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The messaging war over drug prices

Kimberly Adams May 1, 2019
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One of the few areas in politics with a measure of bipartisan agreement is the issue of prescription drug pricing. The Trump administration and congressional Democrats and Republicans all agree prescription drug prices are too high and that something should be done to slow their rapid rise.

Pharmaceutical industry executives were called before Congress earlier this year to explain their pricing practices, and the industry is currently the target of a major ad campaign by the AARP.

“We know our members take on average between four and five prescriptions a month,” said David Certner, legislative counsel for AARP, which claims a membership of 38 million people over 50. “It’s obviously a huge cost for them and one of the biggest out-of-pocket costs they have.”

AARP is using its own platforms (magazines, newsletters and website) to mobilize members, who are part of a demographic that tends to vote more and make more political donations than other age groups. But the ad campaign has other targets as well.  

“We’re targeting members of Congress and elected officials here [in Washington, D.C.] who are going to be the decision makers,” Certner said. “We’re also targeting state officials because we’re working around the country in different state levels to also take action.”

On top of the ad campaign, AARP spent more than $8 million lobbying Congress last year, according to the Center for Responsive Politics. Pharmaceutical Research and Manufacturers of America (PhRMA), the industry’s main lobbying group, spent nearly $28 million. The multibillion-dollar industry, which according to PhRMA employs more than 800,000 people, has a lot on the line in any potential legislation and is grappling with an image problem.

PhRMA did not make anyone available for an interview for this story.  

High-profile price hikes, such as the EpiPen scandal, are paired with the rapid increase in prices for drugs like insulin. Karen Cox, a transportation engineer in New York, said the rising cost of insulin for her daughter, who has Type 1 diabetes, has given her more than a few sleepless nights.

“I hate to say it,” Cox said, “but of course I think that the pharmaceutical companies are benefiting from this.”

A print advertisement from PhRMA’s “Let’s Talk About Cost” campaign.

Cox said a decade ago, her out-of-pocket cost for a three-month supply of insulin prior to hitting her deductible was $300.

“Those three vials of insulin now are $600,” Cox said. Her daughter aged out of Cox’s insurance plan last year and has her own high-deductible plan now. “I told her if she ever was not able to afford her insulin that I would help her pay for it,” Cox said.

Despite her frustration, Cox is aware the blame for the rising costs doesn’t lie solely with the drug companies. She points to other “middlemen” also seeking rising profits. It’s a narrative that PhRMA has been highlighting in its own wide-reaching ad campaign, called “Let’s Talk About Cost.” With television, radio and online ads, the group points to hospitals, insurance companies and pharmacy benefit managers as holding the responsibility for rising costs.

“There’s plenty of blame to go around,” said Robin Feldman, a law professor at the University of California-Hastings. She recently authored a book on what’s behind rising prescription drug prices called “Drugs, Money, and Secret Handshakes: The Unstoppable Growth of Prescription Drug Prices.”

“Everybody wants to point to someone else as the bad guy. But to be fair, each of the parties is contributing to what is driving the prices up,” Feldman said. She said at every step in the process — from the drug manufacturer’s lab to your bathroom medicine cabinet — there are companies with shareholders demanding profit. Profits millions of potential voters say come at too high a cost. “People are hurting, and they are letting their interest groups and their politicians know how they feel about it,” Feldman said.

Those politicians have unleashed a slew of proposals for how to bring down drug prices. But, for now, they are proposals with no clear path to an agreement on what should be done — just an agreement that something has to be done.

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