thank you for inviting me to share my story. I am from indiana. Just outside of south bend. At the age of 40, my husband died from a sudden heart attack. I raised three children on my own. I was fortunate that to be a judge. And an administrator with what i felt were good benefits. That set me up for a good retirement. That all changed however when i was diagnosed with multiple myeloma years ago. It is an incurable but treatable broadcaster. I underwent a bone marrow transplant. I am blessed to be in remission today. I am thankful for every day. However, to keep my ken tribbett, i must take the drug. This plan initially felt really good. I will get to live longer. How to raise my grandchildren. For the summer my favorite lake. The prices over 250,000 per year. Last january, on Medicare Part<\/a> d, because i am 70, i went in and out of the doughnut hole. Plane 4950 the first month. The more than 8000 outof pocket of the rest of the year. This is on medicare. That cost is totally unaffordable for me. Is 70 into serious debt. I was entirely underwater. I had to make the decision to refinance my house. It was three years from being paid off. Now im starting completely over. I have been fortunate to receive the customer representative out ofpocket. This is yeartoyear. They can always falter. It is income dependent. I do not feel i should have to depend on these yearly grants to be able to live. To afford the medication that i need to survive. I did qualify in years and some i do not. A phyllis but my life doing some of the right things. Teaching public school. Raising my children. I do not feel it is right that despite all this works and careful planning, a face financial challenges because of cancer i have no control over. I am really thrilled and grateful that additional time it has given me. Having cancer is really hard. I should not have to lose my savings and stress over finances just to stare life. I am encouraged by the Action Congress<\/a> is starting to take. I am particularly grateful for this committee. What patients need most is a real change to the system and congressional action that would bring down drug prices. For me, one solution would be to great effect. It addresses a pack the company that makes reprimand. The years to deny Generic Companies<\/a> access to samples. This prevents generic competitors from coming to market and allows the teams to set the price. I came to dc last year to encourage congress to pass the important piece of legislation. Im grateful the bill has passed the house energy and commerce committee. I really hope it gets over the finish line as soon as possible. Thank you. Thank you very much. First of all i want to thank our witnesses for being here. Clearly, you have shared very personal stories of pain. Often say this often out of pain comes our passion. Pain and passion. Purpose. So we thank you. You are here to remind us of the absence of Drug Companies<\/a>. Will consequences. To real people. Let me start with you. It is the most difficult choice you and your family members have had to make because of the price of a certain drug. Just so you be prepared. Im going to ask you the same question. Thank you. Of phil the most difficult thing was just keeping up. As an adult now, i feel i have made the sacrifices. Im 23 years old. I am tired. I do not want to be tired anymore. I do not want anybody else to feel like phil. I feel it is unfair. Of the four people under the age of 30 who died last month. Everyone who had been affected by resting that the did not get to have that decent quality of life. Let me ask you the same question. What has been the most difficult decision you have had to make. You also said something that was so powerful. When you talked about your son. A race against time. One of the things that i have noticed. Nih is a phenomenal place. Coming up with things that used to be fertile. Theyre coming up with solutions to make them chronic. Hopefully the things that are going on that you talked about will be helpful to your son. What is the most difficult decision to have had to make with regard to your situation. The one difficult situation i have had to face is actually a decision that was difficult but also decision when he was diagnosed, i do not even think i would be able to be in the position to have to make a decision. Jordan actually qualify for 2 Clinical Trials<\/a>. For similar drugs that are designed to do the same thing. I actually had to make a decision at the last minute to choose one drug company over another because of the Clinical Trial<\/a> design. The third of them to be on placebo. For 96 weeks. It is really hard when you know that what happens so quickly and at this age. Like i said at his age, whenever thought he would be doing the things he was doing. In the Clinical Trial<\/a> right now, receiving a placebo for 96 weeks, we know it happens. It happens when these kids do not get treatment. For me, that was kind of a bittersweet thing to say. I never thought id be able to have Clinical Trials<\/a> to choose for my son. And grateful for the administration. This is not what the purpose of this community. You asked me the question that we also need to continue the Clinical Trial<\/a> design. The most difficult decision was having to make the choice to go on affordable. The current one im on made it affordable. I just got married. My husband and myself had to make the decision that i cannot have kids if im on it. It is absolutely not allowed. That sucks. To be quite frank. I wish there were generic options for me. I do not mind paying for a drug. And is to be accessible and affordable. I do well. There is no way anyone can afford 1100 per month. They just keep producing new biologics. It is even more expensive than the current ones on the market. There is no generics available. That is huge for somebody like me. Thank you. I think the most difficult things is the induction therapy needed. I went to the drug county. My bill was over 4000. I cannot pay. I was just shocked. That was delayed three months until i came up with the cash in order to pay to start treatment. That was difficult. It was also more difficult to refinance my home. I think we had a home to refinance. Other people are not that lucky. To be that close to being debt free and having to start over is very difficult for me. I have many more questions to ask. My minutes are up. I yelled to miss miller. Thank you mr. Chairman. I want to thank each of you for being here to share your stores. They are heartwrenching and very real. Very personal for you. And for your loved ones. I am grateful for you coming. Sharing with us today. There is a difficult balance that somehow we have to strike in all of this. You are bringing some suggestions to the table that i think need to be looked at. All of this needs to be looked upon from a big perspective. Dollar in a situation where the cost of medication for you and your loved ones are just astronomical. There was about five percent of americans having to pay the list price on drugs. I do not know if any of your having to pay the list price. On that or not. Fewer than five percent and repair the best path. I know a couple of you spoke specifically. I went back and looked. Thats it over 14 years for them to develop the drug. 800 million. To produce the drug. From what i have been able to see, that was about 140,000 patients taking cell genes. Oncology medicine. They have been assisted to the support program which contributed over 1. 4 billion back to patients who were involved in taking similar drugs. We invested 37 percent of the revenues back into research and development. Somehow we have to strike a balance here. No question as to the enormous cost people like you are here today. In this room are grateful for the tremendous job that Drug Companies<\/a> are doing to come up with drugs that help, that way you are able to be with your grandchildren. But being able to get those drugs back to us in an affordable way is another issue. That has to be addressed. Again, i am grateful for you coming here. The pharmaceutical companies spent over 169 billion annually on research and development. And we are blessed to be in this country where those Companies Put<\/a> that kind of money in the development to help. With situations like this. One thing, ms. Mclinn, that i was intrigued about with your situation and reading about your story, is the right to try interest that you have and that you have worked with then governor pants. Can you tell us a little bit about your experience with that, fighting for the right to try . Sure. When jordan was five, we actually didnt have a Clinical Trial<\/a> available to us, so i heard about a drug coming up through the pipeline. Based on the inclusion criteria, i didnt believe at that time that jordan would be able to make it into the Clinical Trial<\/a>. I am passionate about patients receiving access to treatment. I dont care what the pathway is, i am just passionate about patients being able to access those treatments. At the time, we didnt think jordan would qualify for a trial, so we started fighting for the right to trial law, which says if a drug has made it through phase i and a patient wants to try it and you have a drug company under doctor willing to make that happen, you should have the right to do that. So we did start, in hours home state of indiana, when mike pence was the governor. It passed with unanimous bipartisan support, across the nation, really. Then we did start working on federal legislation that was passed into law last may. The law does bear jordan names. Jordan is not retrieving a treatment through the right to try pathway. He is receiving a treatment through a Clinical Trial<\/a>, which is what we wanted to start with. But i am happy to tell you about our friend matt molina, a former navy pilot battling mls and he didnt make it into a Clinical Trial<\/a>. But a few months ago jordan got to be there with matt when matt received his first treatment of an experimental treatment for mls, through the right to try pathway. It has been really awesome to be on that journey and for jordan to be part of seeing that come full circle and see someone who has been able to benefit. Last week matt became the first person ever to receive a fourth treatment and he is doing very well. Thank you. Thank you mister chairman. Before we go to ms. Norton, mister mitchell, would you comment, i want to be effective and efficient. Would you comment on what he just said, because he makes a good point when he talks about research and development and the fact that there are programs to discount drugs. A couple of things, mister chairman, thank you. First of all, approximately two thirds of americans pay some or all of the cost of their drugs based on list price. People in high deductible plans pay list price for their deductible