No Time to Wait: Proposals to Lower Prescription Drug Costs — Senate Hearing 117-249 (April 12, 2022)
Summary
Senate Hearing 117-249 (Serial No. 117-16) records a field hearing of the Special Committee on Aging, "No Time to Wait: Proposals to Lower Prescription Drug Costs," on April 12, 2022, in Phoenix, Arizona, with Senator Mark Kelly presiding. Witnesses were Dana Kennedy of AARP Arizona, Suganya Karuppana, M.D., of Valle Del Sol Community Health, Dora Vasquez of the Arizona Alliance for Retired Americans, Jenny Pena of Banner MD Anderson Cancer Center, and Judy Wilson, an MS patient. Senator Kelly's opening statement describes a bill to cap out-of-pocket insulin costs at $35 a month and a plan for Medicare to negotiate drug prices and limit Part D out-of-pocket costs to $2,000 annually. Ms. Kennedy testified that the average annual cost of prescription drug treatment in Arizona increased 26.3 percent between 2015 and 2019.
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“No Time to Wait: Proposals to Lower Prescription Drug Costs — Senate Hearing 117-249 (April 12, 2022).”
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[Senate Hearing 117-249]
[From the U.S. Government Publishing Office]
S. Hrg. 117-249
NO TIME TO WAIT:
PROPOSALS TO LOWER
PRESCRIPTION DRUG COSTS
=======================================================================
HEARING
BEFORE THE
SPECIAL COMMITTEE ON AGING
UNITED STATES SENATE
ONE HUNDRED SEVENTEENTH CONGRESS
SECOND SESSION
__________
PHOENIX, ARIZONA
__________
APRIL 12, 2022
__________
Serial No. 117-16
Printed for the use of the Special Committee on Aging
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
47-456 PDF WASHINGTON : 2022
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SPECIAL COMMITTEE ON AGING
ROBERT P. CASEY, JR., Pennsylvania, Chairman
KIRSTEN E. GILLIBRAND, New York TIM SCOTT, South Carolina
RICHARD BLUMENTHAL, Connecticut SUSAN M. COLLINS, Maine
ELIZABETH WARREN, Massachusetts RICHARD BURR, North Carolina
JACKY ROSEN, Nevada MARCO RUBIO, Florida
MARK KELLY, Arizona MIKE BRAUN, Indiana
RAPHAEL WARNOCK, Georgia RICK SCOTT, Florida
MIKE LEE, Utah
----------
Stacy Sanders, Majority Staff Director
Neri Martinez, Minority Staff Director
C O N T E N T S
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Page
Opening Statement of Senator Mark Kelly.......................... 1
PANEL OF WITNESSES
Dana Kennedy, State Director, AARP Arizona, Phoenix, Arizona..... 3
Suganya Karuppana, M.D., Chief Medical Officer, Valle Del Sol
Community Health, Phoenix, Arizona............................. 5
Dora Vasquez, Executive Director, Arizona Alliance for Retired
Americans, Phoenix, Arizona.................................... 7
Jenny Pena, Associate Manager of Pharmacy Patient Advocacy,
Banner MD Anderson Cancer Center, Phoenix, Arizona............. 8
Judy Wilson, MS Patient, Phoenix, Arizona........................ 9
APPENDIX
Prepared Witness Statements
Dana Kennedy, State Director, AARP Arizona, Phoenix, Arizona..... 25
Suganya Karuppana, M.D., Chief Medical Officer, Valle Del Sol
Community Health, Phoenix, Arizona............................. 28
Dora Vasquez, Executive Director, Arizona Alliance for Retired
Americans, Phoenix, Arizona.................................... 34
Jenny Pena, Associate Manager of Pharmacy Patient Advocacy,
Banner MD Anderson Cancer Center, Phoenix, Arizona............. 37
Judy Wilson, MS Patient, Phoenix, Arizona........................ 43
NO TIME TO WAIT:
PROPOSALS TO LOWER
PRESCRIPTION DRUG COSTS
----------
TUESDAY, APRIL 12, 2022
U.S. Senate,
Special Committee on Aging,
Phoenix, Arizona.
The committee met, pursuant to notice, at 10:58 a.m., at
ASU Collaboratory on Central at the Westward Ho, 618 North
Central Avenue #100, Phoenix, Arizona, Hon. Mark Kelly, member
of the committee, presiding.
Present: Senator Kelly
OPENING STATEMENT OF SENATOR
MARK KELLY
Senator Kelly. Good morning, everybody, and thank you.
Thank you for joining us here this morning at the Westward Ho.
We chose this hearing here because hundreds of Arizona seniors
call this place home, and I would like to thank Arizona State
University for hosting us here in their downtown campus.
I am very excited to be here today to chair a United States
Special Committee on Aging hearing. This is my first field
hearing, and I cannot think of a more important issue facing
Arizona's seniors than the one we are here today to examine,
and that is, how do you lower the cost of prescription drugs?
You know, right now, supply chain issues are driving up the
cost of everything, from a pound of ground beef to a gallon of
gas, and when you live paycheck to paycheck, or especially when
you are on a fixed income, these rising costs make everything
harder. They make your life harder, but when you add on top of
that, paying for your prescription drugs as well, and we are
talking about medications that people need to survive, Arizona
families and seniors are facing choices that nobody should ever
have to make.
Across Arizona and across the country, this is the reality
for far too many people. Now I have heard this directly from my
Senior Citizens Advisory Group. Now we get together about every
3 months, and this is a problem that gets raised every 3
months, and as it should be. You know, and it is that 34
percent of seniors here in Arizona are concerned that their
household won't be able to afford their needed prescription
drugs in the next year, and those concerns, they are not
unfounded.
Last year, more than 1 in 10 Americans aged 65 and older
skipped a pill because of the cost. One in eight older
Americans report to have delayed their retirement because of
the cost of their prescription medication. Now I have heard
from Arizonans across the State who are seeing the costs of
their prescriptions continue to climb or spike or even double
in a year, and that is unacceptable, and the data backs this
up.
Medicare spending on prescription drugs is rising. Spending
on Medicare Part D, the prescription drug benefit, has doubled
over the past decade, and it is expected to grow faster than
most other areas of Medicare spending in the years to come. Now
this is going to result in both greater spending, greater
spending for the Federal Government, and greater spending for
Arizona seniors out of their pockets, and this is a problem.
The data shows that spending is going to go up, but not
because seniors are accessing more prescription drugs, but
because the drugs are becoming more expensive. From 2012 to
2017, the average cost of a prescription drug treatment in
Arizona increased by almost 58 percent. The costs are going up,
and this should alarm all of us, but that is why we are here
today, and that is why I have worked on solutions to drive down
the costs of prescription drugs. Just in the past couple of
weeks, the House of Representatives passed a bill which I am a
co-sponsor of that would cap the out-of-pocket cost of insulin
at $35 a month.
