Do people even matter to big pharma?

The Republican blockade of President Biden’s nominees for federal agencies escalated last week and now allows profit-hungry middlemen to keep prescription drug prices high. Last Thursday, the Federal Trade Commission was blocked from initiating an investigation into how pharmacy benefit managers (PBMs) are responsible for higher drug prices. This has PhRMA written all over it.

PBMs thrive specifically off of secrecy in having more knowledge about the pharmaceutical supply chain and using that asymmetry to boost their profits at the expense of patients. An investigation into their practices would be the first step to policy changes to prevent that.

High drug prices are a perennial complaint of the electorate. Democrats and Republicans alike constantly pay lip service to fix the problem because PhRMA writes big lobbying checks.

On September 19, 2019, House Speaker Nancy Pelosi introduced the Elijah Cummings Lower Drug Costs Now Act. The bill, known as H.R. 3, was a shot across the bow of an industry accustomed to congressional docility and deference. Despite Donald Trump’s campaign promise to rein in drug companies that he said were “getting away with murder,” he and every other Republican were silent when H.R. 3 was delivered stillborn into Mitch McConnell’s Senate in November of 2019.

The Congressional Budget Office estimated the original H.R. 3 would have reduced government drug spending by $500 billion, enough to pay for expanded dental, hearing, and vision coverage for more than 60 million people on Medicare.

In the meantime, Mark Alles, the former CEO of Celgene, received a $500,000 bonus as a consequence of his decision to crank the monopoly price on a cancer drug, Revlimid, which is little more than repurposed Thalidomide, a generic tranquilizer invented in the 1950s. In an internal presentation, Celgene executives attribute its “winning” of the Revlimid market to the U.S. government’s inability to negotiate prices — which the executives describe in Pharma’s funhouse lexicon as “free-market competition-based pricing for Medicare and commercial insurance.”

Where does this leave patients? Pharma’s attitude is “who cares?”. Big pharma is about MBA spreadsheets on maximizing profits and rewarding shareholders at the expense of us all.

DTC marketing isn’t about “helping” people; it’s about pushing expensive branded drugs that go up in price every year while CEOs tale home tens of millions of dollars in compensation.

I keep hoping that the industry will change. Still, I see employees who made terrible decisions and were forced out of drug company positions starting new jobs with another pharma company.

PhRMA is a disgrace to the industry and is only about maintaining the status quo. I hope one day that will change, but it’s getting harder to believe.