period. People on medicare pay their out of pockets in part be paste on list price. People who dont have healthcare coverage pay based on list price and secretary azar points out that is roughly two thirds of all americans paying in whole or in part based on list price. That is the first thing i want to straighten out. That is a lot of money for a lot of people when prices are high. Second, i know that with respect sir, that you just quoted about the development of revlimid, but it is a drug, it is a derivative, it was invented in the 1950s. They stumbled into it accidentally. Based on Clinical Trials<\/a> that were done in academia. That drug came to market in 2005, revlimid did. There is still not a generic for revlimid and the reason is that the company has been able to extend its monopoly by abusing the laws that are put in place. I fully agree that when a drug Company Brings<\/a> an innovative drug to market, we want them to profit. The whole system is based on that. Five years for small molecules, seven for organ, 12 for a biologic and make a lot of money. But at the end of that period, congress has said we are supposed to let markets drive down price through competition and celgene has prevented that from happening. The result is it was introduced in 2005 at 6000. It cost 18,000 today. One capsule today costs 720. This is an old drug. There is no excuse for this and celgene is not plowing all the money that they cant claim to plow back into r d. They are milking an old drug, which is how they keep their stock price up and if we didnt allow them to do that, they would be forced to innovate to make money, which is what we want them to do. Thank you very much for clarifying that. Thank you very much. Ms. Norton. Thank you very much, first for the hearing, mister chairman, but very much for the testimony today. I appreciate the clarification. No one on this side once anything but a fair return for the work. We have abundant evidence here of a great deal more than what anyone would regard as fair return. Of course, people go to canada. There is reason to believe that Drug Companies<\/a> there want a fair return, too. I think you have made the best case, a better case than we couldve made, by describing your own experience. I would like to ask ms. Skipper a question because i was intrigued by the fact that both she and her sister had diabetes. Is this type i diabetes . Yes. This is very serious diabetes. You had the medicine yourself, when your children . Yes. Now, insulin is one of those drugs we want to look at to see whether there has been an increase over time. I dont know of improvements that have been made in insulin. Do you know of improvements that have been made in insulin when you get insulin . Are you told you are Getting Better<\/a> insulin than emma lets say, you wouldve gotten 10 years ago . No maam, it has been the same insulin. So the drug itself is not changed . No. What about the prices . The prices have gone up, i believe over 300 in the last 10 years. How has that affected, this increase in prices, you indicated you had been in college during part of this time. I believe i remember you said that if the drug was miscalculated by one unit yes. You could risk your life. Yes. Did you ever ration the drug . Yes. When i said that i had to eat less food, okay so with insulin, there is like a little calculation. How many carbs youre going to eat and you have to figure out your blood sugar and the correction factor, what is correct for your blood sugar. So, i didnt have enough insulin, so i ate less food because i didnt have a choice but to take less insulin, because i wasnt getting a consistent supply. So i had to eat less food because i didnt have enough insulin to really, you know, take care of myself. So you are trying to make your insulin, what insulin you had, last longer . Yes maam, yes. How could you calculate it . Did you have some scientific way, some measurement to calculate whether or not you are at risk when you decided to take less insulin or how much insulin to take, less than what was the calculated dose . I dont have any pancreatic function, so if i do the math. You mind if i give you an example . Yes. So with my sugar is 250 and my target is 150, i would have to subtract the 250 and the 150 and divide that by what is called a correction factor. So for every, say 35 points over my target, i would have to take one unit. Then i would add that, on a scale of every seven grams of carbohydrates, i would take one unit. So that is how you calculate it, but if i dont have an actual monthly supply of that, i have to figure out how to make that stretch. So by eating less food, i mean, i wasnt really able to affect what was right for my blood sugar. Leaving this calculation to use sounds itself very risky. I understand that your sister was hospitalized and nearly died last year as a result of rationing insulin. How did that happen . Did she and correctly calculate . She took less. We were literally sharing the same vial of insulin. So we were both using the same vial of insulin. So she took less than what she was supposed to take, to ensure that there was enough insulin left in the file so i could take my dose. But she didnt realize i had already taken my dose and she took less, so i would be able to take my dose. All i can say, mister chairman, is case made. Thank you very much. Ms. Miller. Thank you chair cummings, Ranking Member<\/a> jordan, and thank all of you for being here today. Ms. Mclinn, thank you for sharing your family story and your experience as a mother and a grandmother. It is really heartwrenching to hear. I am so glad that the innovation and research is helping jordan and giving him and so many other people hope. In your testimony, you discussed the importance of not finding a onesizefitsall solution when it comes to treating patients. Can you talk about what this means for your family . Well, just for an example, jordan has a rare disease that affects one in 5000 boys. The drug that jordan is trying right now is really only designed to help 8 of patients, so jordan has a rare disease and then he is a rare subset of that. So we have lots of drugs right now coming up in the duchenne pipeline and not just for duchenne, lots of rare diseases. Even though jordan is doing well and has a treatment now, it is not a cure. It is designed to slow the progression of his disease. He is 10, he is still young. He is doing well, but we need more treatments to continue to be developed. We need treatments for joseph, who i told you is 16 years old. We need treatments for all of our boys and we need treatments that have yet to be discovered. So innovation is so important to us and it is not onesize fitsall. Like i said in my testimony, these are heartwrenching stories that these other witnesses are sharing. I want to be careful that we are not mashing the two together, because something has to be done about this, right . But we also have to protect innovation and make sure that companies, that they are still going to work in this space. I need them in this space and so do so many so other people. I think you hit the nail on your comments there. We all do want to do something and it seems to me that you are buying time and by the time your son is 16, you are hoping that it has, you know, been changed even more. Again, it is so heart wrenching. What suggestions would you have for congress on how we can better encourage innovation and reward it . I honestly dont have a big, like all hot answer to that. I really came here today to remind you, as you are having these discussions, please remember not to make decisions if you are changing policies. Please do not make decisions that will impact the innovation and squelch that, because i think it is okay that companies are making a profit. How much . I dont know. I look at how much money. Just jordan alone, we travel out of state. He is 2 1 2 years in. We went out of state every week. He is one of 16 in this trial. This is a small trial. Some Clinical Trials<\/a> are much bigger than this. I just look at how much money. I mean, i dont know how much, but i know traveling is not expensive. I think of the doctors, the nurses, the surgeries hes had. He has had two muscle biopsies, where they had to take a sample of his muscle before he started the trial and another one 24 weeks later to see if he was producing more distro finn. I am happy to tell you all the boys are producing more, which is incredible. When you think about the surgeon who did that, the nurses in the room, the scientists, the storage of those muscle biopsies, there is so much that goes in. There is a lot of expense that goes into Clinical Trials<\/a> and i just want to make sure that we are not forgetting about this as we have these conversations. I think your grasp is great and we can all learn from this. One of the hardest parts of my job is trying to see the unintended consequences of whatever we legislate or whatever we make as a law or a rule, because five years down, one year down, we may be dealing with something we didnt intend to happen. So we are always trying to be so careful with what we do. Thank you very much, all of you, for being here today and i yield back my time. Thank you. Mr. Welch. Thank you. I want to thank you. Every once in a while we get an opportunity to do something useful in congress, not often. Today is one of those days. I just want to give you my reaction. It is not for you to tell us what we should do to bring these prices down. You are the face of the harm caused by our failure not to bring the prices down. And each one of you has a separate story. I know you lost your husband at 40. Raised those kids alone. You end your sisters, sharing your insulin. And what i love about listening to you, is you are living your life. Youve got a real challenge. This is outrageous. You shouldnt have to be contending with unaffordable medications. It could happen to anybody sitting up here. It is just the luck of the draw. When faced with that, there is not a fairness thing. You dont know why it happens. There is nothing you did to make it happen, but then you own it. You have to make a decision and each one of you made a decision. You are going to live your life. Youre going to fall in love and get married. Yeah, i mean that is, that is really lifeaffirming. What i find so inspiring about it is you dont you are not angry. I mean, youre frustrated, you are worried, but i didnt hear anger. You are entitled to some anger at us. Because it is our job to make certain that these companies dont rip off the patent system. Dont rip off the taxpayer. Dont game the system. And it is for us to figure out how they are doing that. Youve testified, mr. Mitchell, many times. You are really as knowledgeable as anybody about all the ways in which the Companies Put<\/a> profits ahead of people. But i