Now, as many of you know, insulin is a drug that is not
optional if you are a Type I diabetic, you need it to survive,
and many people have to take it for decades and they do it. Yet
Americans, we pay 10 times more than folks in many other
countries for insulin, so we are working to change that. I have
also worked to negotiate a plan that would lower out-of-pocket
costs for seniors, drive down prescription drug prices, and
prevent price gouging from drug companies.
Under this plan, for the first time ever, Medicare would be
able to negotiate directly with drug companies to get a lower
price on the most expensive drugs on the market. Now, this plan
would also prevent drug companies from raising the prices of
these drugs faster than the rise of inflation, or if they still
choose to do that, it would require that they pay a rebate, and
it would restructure the Part D benefit so that seniors on
Medicare Part D pay no more than $2,000 annually out of their
pocket, and it would also allow the costs to be spread out,
that $2,000 out of their pocket to be spread out over the year.
Now these reforms will drive down the price of prescription
drugs, lower out-of-pocket costs for seniors, and make our
country more financially secure, saving hundreds of billions of
dollars over 10 years, and I will keep pushing this proposal
forward in the Senate, and I will continue to make the case to
my colleagues that we need to act now, not next month, not next
year.
Arizona seniors cannot and should not wait any longer, so
today we are going to bring D.C. to Arizona, to hear directly
from Arizonans about how rising prescription drug costs are
impacting them and discuss the urgency to act on solutions, and
I would like to ask each of our witnesses to please keep your
remarks and questions to 5 minutes--you see how I did that. We
got a clock right there, and now I will turn to introductions,
I am pleased to introduce our witnesses. Our first witness is
Ms. Dana Kennedy, who currently serves as the State Director
for AARP. She has spent more than 20 years as a leading
advocate for working families, retirees, and women, and has
long worked with nonprofit organizations in the State focused
on disability and aging.
Thank you, Ms. Kennedy, for being here today and sharing
your experience and your expertise with this committee. Our
next witness, Dr. Suganya Karuppana--did I get that right?
Dr. Karuppana. You got it.
Senator Kelly. Alright, I practiced. She is the Chief
Medical Officer at Valle del Sol Community Health. She also
serves as a Chief Medical Operations Officer. Dr. Karuppana has
more than 20 years of experience in health care and a decade in
physician leadership in community health. Thank you, Dr.
Karuppana, for being with us today and for sharing your work
with this committee.
Next, I would like to introduce Ms. Dora Vasquez. She is
the Executive Director of Arizona Alliance for Retired
Americans and has more than 25 years' experience in local and
State Government. In her role, Ms. Vasquez works to advance
public policy that strengthens the health and retirement
security for older Americans, so thank you, Ms. Vasquez, for
being here today and for sharing with the committee.
Next, I will introduce Ms. Jenny Pena, Associate Manager of
Pharmacy Patient Advocacy at the Banner MD Anderson Cancer
Center. Ms. Pena has over 19 years' experience in the pharmacy
career field. Her work as a patient advocate allows her to hear
firsthand from patients who struggle to afford their health
care and prescribed cancer treatment.
Thank you, Ms. Pena, for being here with us today and for
sharing your work with the committee, and last but not least,
my new, good friend, Ms. Judy Wilson. Met her at her car
outside. Ms. Wilson is a recently retired Medicare enrollee who
is living with multiple sclerosis. She is also Rotarian for 22
years, the volunteer for the MS Society, and a mentor for the
Community Health Mentor Program, and a grandmother of four.
Thank you, Ms. Wilson, for being here today and for also
sharing your story. We will now turn to our witnesses for their
statements, so we are going to begin with Ms. Kennedy, so Ms.
Kennedy, you can begin, and we have got the clock there. If you
go over by a minute or two, not a big deal. If you go under, we
will you pass the time down the line.
Ms. Kennedy.
STATEMENT OF DANA KENNEDY, STATE DIRECTOR,
AARP ARIZONA, PHOENIX, ARIZONA
Ms. Kennedy. Great. Thank you, Senator. AARP, on behalf of
our 38 million members, over 890,000 members in Arizona, and
all older Americans nationwide appreciates the opportunity to
submit testimony on this important hearing of the Senate Aging
committee. High prescription drug prices hit older Americans
particularly hard.
On average, Medicare Part D enrollees take between four and
five prescriptions per month, often for chronic conditions that
will require treatment for the rest of their lives. At the same
time, Medicare beneficiaries have a median annual income of
just under $30,000. One-quarter have less than $8,500 in
savings. In Arizona, the average annual cost of prescription
drug treatment increased 26.3 percent between 2015 and 2019,
while the annual income of Arizona residents only increased
15.6 percent.
This population simply does not have the resources to
absorb the rapidly escalating prescription drug prices, and
many are facing the reality of having to choose between their
medications and other basic needs such as food and housing. In
the case of one of our members, Leona G., age 74, she has maxed
out her credit cards to afford her blood thinner Eliquis. She
only received Social Security benefits and a small pension
check each month. Unfortunately, Leona isn't alone.
We know the one reason someone doesn't fill a prescription
is because of the cost. For years, prescription drug prices
increases have dwarfed even the highest rates of general
inflation. If consumer prices had risen as fast as drug prices
over the last 15 years, gas would now cost $12.20 a gallon,
milk would be $13 a gallon.
Just in January, the drug industry raised prices on over
800 prescription medications just as they increased prices for
decades, including three-quarters of the top 100 drugs with the
highest spending in Medicare Part D. AARP is mindful that high
and growing prescription drug prices are affecting all
Americans in some way. Their high cost is passed along to
everyone with health coverage through increased health care
premiums, deductibles, and other forms of prescription drug
spending and other public programs like Medicare and Medicaid.
These escalating costs will eventually affect all of us in
one form of health care costs, higher taxes, cuts to Medicare
or Medicaid, or all of the above. In other words, every single
American taxpayer is paying for high prescription drug prices,
regardless of whether you are taking medicine or not.
Fortunately, there is action the Senate can take right now.
There is longstanding and overwhelming bipartisan support among
voters for Medicare to negotiate with drug companies for lower
prices.
The policies before the Senate that the Senator Kelly is
leading on include Medicare negotiations, capping out-of-pocket
costs under Medicare Part D, and penalizing drug companies that
increase their prices faster than inflation, will provide long
overdue relief to older Americans across the country. These
policies, taken together, will help reduce drug prices and out-
of-pocket costs. This is important because real relief for
seniors and all Americans must include policies that get to the
root of the problem, the high prices set by drug companies.
American seniors aren't the only ones who stand to benefit.
