Biden Summons Bernie Sanders to Help Boost Drug-Price Campaign

The Washington Post / Dan Diamond

13:36 JST, April 4, 2024

Biden and Sanders discussed their joint efforts to lower the out-of-pocket cost of inhalers for tens of millions of Americans who rely on the devices to treat asthma and other conditions, speaking to an audience of about 75 health policy experts and advocates.

“Finally, we beat Big Pharma,” Biden said, touting his broader efforts to cap insulin costs for Medicare patients at $35 a month and require the government to negotiate with drug companies. The president also credited Sanders for his help steering the legislation through Congress. “Bernie was the one who was leading the way for decades,” Biden said.

Wednesday’s event was part of a broader election-year push by Biden to highlight Democrats’ efforts to lower drug prices, including a cap on seniors’ out-of-pocket costs at $2,000 a month starting next year and a Federal Trade Commission crackdown on drug industry patents that they say have stifled competition. Officials said they are working to build on their efforts, such as broadening the $2,000 out-of-pocket cap to all Americans.

“We’re going to keep challenging unlawfully listed patents that block competition from cheaper generic drugs,” FTC Chair Lina Khan vowed.

Polls have shown that most voters are unaware of Democrats’ efforts to lower drug prices, prompting a flurry of administration speeches, news releases and officials’ trips to swing states – and now Biden’s joint speech with Sanders.

The two men – longtime Senate colleagues, one-time political rivals and now allies in the effort to keep Donald Trump out of the Oval Office – have made drug prices central to their 2024 political agendas, adopting approaches that Sanders says are complementary.

Biden, running for reelection, has trumpeted his far-reaching Inflation Reduction Act efforts to cap insulin costs for Medicare patients, lower the cost of some Medicare patients’ drugs and subsidize low-income seniors’ spending on medicine. But the law’s effects on drug prices remain largely theoretical for many voters; a plan for the government to negotiate prices with drug companies faces court challenges and remains years away from being fully implemented.

Sanders has adopted a more granular approach: naming and shaming individual pharmaceutical companies and executives, using his powers as Senate health committee chairman to threaten them with hearings and subpoenas. The efforts have helped produce tangible results. Sanders and his colleagues pressured three drug companies to cap the out-of-pocket cost of inhalers at $35 a month – down from several hundred dollars per month – an achievement that Biden touted at the White House, linking it to his administration’s crackdown on inhaler patents. But targeting individual companies is not easily scaled across the vast pharmaceutical industry, and industry experts say the companies are making concessions to Sanders that do not fix the core drivers of America’s disproportionately high drug prices.

“The caps do not solve every problem, but they certainly will benefit a large number of patients with asthma and [chronic obstructive pulmonary disease] who rely on inhalers,” said William Feldman, a pulmonologist and health policy researcher at Harvard Medical School who has studied the devices’ high costs and spoken with Sanders’s team.

Feldman added that the drug companies that recently agreed to lower inhaler costs for patients will still collect far more from insurance companies, among his other concerns. “There continues to be very expensive [inhalers] that don’t have generic competition,” he said.

Republicans have targeted some of Biden’s drug-pricing efforts, with the influential House Republican Study Committee calling to repeal provisions that they claim will impede research and development, and Trump has argued that he is best positioned to take on the industry. As president, Trump issued executive orders designed to rein in pharmaceutical prices and has pledged to resume those efforts if reelected, including by resurrecting orders blocked or rolled back by Biden. One of those planned orders would require drug companies to grant their “most-favored-nation price” to the United States.

“Under my policy, the United States government will tell Big Pharma that we will only pay the best price they offer to foreign nations, who have been taking advantage of us for so long – the United States is tired of getting ripped off,” Trump said in a campaign video released last year. “Biden canceled my tough-on-pharma policies the moment he had a chance.”

Politicians have spent years vowing to combat high drug prices, a perennial concern for voters in both political parties. More than half of Democrats and Republicans said they were worried about prescription drug costs, according to a February poll by KFF, a nonpartisan research organization. But Biden’s drug-pricing changes have not resonated with many Americans. About three-quarters of adults were unaware of the Inflation Reduction Act’s provisions to cap insulin costs and seniors’ out-of-pocket spending, according to a November KFF poll; about two-thirds were unaware the law requires the government to negotiate with drug companies. Most Americans 65 and older also were not aware of the law’s provisions.

“It’s a messaging problem,” said Ashley Kirzinger, KFF’s associate director for public opinion and survey research who said she was particularly surprised given the decades-long bipartisan goal to address drug prices. “It was such a high priority for seniors. … The fact that they are still lagging in awareness is really striking to me.”

Trump’s allies have argued that Democrats are focusing on health care because voters generally favor Republicans on many issues, including the economy, immigration and crime.

“Biden doesn’t have a lot to run on,” said Joe Grogan, who led the Domestic Policy Council in the Trump White House. “They’re hoping that health care is going to be a strong suit for them, but I actually think it will be a vulnerability if the case is prosecuted effectively.”

Wednesday’s White House summit comes nearly five years after Sanders and Biden began battling for the Democratic presidential nomination, offering different prescriptions for how to fix the health system. While Sanders supported Medicare-for-all, a universal health-care program that would abolish private health insurance and make other major changes, Biden called the plan politically unworkable and said he would instead build on the nation’s existing infrastructure, such as by expanding protections in the Affordable Care Act.

The fight played out for more than nine months across 10 debates, with Sanders arguing that Medicare-for-all would help rein in high drug costs by forcing pharmaceutical companies to negotiate with the government.

The two men continued to be at odds over health policy after Biden entered the White House and Sanders became chairman of the Senate health committee two years later. Sanders last summer held up Biden’s nomination of a director for the National Institutes of Health, saying he was dissatisfied with progress on lowering drug prices, and he warned the president that he would block other nominees who weren’t prepared to “stand up and fight” the pharmaceutical industry.

But the gap has closed.

“President Biden is the first president in memory – in my lifetime, at least – to really have the courage to take on the industry,” Sanders said in an interview Tuesday.

As Biden and Sanders battled for the Democratic nomination, Trump undertook his own drug-pricing efforts, issuing executive orders to target insulin costs, import drugs from other countries and peg U.S. drug prices to lower prices abroad.

Those efforts continued even after Trump lost reelection.

“The drug companies are going crazy putting up nasty ads against me,” Trump wrote on social media in December 2020. “They don’t want the U.S. to have the lowest drug prices in the world, but we now will. Big reductions coming. No other politician would do this!!!”

Trump’s orders were mostly blocked by the courts or rolled back by the Biden administration. In the interview, Sanders dismissed Trump’s efforts as empty rhetoric.

“Donald Trump, in fact, did talk a lot – campaigned a lot – on the high cost of prescription drugs,” Sanders said. “But he accomplished nothing.”