think it is really, really helpful for you to be here for us to hear you. Because we are starting to come together. Weve passed some you know, mr. Cummings has been a leader in trying to get the prices down for years and it is starting to make a difference. The Senate Finally<\/a> passed legislation that will put a significant dent and bring down the cost to about 100 billion. You know, what i get so frustrated at is the self righteous justification from a lot of the companies that are making a lot of money, that if we do anything to make the prices affordable, anything close to what is paid for these medications and all the other countries except ours, it will end, quote, innovation. It may end 100 million paydays, which i hope it does. But you know, bottom line, we are all in this together and politics is about trying to find ways where the things that are common problems, we can come up with solutions that work for all of us. That is the job. And there has got to be a commitment that i know the chairman has, and many of us. If you get medication, youve got to be able to afford it. I bet i speak for everybody. Thank you so much for deciding to just keep living your life each day, despite the challenge you face. My hope is that we will do our job, to deserve your respect. That you have earned yourselves. So, i just want to say thank you. Mr. Mitchell, i have a little time left. I will use your time if you will allow me. I just want to say, i want to quote secretary azar, who said, i have been a pharmaceutical ceo and i am aware of the old, tired talking points that if we take one dollar out of profit, the engine of innovation will grind to a halt in this country. I am tired of those talking points and so is President Trump<\/a>. I just want to say, amen. Thank you. Thank you all very much. Mister chairman, thank you. Mr. Jordan. Ms. Mclinn, you are the embodiment of something i believe. We have all these lobbyists in town, but no lobbyist will be a mom on a mission. We appreciate your passion and your love for your son jordan. You talk about your situation, and if you dont mind, you have private insurance . How are you covering these tests and trials that jordan is a part of . The drug company pays for it. Really . Interesting. I think that is really important to know that, that these Clinical Trials<\/a> are expensive and the money doesnt always come from taxpayer money. I know some does and i know that nih, you know, i know that there is funding for rare disease, but jordans trial is being paid for by his drug company. So all those trips we make, all the doctors some of the nurses, the drugs. All of it, they are paying for that. So that is why, believe me. None of us want high drug prices. No one in this room, no one in this country, thinks we want that. But i dont want us to miss the point that sometimes there are reasons that drug prices are high and i think in jordans case it is reasonable to expect that his drug is going to be expensive for that reason. Doctor mitchell, excuse me, mr. Mitchell, you mentioned in your Opening Statement<\/a> three things you need to happen. Can you walk us through those again . Mr. Hice mentioned earlier, i think you, ms. Mclinn, all of them talk about this balance we need. You want the innovation happen, because you said in your Opening Statement<\/a>, without innovation they will not find what is needed for you to continue to live, so innovation is critical. But price matters, too. That is where we are at, so lets figure out how we can keep both. I think you had three points you made in your Opening Statement<\/a>. I really appreciate you offering me the chance to repeat them, sir. We need to reform patent law. The creates act that you helped sponsor and helped advance in congress is important. Pay for delay deals that dont allow generics and bio similars to come to market timely. Citizen petitions, 95 of which are filed by Drug Companies<\/a> and 92 of which are kicked by the fda. Former commissioner gottlieb flagged as a problem. Patent ticketing, that senator korman has tried to take on. This is to make the system that you all built work, so we can award innovation with a period of exclusivity and let them make a lot of money, because you did innovation, you took a wrist. Exactly right. There is a reason patent protection is in the constitution. We want people to take risks, come up with great ideas, innovative things and do it. Exactly, but you have to make it balanced so when that time you intend is over, competition and free markets can drive down the price. That is our system the way it is today, so it is not working. That is one. Two, we really fundamentally believe the United States<\/a> should do what every other country in the world does and it should bargain directly with the Drug Companies<\/a>. We should strike a noninterference clause and medicare should negotiate drug prices. We think the negotiation is the essence of a capitalist system. When you are in a situation where someone can come in and dictate a price to you, that is not freemarket. That is giving a monopoly and allowing the monopoly to be enforced at taxpayer expense. And third, we do think we have a problem down the supply chain. One of the problems with our system is that when list prices go up, everyone down the supply chain makes more money, so they all have an incentive to have list prices continue to go up. Pbms, chief among them. We think secret rebates are bad policy. We dont think they work for patients. As a patient i cant know if the preferred drug is there because it is the best drug or if it is the least expensive among equally effective drugs, or it is there because they got a big kick back from the drug company. This is happening, so we would also like you to address transparency with pbms. I understand. Thank you. I appreciate that. The key to me is, we have this amazing system where we do get innovation. We do get the greatest drugs researched, developed and brought to market right in the United States<\/a>. We have to make sure that continues, but happens in a way that people can actually afford medicine they need. Treatment that they need which is so thank you all for being here today. With that, mister chairman, i yelled back. Mister raskin. Thank you. I want to thank you for calling this meeting at the beginning of our recess and i wish that all of the media which swarm over this congress when we conduct oversight into government corruption and criminality were here today, because this is a crime, too. This is corruption and this is a nationwide scandal. I must say this is the finest and most Inspiring Panel<\/a> of witnesses ive seen since i got to congress and i hope every american takes the time to watch your testimony today or tonight or over the weekend. I wish i had an hour to question all of you. Mr. Mitchell, i have a special attachment to your testimony, because it is so lucid, brilliant and clear, and also because you are my constituent. You make the eighth district of maryland proud. I wish i knew someone who had millions of twitter and snapshot followers all over america who could retweet your testimony. Maybe i could prevail over one of our distinguished freshman members of the committee to make you famous today, mr. Mitchell. My friend from ohio launched his remarks today with the now obligatory attacks on socialist, but it is not socialists who are jacking up the prices to make Prescription Drug<\/a>s unaffordable for millions of americans. And it is not socialists who are stifling competition. It is the Large Pharmaceutical Companies<\/a> themselves. This should be no surprise to my beloved adam smith, who understood that companies are in the business of profit not out of altruism, but self interest. That is what makes the market work, but if you allow those companies to get so big and so powerful that they take over the system, they will destroy competition. Every significant freemarket economist has understood that. I think that is the burden of your testimony, mr. Mitchell. That is what is going on. If they can make profit by paying off generic competitors to stay out of the market and keep prices inflated, they will do it. If they can make extra profit by obtaining new drug patents for old drugs that have long been on the market, they will do that. And if they can inflate their profits by lobbying congress to keep us from engaging in the cardinal market activity of negotiating for lower prices, they will do that, too. And our job as representatives in congress is not to bow down to large corporations, but to stand up for them for the Public Interest<\/a> and for the people. Mr. Mitchell, in just two years, as a person dealing with an illness, a serious illness, you have built a community of more than 150,000 patients and families to fight for lower Prescription Drug<\/a> prices. To fight for real competition and to fight against monopoly pricing. In medical services. Now, you say that these high drug prices are not about innovation. That may have been the single most important thing you said. Explain why high drug prices are not about innovation. There is no correlation and multiple academics have studied this, between the cost to develop a drug in the price at which it is set. It is set as high as the company can set it, because of what you said. They are profit maximizers. As long as we let them do that, they will continue to do that. Why would they stop . It is their job to take care of their shareholders. That is my concern that that balance between ensuring that we give a really good, rich return for excellent, Innovative New<\/a> drugs, and ensure that a price is set that is affordable. May i give you one example . Yes, and then i will follow up with another question. Im very concerned because nih reports, francis collins, director of nih reports there is an impending cure coming for sickle cell out of nih. We checked. It turns out the invested 300 million. And nih reports it is spending 100 million per year right now on a sicklecell cure. These gene therapies are coming to market between 500,000 and 2 million. If we have a cure for sickle cell that comes out of nih, that will be for 100,000 people in this country who have sickle cell, it will cost us 100 billion. And there are 400 gene therapies and development. How are we going to pay for this . Let me follow up on that. I am the proud representative of not only you, mr. Mitchell, but the nih which invests billions of dollars in scientific and medical research to find cures for diseases our population is struggling with. When they come up with breakthroughs, though scientific inventions and discoveries are used by these companies. So, should the Public Investment<\/a> in the research be also considered when we are deciding about the regulation of Prescription Drug<\/a> prices . The gentlemans time has