Lowering prescription drug prices will also save Medicare
program and taxpayers hundreds of billions of dollars every
year. Medicare spends more than $135 billion on prescription
drugs. Last October, a survey commissioned by AARP Arizona
conducted by OH Predictive Insights showed Arizonans across the
aisle agreed on the need for affordable medication and action
by Members of Congress.
An overwhelming majority of Arizonans agree Congress needs
to tackle high prescription drug costs because some people
can't afford to buy medicine or pay their necessities. Eighty-
nine percent of those surveyed agreed. The survey results
showed a vast majority support for each proposed measure being
discussed in Congress to reduce drug prices. The most favored
initiative was allowing Medicare to negotiate for the price of
drugs, winning over ninety-four percent of Arizonans.
Further, two-thirds, sixty-six percent of Arizonans
surveyed do not believe that innovation will suffer if Medicare
is allowed to negotiate for lower prices. Clearly, Americans
are fed up with paying three times what people in other
countries pay for the same drugs.
More than 4 million people across the country, including
over 113,000 in Arizona, are joining AARP to sign a petition to
demand lower prices for prescription drugs. There will never be
a better time to lower drug prices than the historic
opportunity in front of Congress right now.
Now is the time to get it done. Thank you.
Senator Kelly. Thank you, Ms. Kennedy.
Dr. Karuppana?
STATEMENT OF SUGANYA KARUPPANA, M.D.,
CHIEF MEDICAL OFFICER, VALLE DEL SOL
COMMUNITY HEALTH, PHOENIX, ARIZONA
Dr. Karuppana. Okay. Thank you, Senator Kelly and members
of the Special Committee on Aging for inviting me to speak
today on this vital topic, the high and ever rising cost of
medications for our seniors. My career has been dedicated to
serving communities with health disparities. I spent 6 years at
UCLA's County Hospital. I was a Clinical Professor at the David
Geffen School of Medicine, training our next generation of
doctors. Since moving to Phoenix, I have worked exclusively in
federally qualified health centers.
As Chief Medical Officer at Valle del Sol Community Health
in Phoenix, we serve a large number of Latinos, African-
American, Asian, Pacific Islanders, and Native American
patients, all of whom are disproportionately impacted by high
cost medications. As you know, within the Part D prescription
drug program standard benefits, patients must pay the initial
$480 out-of-pocket deductible before the initial coverage phase
begins.
Regrettably, for many patients that initial deductible is
enough of a barrier for them to choose not to purchase a
prescription and forgo needed treatments. While some patients
can qualify for premium and cost sharing assistance, many are
not forthcoming with their health care providers about their
financial limitations because they are embarrassed, some even
choose not to return to their provider when they cannot afford
their medications for fear of reproach.
Community health centers like Valle del Sol are starting to
realize the need to screen for financial challenges and other
social determinants of health upfront to address them early,
rather than waiting to discover these problems after a patient
develops complications due to lack of treatment. Unfortunately,
screening and additional subsidies are not enough to solve
today's problems.
These are the types of scenarios we see day in and day out
in community health centers and other facilities that treat our
seniors on fixed incomes. Patients who have grown to trust
their health care providers often turn to us for help. I can't
tell you the number of times I have heard my patients say, doc,
or doctora, please look at all of my meds and tell me, what can
I skip? It costs me too much each month and I need to stop at
least two or three of them, but when a patient has had a heart
attack with a stent, breast cancer, and a blood clot, every one
of her meds is critical to keeping her alive.
These are hard decisions for patients, but also medically
and ethically difficult for doctors and other health care
providers who routinely face these circumstances. Another
scenario we often see play out involves patients who can afford
their regular daily meds and the initial out-of-pocket
deductible, they can also meet the initial coverage phase where
they are responsible for 25 percent of the medication costs,
but when they have reached the Federal $4,430 threshold, the
Medicare coverage gap, better known as the infamous donut hole,
the patients are then still on the hook for 25 percent of the
cost until they hit $7,050 in out-of-pocket spending when
catastrophic coverage takes effect, and then, even after
spending that much on medication, these seniors are still
responsible for 5 percent of the cost of their meds without a
cap until the year ends and the cycle begins again. For
patients with complex conditions like rheumatologic disorders
and cancers that require specific high cost medications, the
coverage gap and no limit on how much they may have to pay out
of pocket causes real problems.
Many patients who have moderate financial resources are
unable to get treatment because medications totaling thousands
are putting those treatments out of reach. In some cases,
patients ask for treatment regimens that are not evidence based
in order to make it affordable. Those same patients with
moderate resources may ration their treatment in order to make
it affordable, so how do we address these issues? There are
several prescription drug policies proposed by Senator Kelly
that could improve the lives of my patients. For example,
allowing the Federal Government to negotiate prices for high
cost drugs covered under Medicare Part B and Part D,
redesigning the Part D benefit to create a $2,000 cap on out-
of-pocket costs is much more reasonable than today's coverage
gap, and capping co-pays on insulin at $35 will make life
saving diabetes treatment more accessible.
I close today with this, I believe we have a duty to care
for our Nation's seniors, especially those who cannot care for
themselves. Our seniors are not only our parents, our
grandparents, the people who care for us, they nurtured and
raised us, they are the reason we are all here today and we
should remind ourselves we will be in their position later on.
You don't need a physician to tell you that none of us escapes
the aging process, and as such, we may soon find ourselves in
facing the very difficulties I have described today. In that
sense, our duty to our society and our seniors is our duty to
ourselves. I thank the special committee for allowing me to
speak today, and I am willing to answer any questions.
Senator Kelly. Thank you, Dr. Karuppana.
Ms. Vasquez?
STATEMENT OF DORA VASQUEZ, EXECUTIVE DIRECTOR,
ARIZONA ALLIANCE FOR RETIRED AMERICANS,
PHOENIX, ARIZONA
Ms. Vasquez. Thank you, Senator Kelly. Good morning. Thank
you for holding today's field hearing in the great State of
Arizona and for inviting me to testify. I am Dora Vazquez,
Executive Director of the Arizona Alliance for Retired
Americans. The Arizona Alliance for Retired Americans is a
grassroots organization representing more than 48,000 retirees
and seniors statewide, working to advance public policy that
strengthens the health and retirement security of older
Americans.
It is a pleasure to be here with you all today as we
discuss ways to bring the skyrocketing cost of prescription
drugs under control. There truly is no time to wait to lower
prescription drug prices. The Arizona Alliance strongly
supports efforts to eliminate waste and reduce drug costs in
Medicare's prescription drug benefits plans and the system's
finances overall and opposes proposals that shift any
additional cost to beneficiaries.
