Source: United States House of Representatives – Congressman Greg Steube (FL-17)
WASHINGTON, D.C.— U.S. Representative Greg Steube (R-Fla.) today participated in the House Oversight and Government Reform Committee’s hearing on pharmaceutical drug pricing.
“Over 3.5 million Floridians are enrolled in some form of Medicare prescription drug coverage. With so many of my fellow Floridians and constituents dependent on life-saving prescriptions, I understand the need for affordable drug prices,” Steube said. “Despite the efforts of Republicans to make bipartisan progress to reform the prescription drug standards, our Democrat colleagues refuse to collaborate.”
The goal of the hearing was to determine the source of price hikes in certain medicines and if the companies have been negligent in protecting patients from high out-of-pocket payments.
Steube questioned Amgen CEO, Robert Bradway.
Steube’s full remarks can be found here or below.
“Thank you, Madam Chair. Over 3.5 million Floridians are enrolled in some form of Medicare prescription drug coverage. With so many of my fellow Floridians and constituents dependent on life-saving prescriptions, I understand the need for affordable drug prices.
Despite the efforts of Republicans to make bipartisan progress to reform the prescription drug standards, our Democrat colleagues refuse to collaborate. They will try to suggest that H.R. 3, which is a key example of partisan government overreach, would solve some of the problems we will be discussing today.
This is not the case and the Trump administration decisively acted to approve a record number of generic drugs and bring down overall prescription prices down 13%. Obviously, there is still a lot of work left to do and I am glad we are taking steps to discuss the situation and hope we can move towards establishing solutions.
Mr. Bradway, my first question is to you– what is Amgen currently doing to assist in this mutual goal of providing Americans with lower drug prices?
BRADWAY: Congressman, thank you for the question. As I mentioned in my opening statement, our net prices in the United States have decreased in 2018 and 2019, and we’re on track to have further decreases in 2020. In addition, Congressman, we’ve made a significant investment in biosimilars and we are making available to patients and prescribers biosimilar medicines for some of the biggest selling drugs in the United States at more affordable prices that the innovator products that they are designed to replicate.
In addition, Congressman, we are working with a variety of different patient assistance programs through which we give away free drugs to those who are uninsured and can’t afford their drugs, or underinsured. We try to provide copay assistance for those who are struggling, but have insurance plans, but are struggling with making payments for their deductibles and seeking to make contributions to other charitable foundations that can assist patients with their medicines as well.
So, across the board Sir, we are trying to do quite a lot to help make sure that patients who need medicines can afford them.
STEUBE: I was interested that in your testimony you stated that Amgen voluntarily lowered the list price of one of your medicines by 60%. However, you described a situation where even after lowering the list price, some patients did not see a meaningful difference in what they had to pay-out of pocket at the pharmacy.
Some of my colleagues believe that forcing you to lower your prices will solve all of our problems but it doesn’t seem like that happened in that instance. Can you explain why?
BRADWAY: Thank you Congressman, yes. You are referring to a drug called Repatha, which is our product, designed to lower cholesterol and prevent heart attacks and strokes. It’s one of our most important and innovative new medicines. We lowered the list price for that medicine by 60% in order to try to make it more affordable at the pharmacy counter.
Remember, that patients pay a copay as a function of list price. So, by lowering the list price, we were lowering their out of pocket expenses. However, we found that it took more than a year for the insurance plans to move patients, to direct patients, from the high list price product to the low list price product.
So, we ran the experiment and found that it didn’t work in the way that we thought it would. We see this as an example of how the system is not working today for patients, and as one of the reasons why we think that we need to reform the rebate system that exists in the United States today.
STEUBE: Thank you, I understand there are certain payment programs in place which can help patients afford drugs like Enbrel and Sensipar – would you be able to discuss their effectiveness and any other similar initiatives that you’re discussing?
BRADWAY: Thank you, yes, we have a number of programs designed to help patients pay for expensive medicines. So, for example, in the case of Enbrel, we have copay assistance in place so that more than three quarters of the patients who use Enbrel today have a co-pay of less than $25 dollars- or excuse me- less than $50 a month for their medicine.
When it comes to Medicaid, 93% of patients are able to receive their medicine at less than $10 a month in copay. And when it comes to Medicare, we have 77% of the patients being able to receive their medicine at less than $50 a month.
So, there are examples across our portfolio of the ways that patients are benefitting from the support provided to them in order to be able to access these innovative lifechanging medicines.
STEUBE: Does Amgen utilize rebates for PBMs and how does that impact patient price?
BRADWAY: Yes, we do use rebates. Again, rebates are a function of list price, so if we increase the list price, we increase the rebate. You might ask, we are we increasing the rebate? Why do we feel pressured to increase the rebate? And the answer is- to secure competitive formulary position for our molecules.
So, we increase the list price to be able to increase the rebate to the intermediaries. The unfortunate effect of that is it also increases the out of pocket cost for patients at the pharmacy counter. And again, that’s why we advocate for changes that would include passing through the rebate at the pharmacy counter.
STEUBE: Thank you.”