expired, but you may answer the question. Thank you, mister chairman. We should and i also think we should Pay Attention<\/a> when you talk about the Drug Companies<\/a> financing Clinical Trials<\/a>. That we give them tax breaks for that. The orphan drug act gives them, for the trials that are done for ms. Mclinn son, a tax break. So taxpayers are not only financing through nih, but various Tax Advantages<\/a> to the companies for doing that research. By the way, dont stop that. Keep it going. I need new drugs im going to die. And that is straight up a fact. So we want it, but we want the drugs to come forward at prices we can afford. Mr. Keller. All right, mr. Roy. Thank you, chairman. Specifically i want to thank the chairman for continuing to have hearings on this topic and shining a spotlight on this issue. I concur with my colleagues who are saying that this is an inspiring hearing of sorts, listening to this great panel and that this is something where hopefully we have a bunch of bipartisan interest in trying to solve. Mr. Mitchell, i have been particularly interested in what you have to say. I would agree with my colleague from maryland, the you presented this in a particularly lucid way. I would also add the quote from ms. Mclinn, it is okay companies are making a profit, how much i dont know. That pretty much sums up my general philosophy on this. I want innovation to continue. I Want Companies<\/a> to make the maximum dollar they can make to encourage innovation, within some sort of boundary recognizing our patent system, thats constitutionally prescribed, is critical to the formation of these drugs. I was listening to your testimony, miss holt. I spent a lot of time with people dealing with myeloma when i was at md anderson seven years ago, with hodgkins lymphoma. I was trying to remember when it was and i was looking through my old email files, gmail, looking through it and found july 28, 2011, which i guess would be this coming sunday would be eight years. This is the email back and forth with my wife when i was at the doctors office, thinking i had walking pneumonia and i was starting to figure out i didnt. So i now know that was july 28, was the date. Then i found out a few days later, got the results that it was hodgkins lymphoma. I said is that the good kind of the bad kind, hodgkins or non hodgkins . The doctor said i guess that is the good kind. Going through that obviously changed perspective. I was on a trial down it md anderson. I spent every two weeks, from august through january 2012, going down to md anderson in the trial clinic section there and getting treated. It was not fda approved at that point. It was fda approved for relapsed patients. I was, you know, a new patient. And i am very grateful that that drug was being brought to market. That a Pharmaceutical Company<\/a> was making money doing it. Some of the research that went into developing that, of course, mr. Mitchell as you said, came from nih and other avenues of publicly funded research, including the university of texas and other avenues. So for me, the question i am trying to wrestle with, and often in congress we dont acknowledge what we dont know, when in fact generally there is a lot more that we dont know than we know. But you know, i dont know the answers to how much money that is coming through nih and publicly funded research, that then goes to a privately Held Corporation<\/a> and what agreements that exist, and how much profit should be allowed, right . I cringe when i think about the government setting what profit is allowed. I believe in the markets and i want the markets to work, but as my colleague from maryland was talking about, we dont always have a full market going on here in terms of competition, because we have all these issues. I dont mean to filibuster here, because like my colleague said, i would like to say here for an hour and have a giveand take. I am intrigued by all you have to say. Im interested in a number of pieces of legislation, including the ones that were mentioned. My fellow texan mentioned some legislation each of you have. Im looking at all of that. Im cosponsoring legislation 2139, patients for Affordable Drugs<\/a> now, which i think mr. Mitchell you are part of founding, is supportive of him trying to stop some of the games that Patent Companies<\/a> play by dragging these things out and tweaking the formula and moving it down the line. These are all things i think we need to look at. You know, again, provided that as, ms. Mclinn i think you rightly pointed out, and you too, mr. Mitchell, all of the panelists, that we preserve innovation. Make sure there is an abundant supply of drugs continuing to be developed so we have these lifesaving cures and are able to distribute that around the world. Which is what companies are structured to do, for profit. But we have a lot of work to do to make sure the packet patent system is not gamed. That they are not driving up prices on getting more transparency in the process. And i think the three points you outlined, mr. Mitchell. I just did what i hate to do, i think i used my five minutes without asking a question. I apologize for that. I looked down and realized i used my five minutes. But i appreciate the questions you have answered and that you spent the time out of your busy schedules to be here and i think the chair for having this hearing. Thank you very much. Ms. Ocasiocortez. Thank you, mister chair. I appreciate you holding this hearing. I think first and foremost to each and everyone i want to say firstly, that i am sorry. I am sorry youre going through the things you are going through. I understand and have experienced not all of what you all are experiencing, but some of it. When i was 16 years old, my father was diagnosed with a rare form of lung cancer. He was in experimental trials in order to save his life. My family almost lost our home. In order to try to keep him alive and just try to keep our family together. A lot of folks, you know, many people know that i was working in a restaurant when i got elected. But they dont know why. And the reason why is because we lost my father to a rare form of lung cancer. We couldnt find treatment for him. The other thing that i want to say, too, is that none of this is your fault. So often we are made to feel guilty for the things we cannot afford, when there is no reason that her treatment should be this expensive in the first place. One of the things that i wanted to kind of get at is this idea that all these drugs should be as expensive as they are right now. Because i dont think that that is true. Ms. Skipper, you said that with your insurance, your insulin is 1000 a month, is that correct . Yes. When insulin was first developed, the patent was sold do you know, do you understand based you know this story . Yeah, for one dollar. For one dollar, right . That is a much the patent for all insulin was sold for. You know the reason why it is 1000 with insurance for you . No. Neither do i. I have no idea. Frankly, i dont think corporations well, i dont think corporations will give us a reason why. A lot has been made about how much money has been spent on research and development. Between 2006 and 2015, about 465 billion was invested in research and development. I think every dollar put into research and development of pharmaceuticals is a good dollars spent. But let me see, mr. Mitchell, are you familiar with stock buybacks . I know what they are. And what is a stock buyback . It is when a company decides to purchase shares of its stock in order to drive up its stock price. So in the between roughly 10 years, 465 billion was spent on research and development. The amount of pharmaceuticals spent on that same time to buy their own stock for the sole purpose of driving up the price was 516 billion. So they spent more than their entire budget on research and development on a tactic to drive up their own price. Stock buyback used to be illegal in this country. Once they were made legal, they were allowed. One of the things, when a company buys their own stock, it drives up the price of their stock. Something that is not talked about is that ceo pay is tied to stock price. So ceos right now are not incentivized to invest in research and development. There incentivized to raise their stock price. So you know, there is a lot of debate as to what can be structured. Whether we can go singlepayer, whether we maintain our insurance system the way it is, how you make it more competitive. Whether you dont, et cetera. I think one very clear thing that we can see, mister chair, is that if we eliminated stock buybacks, we could reduce the cost outlays of pharmaceutical companies by at least half, when you compare Just Research<\/a> and development and the stock buybacks alone. Again, i just want to thank every one of you for sharing your stories today. Because, there is no reason for a drug as simple as insulin, which costs 21 in canada, for a 10 milliliter bottle, to cost the equivalent of a mortgage payment or sometimes two mortgage payments. With that i yield, thank you. Thank you very much. Mr. Meadows. Thank you, mister chairman. I think each of you for your testimony today. I apologize for being a little bit late. Actually i was at the white house working on Prescription Drug<\/a> prices. So i want to let you know, this is bringing a number of us together from opposite sides of the aisle. I have had a number of conversations with the chairman. We both have a passion to not just make this political, but make it real. And ms. Skipper, you should never have to ration yourself with insulin. You should also be able to have that affordable drug, as ms. Ocasiocortez just mentioned, because that is a drug that is been around for a long time. I can tell you that there was one regulation that was changed, actually just a week ago, that will start to help with that. There are more being proposed. But we need to work in a bipartisan way. I think you have a commitment and i am here to tell all five of you, you have a commitment to a bipartisan effort to make sure we do this. My good friend from vermont, ms. Welch, mentioned that they passed something out of senator grassleys committee yesterday. Now, is that the perfect answer . I can tell you it is not. But i can tell you, that democrats and republicans are looking at this very, very closely. And help is on the way. In the near future. I can tell you that i believe that we must announce an initiative that hopefully will gain traction legislatively in the house and in the senate and act on that, i believe in september, when we come back from recess. Mr. Mitchell, i want to hit on one area. You mentioned pbms. The middleman that continues to, in ways, drive up prices. It has become part of our delivery system, so as we look at that, we created pbms. I dont know if you know