We support the fundamental goals of this hearing, namely,
to demonstrate the harm that exceedingly high prescription drug
prices cause seniors citizens and the American economy. Senator
Kelly has been a leader in the effort to lower the cost of
prescription drugs through Medicare negotiation, out-of-pocket
caps, and a Part D redesign that includes a cap on the price of
insulin. All of these tools are needed to reduce the cost of
prescription drugs. Americans pay the highest prices in the
world for prescription drugs, and prices of hundreds of drugs
have already increased by 5 percent in 2022, far outpacing
inflation.
According to a March 9th, 2021, report by the Government
Accountability Office, in 2020, Americans paid two to four
times more for 20 brand name drugs than people in Canada,
France, and Australia. Seniors who take the most prescription
drugs to stay healthy bear the brunt of these high cost,
because of this terribly excessive cost of prescription drugs,
a quarter of Americans and 20 percent of seniors report not
being able to afford their prescription.
As a result, millions of Americans do not take their
prescriptions as prescribed by their doctor and instead are not
filling them, skipping doses, or taking fewer doses than
directed. This should not be tolerated in a Nation as wealthy
and resourceful as the United States. The Arizona Alliance
strongly believes that the Secretary of Health and Human
Services must be allowed to negotiate lower drug prices under
Medicare.
According to the Congressional Budget Office, Medicare
price negotiation would not only assist seniors to afford their
medicine, it would also save the U.S. Government billions of
dollars. The CBO estimates that Senator Kelly's proposal to
allow negotiations would lower spending by $78.8 billion over
10 years. This would create savings that could be reinvested
back into Medicare for greater or improved coverage.
Another contributing factor to the casual effect of high
drug prices is the abusive practice of drug companies that take
advantage of the U.S. patent system. The Arizona Alliance
strongly believes that legislation needs to be enacted to curb
these often egregious abuses. Pharmaceutical corporations use
numerous tactics to extend patent terms, costing Medicare
billions of dollars.
For example, and AbbVie Pharmaceutical reached an agreement
through a pay for delay deal with its competitors, Novartis and
Amgen, to delay the entry of those companies biosimilars in the
United States until 2023, a delay agreement that is costing
American taxpayers $19 billion. Last, the Arizona Alliance for
Retired Americans strongly supports meaningful drug price
reforms in the plan supported by Senator Kelly that passed in
the House.
The most important of these include capping co-pay for
insulin at $35, setting a $2,000 annual out-of-pocket cap for
seniors' medication in Medicare Part D, and creating new price
gouging penalty for drug companies that raise prices faster
than inflation. I want to thank you again for providing me with
the opportunity to present testimony on behalf of the Arizona
Alliance for Retired Americans on this critical issue, and I
would be pleased to answer any questions you may have. Thank
you.
Senator Kelly. Thank you, Ms. Vasquez.
Ms. Pena?
STATEMENT OF JENNY PENA,
ASSOCIATE MANAGER OF PHARMACY PATIENT ADVOCACY,
BANNER MD ANDERSON CANCER CENTER, PHOENIX, ARIZONA
Ms. Pena. Thank you, Senator Kelly. My name is Jenny Pena,
and I am the Associate Manager of Pharmacy Patient Advocacy at
Banner MD Anderson Cancer Center, specializing in oncology.
Banner MD Anderson is part of Banner Health, one of the largest
secular nonprofit health care systems in the country and
largest private employer in Arizona.
I am also an Advisory Board Member of the National Health
Career Association and was named next generation pharmacist,
pharmacy technician of the year honoree in 2021. I would like
to express my gratitude to Senator Kelly and the Senate Special
Committee on Aging for providing this opportunity to testify on
behalf of the patients I serve each day. As a patient advocate,
I help patients who are facing life altering cancer diagnosis
access financial assistance to cover costs of the drugs they
have been prescribed.
I work in oncology, these drugs are even pricier than other
non-specialty drugs. An average oral drug to begin treating
breast cancer at cost about $1,100. For pancreatic cancer, the
average is around $5,500. The cost of starting oral treatment
for chronic myeloid leukemia has an average cost of $32,000.
These drugs are clearly incredibly expensive. According to
the National Cancer Institute, most cancer drugs launched
between 2009 and 2014 were priced at more than $100,000 per
patient for 1 year of treatment. Once a patient has been
prescribed treatment, it is my job to find out what their
insurance will cover of those amounts and what will be left on
their bill to pay out of pocket.
I am extremely protective of my patients, and mama bear
comes out when I am working back end of these claims with the
insurance plans. I always fight to make sure my patients get
the coverage they deserve, but even with good insurance
coverage, my patients can still be left with thousands of
dollars to pay out of pocket. I am the one who makes the phone
call to let the patients know their insurance has approved
their treatment, but that they are going to be left with a high
co-pay.
When my patients hear the amount they are on the hook for,
I typically get one of two reactions, some people are angry.
They have already faced countless doctors, tests, diagnosis,
and other stressors. Now they are faced with costs that may
impact their ability to seek treatment. Others are just sad--
now they are faced with costs that may impact their ability to
seek treatment. They feel hopeless, the costs are too high, and
they surrender to their unknown fate.
Of course, some people don't even know--don't want to know
what the co-pay is because they know they can't afford it. On
these phone calls, you must have a lot of compassion. You are
going to have patients with different emotions, but I
sympathize. This is a very personal issue to me as well. Both
of my parents are from El Salvador and my father is a cancer
survivor.
Thankfully, his diagnosis prompted many others within our
community to get screened, including myself. I know that not
everyone is able to take these proactive measures, and not
everyone can maintain their treatment, especially in
communities of color. Black and Hispanic individuals are more
likely to report cost related nonadherence to their treatment.
My goal is to help prevent anyone from foregoing their
medication due to cost. To do this, I help my patients access
the resources available to assist with these financial
concerns, including foundation grants, free trials,
manufacturer free drug programs, and voucher programs. However,
the process of finding these resources is time consuming and
complicated, time that many of the cancer patients do not have.
Additionally, my Medicare patients are limited in the
assistance they can receive, despite typically being the
population who needs the most financial help. While I am
typically successful in helping my patients, if I was mama bear
before, my papa bear personality comes out, when I am working
to turn over every stone to find a solution for these patients.
I recognize that many medical facilities do not have roles like
mine designated to patient advocacy.
My role in helping patients access their medications is
extremely important, and it is something I am so passionate
about, but to be honest, this should not be necessary. I
believe that everyone deserves access to affordable
prescription drugs despite their age, income, socioeconomic
status, or race.
Congress has to do more to make sure people can access the
care and treatment that they need. I am encouraged by the fact
that I am here today to advocate for solutions. Thank you again
for the opportunity to speak today, and I am happy to answer
any questions.
Senator Kelly. Thank you, Ms. Pena. We will wrap up the
opening remarks with Ms. Wilson.