that, but when hmos came around, we actually created pbms and yet we are seeing this artificial increase in Retail Prices<\/a> that makes it very, very difficult. Would you agree with that . Yeah, the headwaters of the problem is the list price is set by the Drug Companies<\/a>, but we have a system downstream that has reverse incentives and as patients we have a real problem with secret rebates. We dont think they are designed to serve us. We think they are designed to serve the people who make money on this. Right. All right. Ms. Mclinn, thank you for sharing the fact that you are benefiting from the Clinical Trial<\/a> aspect. One of the things that i believe would be helpful, and perhaps you can be a great advocate for this, is as we look at Clinical Trials<\/a>, the expense of getting groundbreaking drugs to market. There is clinical one, clinical two, clinical three trial. What i believe, just like we have done on a few drugs, hiv and a few other cancer drugs, is once we do that clinical to trial and we have shown there is safety, allow those to go ahead and come to market. Allow those, so that while we are doing that clinical three trial, and we know that the harms are limited, that we go ahead and allow those to come to market. It allows a whole lot of Smaller Companies<\/a> who are innovative to bring them to market. You think that would be helpful . Yes. All right. I was hopeful that that was going to be your answer. The other aspect that we have to get to is because of the way that we have structured Prescription Drug<\/a> prices, not just for Medicare Part<\/a> d, but because of the pbms. It is a very integrated system in terms of delivery. So you have retail price, youve got net price, youve got rebates. But when we start to try to hit on one lever or the other, it has an opposite it can have an opposite effect. For example, ms. Skipper, if we were to actually work on one area and say we are going to eliminate the pbms, some companies actually take the rebates that they get from pbms to lower insurance prices, so it is a very, very complex thing. So here is my commitment to you. I believe it is one that the chairman supports. I can tell you, it is one that the administration supports, because i just left. We are going to lower Prescription Drug<\/a> prices and we are going to do that without increasing insurance premiums to pay for it. It is time that we act and the time is now. And i thank you all for being here and i yield back. I want to thank the gentleman, mr. Meadows. Just to assure you, he is absolutely right. There is not a week that goes by that we are not trying to figure this out and trying to work with the white house to get it done from a number of angles and i want to thank you for working with us. Now, ms. Presley. Thank you, mister chairman. I would like to say how much i appreciate your leadership. It is a source of pride for all of us on the committee that the very first hearing that we had in this committee, in this session, was on reducing Prescription Drug<\/a>s. I want to thank all of you for being here today. Ms. Skipper, you said that you are 23 years old and you are tired. We are tired. Like you, that millions of families are suffering. It is not only those of you individually battling this, but all of the people who love you and support you in this journey in the pack and the fact you have two weaponize your experience to be seen and heard. You thank us for limiting listening, but i think that is too low a bar. You need us to act. You have been rationing medication and it seems for far too long, we have been rationing our response and our compassion and our due diligence. So it is critical that we act in that we act in a bipartisan fashion. You know, although insulin has not changed since the mid 1990s, the price has skyrocketed and communities of color have been disproportionately impacted. According to the american diabetic association, black and latino americans are more than 70 more likely to be diagnosed with diabetes than white americans and one in three adults in this country will have diabetes by 2050. The price of insulin has nearly tripled to 6000 over the last decade, an impossible price tag, especially for our young people and young adults. Ms. Skipper, can you just speak to, how have you been obtaining insulin in recent months and years . Through donations. Donations from people from my community, my church, and sharing with my sister. That is burdensome also, because i feel like im taking away from people who could also be using this lifesustaining medicine, but it also makes me appreciate that there is some good in the world and the selflessness of some people. I cant tell you the last time that i filled a prescription for my insulin. So it is just it has been really hard, to just kind of guesstimate how long my supply is going to last. And you talked about, you know, getting a new job and one that includes employerbased health care coverage. How has could you speak a little bit about that and what that coverage has meant and what the difference has been . I mean, its been good if i want to go to the doctor for a checkup. Get my teeth cleaned, get new glasses. You know, go to the gynecologist or anything like that. But for what i actually need to live, it is just, it is hard. It is just really hard and i just dont understand. I just dont understand. Just, i want to dig into that a little bit more, because there are other associated costs which people often overlook in this, so if you could expound on that a little bit. Yes, it is not just insulin. I need needles. I need test strips. I need alcohol swabs. Glucose tablets. Extra food, just in general. And i also have celiac disease, so it is not like i can just eat anything, or, you know. So it has been very costly to live and i do feel sometimes, like, i didnt put this on myself. So why do i have to suffer . Why do we have to suffer . There was actually a recent buzzfeed article speaking about the fact that many twentysomethings are no longer carried on your parents insurance. The precarious position that is putting so many young adults in. It is particularly acute in regard to someone like you, living with type i diabetes. I understand that you and your sister havent been able to use a parents insurance in recent years, but have faced similar struggles to those who have lost their parents employer coverage at that age. Can you tell me what happened when your mother lost her job . When your children . Oh, im sorry. Sorry. Things started to spiral out of control. I was really scared. A few months after she lost her job, i was suicidal, because i didnt want to continue to struggle. I didnt know how me and my sister would make it. I didnt know how my mom would provide for herself, from losing her coverage. It just put us in a really bad spot. Well, thank you, ms. Skipper. Thank all of you. The fact that from hospitalization to stockpiling or buying insulin on the black market, too Many Americans<\/a> are cutting corners in their medical care, simply to stay alive and that is unacceptable. Thank you. Ms. Tlaib. Seriously, chairman . I am the eldest of 14. Ive been taking care of people my whole life. So when i have a motion, it is because ive seen challenges. This committee hits home so, so much. I just want to thank all of you so much for speaking up, because i know i can speak to some of us here. There is a lot of urgency. There is a lack of urgency. When the mother was talking about missing, you know, coming here because she had to be a voice for so many people cant be in this room, i want to thank you for that. Because i know how hard it is. It is funny, our kids are going to be fine sometimes. Were the ones feeling more guilt than they are. Mom, i am doing fine, and with my friends. But one of the things this broken system and the frustration i have. I had all these questions i wanted to pull out, the human stories, but i think you all put a human face to something for years i feel like hasnt truly been translated into the human impact. Until he got so broken down, so to the point that you have people rationing, that you have people actually dying before your eyes, because we have allowed corporate greed. We have allowed corporate greed to come before the people. We, the government in this chamber, we are responsible to protect you from it. And i want to apologize. I want to apologize. I have only been here seven months, but not on my watch. Will i not be able to humanize the impact and pushback against corporate greed. Not just us, congressman kelly, many of us in this room. I want you to know that we truly, sincerely care about your life. A woman came up to me at a coffee hour and said, rashida, i dont understand that they are saying that insulin is not preventative care. Of course i dug deep. She goes, you dont understand, insulin prevents death. I said absolutely. She said her company, this is a big company, said they decided to change the system so now she had to literally sit a whole month before she can pick up her sons insulin. 2800 she has to put together. 2800. I said no, i cant wait for a bill to pass. I cant wait for people to wake up here. Im going to put it on my letterhead. So on my letterhead, i said what are you doing . You are a corporation. I took the Mission Statement<\/a> of the corporation, put it in there and said, youre supposed to be about people, right . Without telling them who it was, i said what are you doing . Youre allowing people to die on your Health Insurance<\/a>. She told me she went in last week to go pick up her sons insulin. She got together 2800. I know where she lives. It was hard for her to raise that money. She went in and she said i dont know what you did, but its 244 now. Right. Thats still too much, but that means there is a will. There waiting for us to tell them to stop. Right . Moms know this. When theres bad behavior, we subsidize, done the research and development, weve done everything we are supposed to do to say to them that you are supposed to be able to provide for the American People<\/a>, access to drugs that help them live. I want you to know, continue to be bold. Continue to ask for more. Even when folks say we all agree, that is great. But action speaks louder. So i only have a minute. I want each of you to tell me in your own personal opinion, why do you think we havent acted in congress . I will start with you. Drug companies are monopolies, have monopoly Pricing Power<\/a>, and monopolies, by definition, have unlimited resources to defend their monopolies with Political Campaign<\/a> contributions and lobbyists. There is 1. 5 lobbyists for every one of you in the United States<\/a> congress. 1. 5. That is like daunting odds, as my dad wouldve said. I think it is the fact that they use their monopoly Pricing Power<\/a> to maintain their monopoly Pricing Power<\/a> and to stop reform from happening. You know, i dont, i dont know the answer, but i think this hearing is, like you said, putting a human face to the issue. I think there are a lot of donations that happen. So maybe it gets pushed back to the back of the shelf. But i can definitely tell sitting here today that you guys are going to do something about it. My disease is really treatable. It is not so treatable for these people. That is not okay. The question, why havent you acted, i think it is an interesting question, because i am going to say i think congress has acted. Because of congress, my son is participating in a Clinical Trial<\/a> that i believe is helping him. I believe patients are accessing treatment sooner and i think everyone in this room and everyone listening is acting right now. I think that is what we need to focus on. I think lets not dwell on why we havent solved this yet. Lets keep doing the next right thing and lets just figure it out and lets do that. Thank you very much. I would say from a patient perspective, not really knowing, you know, i dont know how all of this works. But it seems like the people up benefit from this in not acting. I dont know if its in the Financial Way<\/a> or whatever way, but it just seems like you get a piece of the pie some way, somehow. Thank you. And im just a retired teacher from indiana, but to me its money. I think its money. Its the lobbyists. Its the pressure put on people to do things according to the money rather than to the good. I also see a lot of bipartisan fighting that i think is inconsequential when it comes down to peoples lives. But there needs to be more cooperation. I do think im 70 years old. Im hopeful things will change before i die. And im hopeful in meetings like this that things are finally happening. I started coming to washington, d. C. Two years ago to help the creates bill. Im frustrated its not passed entirely but its making progress. How slow it is for me thats frustrating, but im excited to see progress being made. Thanks. Thank you very much. I too want to thank you all of you being here. Its not easy to tell your story in front of congress, cameras and people in the audience. So i truly, truly appreciate all of you being here. Mr. Chairman, i appreciate you for having this and im proud to serve on this committee but im also proud to be a member of energy and commerce. It makes me feel good to hear you say were moving along and what were doing is meaningful. And we are really working in a bipartisan way which is good for here. You know, because theres so many other ways that were not, but we definitely are in energy and commerce. When i came to congress, the ive been here, im in my seventh year, my district had the highest rate of foreclosures in the state of illinois. And some of the people lost their jobs. Some of it they went for hopi dope mortgage. And i think were on a rebound and things are Getting Better<\/a> for the other reasons but not for the medical reasons. I also on the chair of the Congressional Black Caucus<\/a> helped brain trust and of the top ten diseases people die from africanamericans are number one in eight of them. And ms. Skipper, we work a lot with your issue. The other thing in that capacity im responsible for two conferences a year, and one conference someone shared that they have asthma. And their asthma inhaler is 325 in the United States<\/a>, and she left her inhaler at home, and she was in south africa. Same exact inhaler, same exact company, everything exactly the same and the inhaler was 25. So in coming to congress ive gotten more aware of the issues that, you know, every day people my next door neighbor, whomever have to go through in this fight with low and Prescription Drug<\/a>s or having to choose between, you know, paying bills or buying the drugs or eating. You know, so i promise you i will continue to work really, really hard in this area on both of these committees. One question and i dont know if you know the answer, my colleague ocasiocortez always has a lot of stats so you may have some of the answer, but the money that companies spend in advertising, you cant open a magazine without seeing pages and pages and pages, so i dont know if you would know. 6 billion a year. And we subsidize it. Thats the unfortunate thing. Were the only other theres only two countries in the world that allow direct to Consumer Advertising<\/a> in pharmaceuticals, us and new zealand. And we give a tax break to these companies to send those advertisements our way. And the only reason they do it is to make more money encouraging people perhaps to use drugs they dont necessarily need even. Im one of the last people to ask you a question. Is there anything more you want us to know that you didnt au d already say, anything . I do want to say i would love to visit you and talk about the sickle cell cure and how were going to make sure that drug developed inside the walls of nih. Theyre running Clinical Trials<\/a> right now and theyve spent at least a half billion dollars, how do we make sure that drug comes to the market add a price affordable and accessible. And i have been meeting with people and im in this building 2416 so come at any time. I just wanted to follow up on this question about advertising. I never thought about that before. Thank you, mr. Mitchell, for tell using its only the u. S. And new zealand that permit advertising for Prescription Drug<\/a>s. Are you suggesting you think that should be banned or that the cost of those ads should not be tax deductible for the businesses, ordinary business expenses . I mean, have you done work on this problem . The courts are ruled Drug Companies<\/a> have a First Amendment<\/a> right to advertise. But the Financial Academy<\/a> of sciences and engineering and medicine came forward report 18 months ago and recommended you eliminate the tax reducing for that. I dont know why were subdiz g subsidizing their advertising. Thank you very much. Thank you, mr. Chairman. Thank you for having this hearing. And to the Ranking Member<\/a>, thank you for making it nonpartisan. I just want to follow up a little bit on the earlier discussion. Having spent a good deal of time on this, i would rem to anybody id like to recommend books. Our daily meds is a book by a former New York Times<\/a> reporter. And its called how the pharmaceutical companies transform themselves into slick supermarketing compani marketing companies. We took pharmaceutical companies doing the research, they became the ceos, and they got a reasonable rate of return on their investments. And then for a variety of reasons not just direct to the pharmaceutical industry but more towards the finance industry, this book will tell you they did extensive focusing on groups, 15, 20 years ago. They looked at professions and industries americans trusted and it turned out we trust people with white smocks. We trust doctors and pharmacists and researchers. So they went in and bought up controlling shares and they turned them into marketing companies. So to act like this is something that just happened, it just becomes so bad that weve finally gotten attention. And it needs to be stopped. I know my colleagues have heard this before but sometimes you repeat things lots of times in this building. I know this because i have a pill in my pocket thats sold by johnson and johnson and it keeps me alive. I have a form of leukemia and im thankful for this pill. Its 500. Its the most expensive thing on me until 3 00inate afternoon. And most of the research on that pill came from darpa, the department of defense. If you learn blood leukemia started because of soldiers and sailors getting mustard gassed during world war i. And we spent a lot of researchers to try to help soldiers to be inoculated. And we found out how our blood systems were covered. So this pill that costs 500 here in the United States<\/a> of america, im lucky enough i signed onto a public option that was in the county that i was a county supervisor four years ago and everybody told me dont do it, youll have to get your medical service at the county hospital and my kids and i went to the clinic and we got great service. Its the classic option. The public option would work in this country and does work in some instances. So they helped so that i dont have the kind of costs that you have because thats my supplemental. That pill costs 400 a year ago and then they changed the formula and now its 500. This pill in australia costs 6. 37 with subsidies. Fully loaded it costs 37. Where does the rest of that money go to . And it doesnt go to research. So mr. Mitchell, a study published in the oxford journal of law and bio Sciences Found<\/a> just 22 of drugs receiving new patents between 2005 and 2015 were actually new drugs. The study concluded, quote, rather than creating new medicines pharmaceutical companies are largely recycling and repurposing old ones. According to a gao study Innovative Products<\/a> accounted for only 13 of products from 2005 to 2016. So therein lies the problem. Another hearing we had a pharmaceutical executive here and i said we want invest but we want you to get a reasonable rate of return. It was supposed to be high risk, high return. Theyve gamed the system so its very high risk, low return. One of my two sons name is jordsen, so your story relates to me on multiple levels. This is outrageous. Its just outrageous. Its a crime. These people shouldnt be executives. They should be in prison in my view. Mr. Mitchell, you have any comments . When Drug Companies<\/a> do what you just described, file new patents on old drugs, 78 of are all the patents filed on drugs are filed on existing drugs. Theyre not doing what we all say we want up here which is inest having innovation, in vesting in research and development. And so you guys really have got to stop this abuse that allows them to milk old drugs by gaming the system instead of doing what we need team the do which is invest inivation and new drug development. And we have to keep in mind that a lot of that is also subsidized by the american public. But you have to get them back focused on developing new drugs instead of just milking profits from developing new drugs instead of milking profits oum old drugs. I want to thank you all once again. Your testimony is really important and people need to hear our stories. Thank you mr. Chairman and i yield back. Thank you, mr. Chairman. Thank you for your leadership. Thank you to all of you for sharing your stories, for being so vulnerable, for sharing something that is so personal and for your courage in doing that to help our country move forward. I appreciated representative felipes comments youre here not just as an academic exercise. You want to see some action. One of the things weve been talking about as a country for the longest time but dont