STATEMENT OF JUDY WILSON,
MS PATIENT, PHOENIX, ARIZONA
Ms. Wilson. Senator Kelly. My name is Judy Wilson, and I am
a recently retired. I am on Medicare. I returned for 22 years--
I volunteer for the MS Society, I mentor for Community Health
Mentor Program and, most importantly, a grandmother of four
wonderful children, and I am also living with multiple
sclerosis. MS is an unpredictable, often disabling disease of
the central nervous system that disrupts the flow of
information within the brain, and between the brain and the
body.
I was diagnosed in 2010 after experiencing tingling in my
fingers, lack of balance, depression and anxiety, inability to
write, and incontinence. With the help of my general
practitioner and many specialists, I was able to address many
of my symptoms. Even still, I have lost much of my hearing,
have no sense of smell, my eyesight is compromised, my gait is
off, my number of falls has increased, and I have constant
nerve pain in my feet and hands.
Disease modifying treatments have proven to be the best way
to manage the MS disease course. There are more than 20 on the
market, and it is common for people with MS to move through
several different treatments throughout their life. After some
trial and error with several disease modifying treatments, or
DMTs, my neurologist prescribed Copaxone, a self-injector that
I take three times a week.
When I transitioned to Medicare, I was able to get
assistance from a charitable foundation, and they paid $3,272
co-pay for the first 2 months of the year and then $250 per
month after that, making my treatment affordable for me.
Charitable foundations like the one I used exist for Medicare
beneficiaries to apply to for assistance supporting their
medication, but the need is far greater than supply.
Unfortunately, in 2021, the foundation I relied on ran out
of money. I am unable to afford the over $7,000 per year
without financial help, so I reached out to my neurologist for
help. After discussions with my doctor, I decided to go off my
medications. I didn't have any other options and have so far
been very lucky that I haven't had any relapses or any
setbacks, but I want to emphasize that the decision to stop my
medication was based on money, not medicine.
If I could afford to go back on Copaxone, I would. MS is an
extremely unpredictable, and just because I have been healthy
so far doesn't necessarily guarantee that I will not have a
relapse in the future. For most living with MS, a gap in
medication could mean disease progression, and that would lead
to permanent loss of mobility or cognitive function. This is a
risk I take daily. No one should have to take this risk because
they cannot afford medications they need.
It seems ridiculous that I have to need a charity
assistance to afford my medications, even though I am already
paying $2,040 per year for health insurance through Medicare. I
know I am not alone. A National MS Society survey found more
than 70 percent of people with MS have received financial
assistance for their DMT, and 40 percent of people with MS
alter the use of their DMT due to cost, including stopping,
skipping, or delaying treatment.
As a volunteer self-help group leader for people living
with MS in the Phoenix area, I hear firsthand how difficult it
is for people to afford their medications. There are two others
in my group who have discontinued use of their medications. One
has recently gotten out of the hospital after a 2-weeks stay.
Congress must pass legislation immediately that establishes
an out-of-pocket cap in Medicare and a structure that allows
beneficiaries to spread their costs throughout the year so that
seniors like me can afford to take their needed medication. It
is also critical that Congress keep drug price increases at the
pace of inflation and allow Medicare to negotiate better drug
prices on behalf of its beneficiaries.
When I first began to take Copaxone in 2014, it was priced
at approximately $60,000 a year. It is now at $75,000 a year.
That is an increase of $15,000, or 25.6 percent, in just 8
years for the same medication.
There is no single policy solution that will address the
high cost of prescription drugs, but these policies are an
important step in the right direction and would immensely
improve the quality of life for many seniors, including me.
Thank you for the opportunity to share with you today.
I look forward to working with you to address the high cost
of medication.
Senator Kelly. Thank you, Ms. Wilson. Now we are going to
go back to Ms. Pena because she was going to deliver her
remarks in Spanish as well.
Ms. Pena. Gracias, Senador Kelly. Mi nombre es Jenny Pena y
soy la Gerente Asociada de Defensa del Paciente Farmaceutico en
Banner MD Anderson Cancer Center, especializada en oncologia.
Banner MD Anderson es parte de Banner Health, uno de los
sistemas de atenci0n medica sin fines de lucro mas grandes del
pais y el empleado privado mas grande de Arizona. Tambien soy
miembro de la junta asesora de la Asociacion Nacional de
Profesionales de Salud y fui nombrada tecnico de farmacia del
ano, the next generation pharmacist, homenajeada en 2021.
Me gustaria expresar mi gratitud al Senador Kelly, y al
comite especial del Senado sobre el Envejecimiento por brindar
esta oportunidad de testificar en nombre de los pacientes que
atiendo cada dia. Como defensor del paciente, ayudo a los
pacientes que enfrentan diagnosticos de cancer que alteran sus
vidas al acceder a asistencia financiera para cubrir los costos
de los medicamentos que le han recetado.
Debido a que trabajo en oncologia, estos medicamentos son
incluso mas caros que otros medicamentos que no son de
especialidad. Un medicamento oral promedio para comenzar a
tratar el cancer the mama cuesta alrededor de $1,100. Para el
cancer de pancreas, el promedio es de alrededor de $5,500. El
costo de iniciar un tratamiento oral para la leucemia cronica
tiene un costo promedio de $32,000.
Estos medicamentos son claramente increiblemente caros.
Segun el instituto Nacional del Cancer, la mayoria de los
medicamentos contra el cancer lanzados entre 2009 y 2014 tenian
un precio de mas de $100,000 por paciente por un ano de
tratamiento. Una vez que a un paciente se le ha recetado un
tratamiento, es mi trabajo averiguar que cubrira su seguro de
esos montos, y que quedara en su factura para pagar de su
bolsillo.
Soy extremadamente protectora con mis pacientes, y osa mama
sale cuando estoy trabajando en la parte final de estos
reclamos con los planes de seguro. Siempre lucho para
asegurarme que mis pacientes tengan la cobertura que se
merecen. Pero incluso con una buena cobertura de seguro, mis
pacientes aun pueden quedarse con miles de dolares para pagar
de sus bolsillos.
Soy la que hace esa llamada telefonica para informarle al
paciente que su seguro a aprobado su tratamiento, pero que se
quedara con un pago alto. Cuando mis pacientes escuchan la
cantidad por la que estan endeudados, normalmente obtengo una
de dos reacciones. Algunas personas estan enojadas. Ya se han
enfrentado a innumerables medicos, pruebas, diagnosticos, y
otros factores estresantes. Ahora se enfrentan a costos que
pueden afectar su capacidad para buscar tratamiento. Otros
simplemente estan tristes. Se sienten sin esperanza. El costo
es demasiado alto y se rinden a su destino desconocido.
Por supuesto algunas personas ni siquiera quieren saber
cual es el monto de copago porque saben que no pueden pagarlo.
En estas llamadas telefonicas debes tener mucha compasion. Vas
a tener pacientes con diferentes emociones, pero simpatizo.
Este tema tambien es muy personal para mi. Mis padres son del
Salvador, y mi padre es sobreviviente de cancer.
Afortunadamente su diagnostico hiso que muchos otros de
nuestra comunidad se hicieran la prueba, incluyendome a mi. Se
que no todos pueden tomar estas medidas proactivas y no todos
pueden mantener su trato, especialmente en las comunidades de
color. Las personas Hispanas y de color son mas propensas a no
informar sobre su tratamiento relacionada los costos.
Mi objetivo es ayudar a evitar que alguien renuncie a su
medicamento debido al costo. Para hacer esto, ayudo a mis
pacientes a acceder a los recursos disponibles para ayudar con
estas preocupaciones financieras, incluidas subvencionas de
fundaciones, pruebas gratuitas, programas de medicamentos
gratuitos del fabricante, y programas de vales. Sin embargo, el
proceso de encontrar estos recursos lleva mucho tiempo y es
complicado, tiempo que mucho de esto pacientes con cancer no
tienen.
Ademas, mis pacientes de Medicare estan limitados en la
asistencia que pueden recibir a pesar de que por lo general son
la poblacion que mas ayuda financiera necesita. Si bien
normalmente tengo exito en ayudar a mis pacientes y antes era
mama oso, y personalidad de papa oso aparece cuando trabajo
para remover cada piedra para encontrar una solucion para estos
pacientes. Reconozco que muchas instalaciones medicas no tienen
roles como el mio destinado a la defensa del paciente.
Mi papel en ayudar a los pacientes a acceder a sus
medicamentos es extremadamente importante, y es algo que me
apasiona. Pero para ser honesta, esto no deberia ser necesario.
Creo que todos merecen acceso a medicamentos recetados
accesibles independientemente de su edad, ingresos, nivel
socioeconomico, o rasa.
El Congreso tiene que hacer mas para asegurarse de que las
personas puedan acceder a la atencion y el tratamiento que
necesitan. Me alienta el hecho de que estoy aqui hoy para
abogar por soluciones. Gracias nuevamente por la oportunidad de
hablar hoy, y estare feliz de responder cualquier pregunta.
Senator Kelly. Well, thank you. Thank you, everybody, for
their initial testimony here. We are going to start off with
our round of questions, and again, we will try to keep the
answers to 5 minutes per person here. We are going to start
with Ms. Vasquez. In your initial testimony, you talked about,
and hopefully we can get to this in your answer, talked about
some of the ways that pharmaceutical companies can keep the
cost up. Pay for delay is what you mentioned.
There is also other ways of getting around the patent law,
but let me start by saying that there are more than 1.3 million
Arizona seniors on a Medicare plan, and in 2018, tens of
thousands of seniors spent enough money on their prescription
drugs to reach the catastrophic coverage, which based on the
threshold in that year meant they spent more than $5,000 on
medication.
That has since gone up. That number is now over $7,000, and
the average out-of-pocket costs for an Arizona senior on a
Medicare Part D plan was $3,450 for the year. This is
unacceptable, and for seniors, it is not sustainable, but today
we are here to talk about solutions.
Ms. Vasquez, what are some of the solutions that you have
seen that can make prescription drugs more affordable for
Arizona's seniors?
Ms. Vasquez. Well, thank you, Senator Kelly. You know, as
mentioned, we pay more than any other country for the same
prescription drugs that members of the Alliance,
Arizona Alliance urge the members of the U.S. Senate to
pass the drug pricing agreement that you, Senator Kelly,
support.
There is no substitute for the real comprehensive drug
pricing legislation from Congress to make health care more
affordable for retirees, and we hear this time and time again,
Congress must allow Medicare to negotiate lower drug prices and
include provisions that cap out-of-pocket prescription drug
costs at $2,000 per year under Medicare Part D.
Senator Kelly, you worked on cap--to cap the price of
insulin at $35 per month, and the agreement that you worked on
creates a new price gouging penalty for drug companies that
raise prices faster than inflation. In addition, we strongly
encourage Congress to extend APTCs, the tax credits you get to
take advantage--advance to lower your monthly health insurance
premiums, and those need to be extended through 2025.
The current subsidies in the American Rescue Plan benefit
about 9 million people, and those will expire in 2022. Thank
you.
Senator Kelly. Thank you. Then we also need to do something
on the patent reform.
Ms. Vasquez. Absolutely.
Senator Kelly. As well. You mentioned, one pharmaceutical
company paying another to not bring a generic right to market,
and that just hurts everybody.
Ms. Vasquez. Right. Absolutely.
Senator Kelly. Ms. Kennedy, you know, during your initial
testimony, the thing that, you know, that I really did notice
was--I mean, gas prices are high now, but if they went up at
the rate of prescription drugs, you said $12.20 a gallon. That
is remarkable, so that shows you how fast the price of drugs
rises every single year, so lowering the cost of prescriptions,
it is one of my top priorities and it has been while I have
been in the
U.S. Senate for 14, 15 months now, so Ms. Kennedy, AARP has
been advocating for policies to reduce drug costs like those
Ms. Vasquez just mentioned for many years, and AARP has 890,000
members in the State of Arizona.
Ms. Kennedy. We do.
Senator Kelly. You have got to be like the biggest
organization in the State.
Ms. Kennedy. One of the largest.
Senator Kelly. Yes--in the country with the number of
members----
Ms. Kennedy [continuing]. membership organizations.
Senator Kelly. What do you hear from those 890,000 members?
Can you share with us--you know, what are your members--what do
they say about this topic?
Ms. Kennedy. I mean, they are frustrated. I am frustrated.
I actually started working on this issue in 1998. My first job
out of college was working on this issue, and I have worked for
the National Council of Senior Citizens, I worked for the
Alliance for Retired Americans, and now seven and a half years
with AARP, and so there is just a tremendous amount of
frustration that, you know, year after year, we promise to get
something done and we don't get something done, and of course,
we did get an AARP supported Medicare Part D, the drug benefit,
but unfortunately there are still--you know, we knew that there
was still was some unfinished business, so actually getting the
House version done in the Senate would be very helpful, but you
know, what we hear from our members is, you know, they do cut
their medications in half.
They are very resourceful with what they do. They fill
their prescriptions and try to make it last until they get
their next Social Security check. There is a tremendous amount
of guilt if a spouse has a certain terminal illness or chronic
condition, and they simply can't afford it. We got a letter
from a member and his wife, you know, suffered from a stroke
and he feels very guilty that he can't afford her medications,
and so there is just, you know, so many things that people are
doing to be resourceful, but at the end of the day, they are
just frustrated that something doesn't get done, and you know,
we have the opportunity right now to get this done, and I
really appreciate you championing this issue, and let's get it
across the finish line.