do anything is medicare for all. Medicare for all would finally give the ability to negotiate and localwer these drug prices. And Linden Johnson<\/a> when he first passed medicare anticipated wed have medicare for all. And then 25 years ago senator moiahan had experts and at the end of it he said theres one solution, lets extend medicare. President trump in 2000 in his book said why dont we have a Single Payer Health<\/a> care system, its better than anything we have. Yet we keep talking about this, we keep having folks like you testify and nothing gets done. So i want to ask each of you starting with mr. Mitchell do you think medicare for all would help . Affordable drugs only focuses on drug prices and we want very much for people to have access to affordable accessible care but we dont have the position on medicare for all or any of the steps you could take to ensure that people get access to comprehensive coverage. I apologize. Whats your personal opinion . Im not going to express one because im here on behalf of the organization. Ill stay in my lane. I respect that. Sorry, but i think you asked the question a little bit over my head. I dont really have an opinion on that. Im only telling my experience with my issue about a drug that costs 1100 a month with insurance. I respect that. Does anyone have an opinion on it . Ms. Skipper . As i previously stated i dont know all the ins and outs of everything, but i can say this. Being a face of Affordable Campaign<\/a> i go down my instagram news feed and i see people from other countries who are just completely outraged that i have to pay for insulin at all. So if that is what medicare for all leads to, then that is something that i definitely support for someone with fibromyalgia or anything like that that doesnt have to pay hundreds of thousands for something they need to leave, then yes i would support that. Ms. Holt . I may be the only one on this panel that is on medicare right now, and medicare for me involves medicare plus a supplement. And even with that my drug prices are sky high. So if that does not change, then, no, im not in favor of medicare for all. Thats a very fair point. And part of that is because the medicare hasnt been able to negotiate for drug prices, which some of us have wanted to do. Part of that is because we dont have a generic competition. Let me ask you a second question. The president came on the state of the union and he said americans should not be paying more for our drugs than people in britain and france and germany. With folks there and i can start with mr. Mitchell and anyone else who wants to answer, support the idea if an American Drug<\/a> is priced higher than the drugs in these five leading countries, germany, france, britain, japan, then americans should pay the same prices as people in other countries or we should open it to competition. We strongly support direct medicare negotiations, strike the noninterference clause, director the secretary to negotiate drug prices. Theres absolutely no reason we should be paying two to three times what other countries pay for the exact same drugs. Anyone else . I would agree with mr. Mitchell. The founder of t1 International Actually<\/a> moved from the United States<\/a> to london to be able to afford her insulin. And i know there are probably more like her who have had to leave the country in order to live to afford to live. Thank you. Thank you very much. Ms. Maloney. Thank you, mr. Chairman for this really incredibly important hearing and all of our panelists for helping to build a case and putting really the misery that americans are facing with these unAffordable Drugs<\/a>. I believe its a National Scandal<\/a> that they are able to charge these prices without any accountability for how theyre raising it, why theyre raising it. And i want to mention four ways that congress could act tomorrow to combat this based on your testimony today. First of all, competition. The pay to delay that competitors are literally paid not to come forward with the generic or other ways that they delay the process moving forward. Ive heard from your testimony also the gaming of the system where they say that they delay and delay when you should have a generic, they file patents from old drugs so that the time is longer. Thats also hurting people. And what he just pointed out, the fact they can be so much cheaper overseas is an absolute outrage that did we pay for the production, the research and yet when it goes overseas its affordable but not here in america. And i think your story really on insulin is so moving, this was discovered well over 100 years ago. The scientists gave it to the American People<\/a>. He didnt want people to make money off of his invention, and yet now its unaffordable or not even affordable in many places in america to the point that americans are dying. We need to change this and work to make it happen. And i want to follow up with ms. Craig on your story where you talked about your inflammatory condition. Can you describe what its like what this condition is like and what your drug that you received that is now unaffordable, humera, tell us what it does for you and what its like if you dont have this drug that you cannot afford now . Oh, wow, thats opening up a can of worms. Well, when im in a full psoriatic flareup the last one was ten years ago and lasts two months, i was literally covered head to toe in what some would call lesions. On top of that all of my joints ache. Im selfemployed, im a hair stylist and it affected my business. I had to wait six months to go through three processes knowing i would not be able to afford the drug once i was approved and theres no generics available. This drug has been out since 2002. Thats crazy. Its 80 cheaper overseas. The science is there. Its a scandal. Its an absolute scandal. Yes, the generic, the science is there. And in your testimony, you said your written testimony, youre a successful hairdresser, you make a very good salary, better than most americans. Yet the cost of your drug was more than your car payment, more than your Business Insurance<\/a> and more than what you spend for food in a month. Yeah, the first month it went up 40 . And not having it has totally impacted your health. Can you still work without the drug or do you need i can because ive been in basically remission the last two years. Ive had to wean off of humera, ive had to go back on it, ive had to wean off of it. Im currently on an old drug. And you also wrote that advi has failed over 200 additional patents on humera effectively delaying the generic drug and any competition for decades, is that correct . Yes. See that is manipulating the system to not allow americans to afford it. We should stop that and ban that immediately. Id like to say that those 247 patents, that was only last year. Whats the total . Do you know . I believe they filed 247 patents, three short of what you asked but youre close enough. And now i understand you also take embrel now manufacture snd. No, i do not take embrel, ive been on it before but the cost of that was just under 1,200 a month. I just want to say im stressed beyond belief they have manipulated the system to run the price up so that you cant afford the drugs that you need, and i am sorry that youve had to face this challenge for your health, and it is something that we as a Congress Need<\/a> to act on as soon as possible. And all of you have helped make the case and i want to thank you. Mr. Gomez. Thank you, mr. Chairman. This is an issue that unfortunately has been going on for decades, right . I was curious about price gouging when it came to insulin. I did a quick little search one day and i found a lawsuit from 1940, i believe, 1941 basically accusing the companies of price gouging. So this is not anything new. It has been going on for decades. The question is what are we going to do about it . A lot of times its difficult but weve got to keep pushing and coming up with some new ideas, and i think that there is more of a commitment than ever but that doesnt mean it always translates to legislative victories. I was in the california legislator and we did push through some reforms there. It was still difficult but we got it done. But i always say we need to continuously highlight peoples stories to make it a powerful make a powerful impact. And thats why im glad all of you are here. I want people to really hear your stories and empathize. One of the things i always realize is that, you know, the impacts vary from person to person, but its definitely something that people should be able to feel even if theyre not directly impacted. Ms. Skipper, you mentioned in your testimony that you and your sister shared insulin in order to manage your type 1 diabetes. How long did you and your sister share insulin . Were still sharing. Still sharing. When did you and your sister first decide to share insulin . I dont well, i dont think it was more or less a decision to do it. I think it was something that youre forced to do. We were forced to do. How long would you say . Yeah, about seven years. What kind of impact does it have on your health to share insulin . I mean to sum it up i dont know what a good day is. Like, i dont know what a day to feel okay, like i dont know what that feels like. There hasnt been a day where i dont have like i dont have a high blood sugar reading. There hasnt been a day where i dont have like aches and pains. There hasnt been a day where ive been completely exhausted. So, yeah, to explain it the best way i can i dont know what a good day feels like. So we do know that because you dont know what a good days feels like because of your symptoms that see an underlying and chronic impact on your health that will probably im not a doctor but im assuming its not good in the longterm. And we need to make sure you and your sister get the support and insulin that you need. What were you feeling while your sister was in the hospital . Angry. I was very angry. I was angry and for some reason i had i felt guilty, but i dont know why i felt guilty because i know i dont control the price of this drug. I just dont understand why im giving this corporation 40 hours a week and i cant afford to have what i need and my sister has basically put her life on the line to ensure that im that im alive. I was very angry and also like i said like guilt and very shameful because i just very shameful because we it just was hard to see my sister fighting for her life, and it was just i was ashamed that i couldnt get what i needed so that she didnt have to be in that position. I feel your anger. I think the American People<\/a> should also feel your anger. I grew up without Health Insurance<\/a>. I know what its like to see your parents worry about you. To like if you get sick, what does that mean, right . Are you going to get better . Can you get the access you need . We have positives in our Health Care System<\/a> but we have a lot of negatives that we have to work together. But i think sharing your story and making sure people know about it especially with the t1 national the organization, we have to make sure we share the stories. But i think i dont have that many, but i think at least adding our voiceover and over could help make a difference. I thank all of you for being here and sharing your stories. Its important. Thank you so much and i yield back, mr. Chairman. Thank you very much. Just one thing, mr. Mitchell. The price has nearly tripled, the cancer drug that witnesses, you and ms. Owen are taking, is that right . More than triple. Okay. In that sense it was launched in 2005. A yielded supply of this drug can cost almost 225 250,000 per year and sell jen sold about 10 billion worth of the drug in 2018 alone. What did selgen do with all the money . First they gave its ceo a pay raise. His compensation was worth 28 million in 2018, and 3 million more added to that than the previous year. Salary, tell me about that about these drug manufacturing ceos . Do you think that plays a role in these price hikes . And i think the issue in the shortterm of the Drug Companies<\/a> is one of the things not getting us what we want because theyre running up prices in order to drive up their stock price in order to get bonuses and not enough focus is being paid on the innovation that everyone one at this table wants, so you take an old drug and in one year i think it was 2018 they ran up the price 19. 8 in one 12month period. And one of it reasons they did it is because they had a failed crones disease trial. They had to take a 700 charge, so they increased the price to plug up their stock price. I want to thank all of you for being here today. Before i conclude todays hearing i would like to enter into the record two letters the committee has received in recent days. One from the initiative for medicines access and knowledge and one from the National Hispanic<\/a> medical association. These letters discuss the acute impact to Drug Companies<\/a> actions and shifting drug prices are having on patients and communities all across the country. Let me again thank all of you for being here. It is not easy to on national tv, by the way, to talk about your pain. And youre talking about some of the things that are so very, very personal. And a lot of times, you know, when people are suffering, its almost like theyre suffering alone. They feel they feel like they Society Nobody<\/a> knows what theyre going through. I can tell you that there are a lot of people who feel the same way that you feel. They may not be going through what youre going through exactly, and thats why we in the congress we have to move. We dont have any choice. I saw something here today, and im so proud to be the chairman of this committee. I watch our members cry. I watch you all cry. And its because there is a a tremendous pain that comes with hearing your stories. And i think for most of us your pain is our pain. Your dreams are our dreams. Your hopes are our hopes. And i i just wanted to encourage you to keep forging on, ms. Skipper, ms. Holt, ms. Greg and mr. Mitchell. I heard you talking about, mr. Mitchell, how therell come a day when your options run out. When your options run out, and im sure that you worry about going into the doctor and the doctor telling you, sorry, your options have run out. But when there are options, when they are at our fingertips but because of cost and greed, its almost like youre reaching for the option and you just cant get there and itd be one thing if it was just going to debilitate you for a minute, but when your life is going to end as i ought to say when youre dead youre dead. And so its just it reminds me of when in my district in john hopkins, one of the greatest high schools in the world, doing a lot of great things. As a matter of fact, its the hospital that saved my life. I know there are a lot of people outside of that hospital who just want to get in the door. They know the cure and treatment is there. They just cant get in the door. And so to all of you, i want you to keep forging ahead. Keep in mind the words that i said, and i want you to put them on the dna of every cell of your brain. Pain, passion, purpose. Let me tell you something, you being here today, all of you, youre giving other people hope. You really are. But we have a responsibility, too. We have a responsibility to make sure we give life to your hope. And thats little boy whos racing and i just watch you as you talk about that hug and you precious that hug is and what it means to you, and im sure you can hardly wait to get back to him. But when you come in here ms. Mclinn and ms. Skipper, and all of you, and you talk about what youre going through but youre still forging on and youre trying to help somebody else, by the way, keep in mind its not just you that you are seeking help for. And thats the thing i love about all of you. You said no matter what im going to make life better for somebody else, too. And so were going to do everything in our power to help you get to where youve got to go. Because life is precious. It really is precious. And ms. Holt, as i listen to you, and you talked about sometimes feeling or you gave the impression sometimes you felt that your life was spiraling downward. That is not a good feeling, not a good feeling when youve given so much in life over and over again. Taking care of you were a schoolteacher . And doing everything you were supposed to do. Everything youre supposed to do. And all you want to be able to do is be able to hug your grandchildren, be able to go to the park sometimes. You and i are about the same age so i am challenged and dont mind admitting it. But the fact is those are basic things, just basic things. And so you want to be able to go down the aisle maybe with a daughter when she gets married. You want to hel htell her how tr a dress and what kind of shoes to wear. All that goes to the quality of life. By the way, its not just living, its about living a quality life, a life of quality. And so again i thank all of you for being here. I want to tell you, and this may make you feel some hope. Were going to have the drug company folks sitting in them same seats as soon as we come back. And were going to try to understand some of why theyre doing what theyre doing. And i do believe that and by the way as i close, the first conversation that i had with President Trump<\/a> was something that he said i will never forget. He said the Drug Companies<\/a> are getting away with murder. Thats what he said, getting away with murder. And hes right. Because every time somebody cannot afford that medication, every time they cant they have to share insulin and people have to share insulin and all the things that youve talked about, they are. So and im not putting it all on the Drug Companies<\/a>, but this is the United States<\/a> of america. This is the greatest country out here, and we ought to be able to resolve these issues. I want to thank the members for being here, and i cannot end this hearing without saying this because its been really bothering me. You know we get a lot of complaints. We have a lot of dialogue about our freshman members. And ive got to tell you the freshman members on our committee, ms. Ocasiocortez, ms. Talib, ms. Pressley, mr. Hill, are some of the hardest working members of the congress and i told somebody the other day that as i listened to them i am inspired because i realize that ive marched towards the twilight of my life. But to know they are there, that they will take up this mantle and they will carry this ball down the field and get over that line excuse me for a football metaphor. I am a football fan. That means something to me. It is important to me, so thank you very much. And with that, without objection all members did you want to Say Something<\/a> else . Without objection all members will have five legislative days within which to submit additional written questions for the witnesses to the chair, which will be forwarded to the witnesses for their response. I ask our witnesses to please respond as promptly as you are able to. This hearing is adjourned. Cspans washington journal live every day with news and policy issues that impact crow. Coming up saturday morning, Washington Examiner<\/a> immigration reporter discusses progress on the u. S. Mexico border wall and other immigration topics. Then a look at Boris Johnson<\/a> as the new Prime Minister<\/a> and the potential impact on u. S. U. K. Relations with heather cobally on the center from strategic and international studies. And Rolling Stone<\/a> Senior Writer<\/a> talks about his piece all american despair looking at the suicide epidemic particularly in the western u. S. Be sure to watch cspans washington journal live at 7 00eseern saturday morning. Join the discussion. This weekend on American History<\/a> tv, saturday at 5 00 p. M. Eastern a discussion about the 1980 refugee act. I think president carters decision to push for that act and to implement it was a hugely important humanitarian decision, and he deserves every bit of the credit weve heard here today that said we have to be realistic and say that doesnt solve all the problems and in fact it creates them. Then at 6 00 on the civil war, reknowned civil scholar garry gallagher. Whatever i did in academia should also have some dimension that reached tout to people in the era as i was when i was growing up and it seemed there should have been more bridges between academia and the public than there are. And one of the key places that can happen i knew from experience was at battlefields where you can make a connection to the past in a way that you can. Saturday on the 1967 film testimony of truth details civilian injuries and deaths caused by u. S. Bombing in north vietnam. I used to come home from school very happy with all my folks, father, mother, grandfather and grandmother. But all 13 of them including an unborn baby have been killed. Only i am left. Even little babies are innocent victims of these american air raids. And at 6 45 p. M. Historians discuss Health Care Policies<\/a> since world war i. Trumans was universal and would have covered everyone. Initially up to 75 supported the idea of Health Insurance<\/a> for all via the Social Security<\/a> system. Explore our nations past on American History<\/a> tv. All weekend, every weekend. Only on cspan 3. Next, a look at whistleblower protections at the Veterans Affairs<\/a> department. A house subcommittee heard testimony on preventing retaliation by supervisors or departments that may be associated with any active or closed investigations. The hearing will come to order. 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