Senator Kelly. Yes. We don't always have the opportunity,
and right now we do. I mean, there is really no excuse. I
remember speaking to a senior at Prescott, they told me about
how the price of a certain drug went up 3x, you know, 300
percent in a year with no explanation. Do you ever have--does
anybody ever tell you that a pharmaceutical company at least
tried to explain why the price of the drug went up? Is that
something you have ever heard?
Ms. Kennedy. Sometimes they try and say that they offer
some type of benefit to ask their physician if they could get
some samples, but as far as them explaining why they are
raising the prices, I haven't heard a reason for why they raise
it the way they do.
Senator Kelly. With 890,000 members, nobody has ever said,
hey, at least the pharmaceutical company told me why the prices
doubled.
Ms. Kennedy. No.
Senator Kelly. No explanation.
Ms. Kennedy. No. I mean, the other thing is people go to
great lengths to do the research during open enrollment and
figure out like, what medications do I have and what is going
to be the best plan for me? Then they could do all their
research and sign up, and then there is, you know, some
switching that goes around or they do fall into the donut hole
as well, so that is something we need to fix. You know, once
they actually hit that catastrophic benefit, it is very
generous, but how much money do they have to spend to actually
hit the catastrophic benefit?
Senator Kelly. I want to ask you about insulin here. You
know, so we got the House. The House passed this bill to cap at
$35 a month per patient for folks with Part D commercial
insurance plans, so can you describe what a difference this
monthly cap would make to millions of seniors who are--happen
to be Type I diabetics?
Ms. Kennedy. Well, what I do know is we know families all
across the country are struggling with outrageous prices of
insulin and many other drugs, and just in January, prices went
up yet again on 75 percent of the most prescribed drugs in
Medicare, and that is why AARP remains laser focused on urging
the Senate to pass a comprehensive prescription drug reform
already passed by the House that will finally let Medicare
negotiate for lower prices.
It will cap out-of-pocket costs for millions of Americans,
seniors, as well as cap monthly insulin costs, and AARP members
have listened for decades as politicians have promised these
commonsense reforms, and it is time for Senators to keep their
promises on the voters, so definitely the insulin cap would
help, but we definitely need comprehensive prescription drug
reform.
Senator Kelly. You know, the negotiation part of this is so
important. The argument that some folks will try to make for
pharmaceutical companies is they need these enormous profits in
order to develop the next drug, and that is fundamentally not
the situation. I mean, part of this negotiation, if enacted,
would be, you know, there would be--that would be a topic of
discussion.
You know that we, the Federal Government, understands that
companies need to make a profit and they need to have the
resources, but when you see these prices going up, you know,
26.3 percent between 2015 and 2019 is the number that you
stated, when income is only going up 15 percent, that is
unsustainable.
Ms. Kennedy. Absolutely.
Senator Kelly. I mean, you cannot--it is unfair now, but if
those two rates, I mean, they will continue to diverge, nobody
will be able to afford their prescription medications, so thank
you.
Ms. Kennedy. Thank you.
Senator Kelly. Ms. Pena, so thank you for sharing your
experiences with us today, and your work is important because I
agree with you that we should be tackling the problem of high
drug costs comprehensively at the source, not just asking you
to have to patch this up with your patients, and I want to
thank you for all the hard work that you do on behalf of people
that, you know, are just in such a horrible situation.
You know, as we heard today, patients on Medicare Part D
pay 25 percent of their drug costs until they hit $7,050 in
out-of-pocket spending, but I think what it is, is they are
paying between--when they hit $480, it is $0 to $40 and then it
is 25 percent up to $4,000 and something, and then it is
nothing right up to $7,050, and then it is covered with a 5
percent out-of-pocket after that, so you could see how this
gets really expensive very quickly, so how long--could you give
us an example how long it might take one of your patients to
rack up $7,050 in drug costs, and would that necessarily take
multiple drugs and several months, or could that be in one
single treatment? Based on your testimony, I think we all know
what the answer is here, but I want to hear from you.
Ms. Pena. Yes. If you are a patient that can afford the co-
pay, depending, of course, on your insurance plan, it could
take roughly about 3 months before you hit that $7,050, but if
you are a patient on limited income or low income, and then you
are out there seeking support from grants or foundations, and
then again, assuming that you qualify based on your diagnosis
and that there is even funds available in the grant because
they do tend to run out, you maybe never reach that $7,050
because you will never be able to accumulate that amount of
money because of the high costs.
Senator Kelly. Yes, so you pointed out that somebody who
has pancreatic cancer, their drug costs, you said, was $5,500
and I think you meant $5,500 per month, per month, so there are
many scenarios where they are--it is just unaffordable.
Ms. Pena. Correct.
Senator Kelly. Like, they are never going to--they are
never going to get there because they can't afford the first
month of medication.
Ms. Pena. Correct. Yes.
Senator Kelly. However, if we restructured the Part D
benefit program and there was a $2,000 cap, that maybe for some
of these patients it would be realistic if we could spread that
$2,000 over 12 months.
Ms. Pena. I think any cap that is lower than what it is
today would be very beneficial to all patients out there and in
our communities.
Senator Kelly. Okay. Thank you, and this next question is
also for you, Ms. Pena. In your testimony, you mentioned the
various reactions you get when you call your patients to help
plan the next steps of how they are going to afford their
treatment.
You mentioned that every patient has a different reaction
when you tell them. You said some of them are sad, some of them
are angry. Some of them just realize they can't afford it, so I
guess for them it doesn't even matter, but obviously everybody
has a different and unique situation, and we know that the
impact of these costs hits some Arizonans harder than others,
and the high costs are not equally distributed, so can you
describe the disproportionate impact of high drug costs on
Latinos and African-Americans and the Native American patients
that you deal with?
Ms. Pena. Sure. I think part of it is culture. Growing up
in a Hispanic household, you are taught to grow up on, you
know, home remedies, a lot of old wives tales, right, and so we
tend not to go to our providers to get treatment, but also in
some research that I did when I was looking into cost related
nonadherence in those communities of color, I found that a lot
of it has to do with them not even being able to go see a
provider.
They can't even afford the co-pay to go get a diagnosis, go
to urgent care, or see their primary care physician, and so
they have to go through that first hurdle. If they do find the
means to see a provider, they have a second hurdle, which is,
can they afford that prescription medication that they just got
prescribed for their diagnosis? It is just this consistent,
vicious cycle of unattainable medication that they can never
get for treatment, and so that really goes toward that cost
related nonadherence for our communities of color.
Senator Kelly. Then I think it is important that we point
out when a patient doesn't take the medication that they need,
that somewhere down the line they often wind up being
hospitalized.
Ms. Pena. Correct.
Senator Kelly. The overall cost, you know, could be even
higher for the Federal Government by not having individuals
take the medication they need for whatever condition they have.
Ms. Pena. Correct.
Senator Kelly. Thank you. Dr. Karuppana, you know, nobody
in our country should have to make the decision whether or not
to buy groceries or pay rent or utility bill and take a pill,
but in your testimony, you mentioned your experience with
patients who are forced to ration or stop their medication
because of cost, and could you share some examples of when the
high cost of prescription drugs has not only led to hard
choices, but do you have any examples of like harmful health
outcomes, which was what I was just alluding to?
Dr. Karuppana. Sure. I have two examples I can share. One
is similar to what you were just referencing. I had a patient
of mine who had diabetes, and she was previously well
controlled, but she came in for followup with me and that
particular day her sugars were very high, and I asked her, you
know, what changed? She told me that she had to choose between
paying for her insulin or paying for gas for her grandchild to
go to work, and her grandchild was the breadwinner for the
household and the rent was due, and so that was the obvious
choice that she had to make, so that is a common one.
Senator Kelly. Do you remember what her insulin cost was?
Dr. Karuppana. Her insulin costs was like $250 or $300 a
month. Another example I have is a patient of mine who had
ulcerative colitis, so that is an inflammatory bowel disease
that causes bloody diarrhea and can often lead to colon cancer,
so without her treatment, she was having about 10 bloody stools
a day. However, thanks to a disease modifying antirheumatic
rheumatologic drug, her disease was well controlled, and the
blood had stopped.
Unfortunately, the specialized medication became too
expensive, so she started to take her medication every few
days. The blood in her stool was reduced to only three to four
times a day, which she thought was better, but she didn't
understand that that was still putting her at risk for colon
cancer. She ended up needing to get a blood and iron
transfusion, and she ended up being hospitalized because of her
chronic blood loss, and all of that could have been avoided if
she could have just stayed on her prescription.
Senator Kelly. How is she doing now?
Dr. Karuppana. I think she is doing great. I mean, she was
eventually able to get on an assistance program that was able
to keep her on her medication, but it took a long time to
figure out a solution for her, and you know, she has suffered a
lot of consequences in the interim.
Senator Kelly. Do you think these policy solutions we have
been talking about today will help your patients?
Dr. Karuppana. Absolutely. From my first example, if there
was a $35 cap on her insulin instead of the hundreds that she
was paying every month, I think she would have been able to
stay on her insulin and help her grandchild get to work, and in
my second example, the patient who was paying the high amount
for her medication for her ulcerative colitis, I think if there
was an option to reduce the cost of that medication through the
Federal Government negotiating the prices of those specifically
high cost medications, and if there was that $2,000 cap that
was spread out over the course of the year, both of those
things would have allowed her to stay on her medication and
avoid those health outcomes.
Senator Kelly. What do you think her hospitalization cost
are?
Dr. Karuppana. Hospitalizations can run to hundreds of
thousands of dollars. I think she was in for about 4 days, if I
remember.
Senator Kelly. Well, thank you. Ms. Wilson, I want to thank
you for being here today and sharing your experience. I think
it is really important for folks in my position to hear stories
like yours to fully understand how these policies impact
people's lives.
As we have discussed today, I put forth a plan to reduce
the cost of prescription drugs by allowing Medicare to
negotiate directly with drug companies to bring down prices,
and then to also limit how quickly those companies can then
raise the price from year to year without a penalty. There is a
provision in here for--to provide rebates if they raise them
quicker, which is kind of like a penalty, but it would also cap
the out-of-pocket cost of insulin at $35 per month, and for
those on Medicare Part D plans, there would be a cap of $2,000
on out-of-pocket expenses, so Ms. Wilson, can you describe how
these types of policies, like capping your out-of-pocket
prescription drug costs at $2,000 per year, would impact you
and your family?
Ms. Wilson. Sure. Thank you for the question, Senator
Kelly. Although even $2,000 per year out of pocket is a lot of
money, capping what I would have spent on prescription drugs at
that amount would allow me to afford to get back on Copaxone,
and I wouldn't have to worry about my MS progression because I
am not on a disease modifying therapy.
I would also love to see a policy that would allow me to
spread out that $2,000 over a year, so I don't have to worry
about paying all that at once in the first few months. Policies
like this would be a relief to me and so many other seniors,
and that would immediately improve my quality of life.
Senator Kelly. Well, thank you. I am going to continue to
work as hard as I can on this, you know, to make sure we get
that cap, that it can be spread out, that pharmaceutical
companies can't, you know, keep increasing the prices, and then
if we do that, I hope to hear next time I see you that you
were, after we do this, that you were able to get back on the
Copaxone that you need for your MS. Let me close here by
saying, I want to thank all of our witnesses here today for
contributing your time, your experiences, your expertise, and I
especially want to thank Ms. Wilson because it is always hard
for people to talk about their personal story, especially when
it is health care related, so I want to thank you personally
for doing that and sharing that.
As we have heard today, congressional action to reduce the
cost of prescription drugs both for the Federal Government and
for Arizonans is long overdue. I mean, this is not only
savings--remember this, this is not only savings of the
patient, this is savings for the Government as well. We have
got a plan. We know what to do.
We have got to allow Medicare to negotiate the cost of the
most expensive drugs. I mean, that is clear. The Veterans
Administration does this already. This is not unprecedented,
but Medicare, because of current law, they don't--they are not
allowed to do it, and it is essentially to, you know, make sure
the pharmaceutical companies have very high profits, but the
capping the out-of-pocket expenses at $2,000 for Medicare Part
D plans, I mean, we have to get this done, and insulin that has
been around for over 100 years, I don't know, 100 years? I
think maybe more than that. Insulin has been around a long
time. Why does it cost hundreds of dollars per month? You know,
we have got to get that across the finish line, and then, you
know, this legislation will also prevent pharmaceutical
companies from increasing the price of their products at more
than the price of inflation.
Let me say that this is just like also like a fundamental
question of fairness. I mean most of these drugs, correct me if
I am wrong, but most of these drugs are developed and
manufactured in the United States, and it is unfair that
Americans have to pay two to three maybe four times more for
certain prescription medications than, let's say, our, you
know, friends on the other side of the border in Canada or any
other country for that matter. It is just fundamentally unfair.
I am going to continue to work with my colleagues to put
this plan into place, and if the witnesses, if you have
additional statements or something else you want to add that
you didn't get to share today, the hearing record will be open
for seven more days until Tuesday, April 19th.
Thank you so much for participating today, and this is,
just to finish, this is incredibly valuable for me and for the
Senate Committee on Aging, so thank you, and I conclude this
hearing.
[Whereupon, at 12:04 p.m., the hearing was adjourned.]
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APPENDIX
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Prepared Witness Statements
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