Skyrocketing drug prices: A deep dive into the partisan divide in Congress over how to fix it

WASHINGTON, D.C. — Mindy Solango starts every day making sure she has the medication and devices she needs to treat her type 1 diabetes.

“As soon as I wake up, feet hit the floor, check to see where we are,” Salango said.

She takes about seven to eight insulin injections a day and uses a continuous glucose monitor.

“With insulin and everything, it’s about $350 a month,” Salango said.

It was even tougher years ago when she was a single mom with a different insurance plan.

Back then, she paid around $500 a month.

“It became really difficult,” Salango said. “I was rationing insulin, not eating as much.”

For diabetics, rationing insulin is life-threatening.

Salango’s struggle to pay for her medication inspired her to become an advocate for lowering drug prices.

She even took her concerns to leaders in Washington, D.C. in December 2021 when she shared her story alongside House Democrats during a press conference about drug pricing.

“Our only option is to pay or die,” Salango said during the event. “This is not healthcare. This is survival of the richest.”

Nationwide Problem

Salango’s frustration is reflective of homes across America.

We submitted a records request with the Federal Trade Commission (FTC) and found nearly 100 public complaints about different problems with prescription drug prices over the last three years.

In April 2020, a man in New Jersey wrote about his wife’s struggle to pay for liver medication after she signed up for Medicare.

“This drug cost $2400.00 per month,” the consumer said. “We are both retired. Somebody help. WITHOUT THIS DRUG SHE DIES.”

In October 2021, a consumer in Seattle wrote about struggling to pay for testosterone medication and battling with the insurance company for timely approvals.

“This can be extremely harmful and even cruel to the patients that are wrongly denied, and causes needless pain and suffering,” the consumer wrote.

AARP has been pushing lawmakers for years to pass legislation to curb the rising prices.

According to AARP, the average retail price for nearly 150 widely used prescription drugs jumped more than 300 percent over the past 15 years.

“I don’t understand why our representatives are allowing this to happen,” Salango said. “When is enough, enough?”

It’s a question we took to Capitol Hill.

Members of both parties seem to agree it’s a problem that needs to be fixed but disagree on how to fix it.

In fact, the House Oversight Committee released two different reports about drug pricing – one from each party.

Role of Pharmaceutical Companies

In December 2021, Democrats on the House Oversight Committee released a 269-page report after a three-year-long investigation into drug pricing.

Democrats point to unfair business practices in the pharmaceutical industry.

“Internal strategy documents show that drug companies targeted the U.S. market for price increases—while maintaining or lowering prices in the rest of the world—in part because Medicare cannot negotiate directly,” the report said.

The report highlighted the steep rise in drug prices in the U.S.

“Companies in the Committee’s investigation collectively raised prices more than 250 times on the drugs they sell,” the report said. “Eight of the ten companies took more than 20 price increases on a single drug. As a result, the median total price increase since the launch of the drugs in the Committee’s investigation is almost 500%.”

The report also addresses concerns by opponents of government regulation of drug prices who argue that oversight would limit innovation.

“The Committee’s investigation revealed that justifications frequently offered by the pharmaceutical industry for raising prices—including research and development (R&D), manufacturing, and other costs—are not supported,” the report said. “The Committee’s investigation found that companies’ investments in R&D are far outpaced by revenue gains.”

In response to the findings, the pharmaceutical industry accused Democrats of trying to push an extreme agenda.

“Like the disastrous bill championed by Democratic leaders, this misleading report fails to address abusive practices by insurance companies and middlemen who profit off a broken system while patients can’t afford their medicines,” said Debra DeShong, Executive Vice President for Public Affairs at Pharmaceutical Research and Manufacturers of America (PhRMA). “This so-called investigation has ignored the real affordability problems people face, like rising deductibles and other out-of-pocket costs. This is nothing more than a partisan exercise to justify an extreme proposal that will restrict patient access to lifesaving cures and treatments. We think there’s a better way that would lower costs at the pharmacy while preserving choice, access and innovation. We are committed to working with policymakers on commonsense, bipartisan solutions that address the real affordability challenges patients face.”

Democrats on Capitol Hill are standing by their push to regulate some drug prices.

“Pharmaceutical companies engage in really unethical practices,” said Sen. Maggie Hassan (D-NH). “They take a lot of different steps to artificially inflate the prices.”

We spoke one-on-one with Hassan about the ongoing debate over how to crack down on rising drug costs.

“It is unacceptable that people have to make these choices between buying their prescription drugs or putting food on the table,” said Hassan.

Hassan co-sponsored bipartisan legislation with Sen. Bill Cassidy (R-LA) called the “No Surprises Act” which put a stop to surprise medical bills.

That proposal was signed into law in late December 2020.

Hassan is now focused on getting drug costs under control and has held public forums with constituents to hear about their personal struggles trying to pay for medication.

How do Republicans and Democrats come together to reach an agreement to actually fix this problem?” Washington Correspondent Samantha Manning asked Hassan.

“First of all, the biggest thing we could do to fix this problem is allow the Medicare program to negotiate prices with the pharmaceutical companies,” Hassan said. “That’s something I’ve been pushing for a long time and that’s something we really have to stay focused on and I hope some of my Republican colleagues will joins us.”

Pharmacy Benefit Managers

Meanwhile, House Republicans say Democrats have focused too much on the drug companies and not enough on what they call the “middlemen.”

Republicans on the House Oversight Committee released a report in December 2021 called: “A View from Congress: Role of Pharmacy Benefit Managers (PBMs) in Pharmaceutical Markets.”

PBMs are companies that manage prescription drug benefits on behalf of insurers including private companies and Medicare and Medicaid.

“PBMs use their market leverage to increase their profits, not reduce costs for consumers,” the report said. “Drug manufacturers actually raise their prices due to PBMs.”

“PBMs increase patient co-pays,” said Rep. James Comer (R-KY), the Ranking Member of the House Oversight Committee, in November 2021 during a forum on the role of PBMs.

“PBMs also exert immense control over patient formularies allowing them to steer patients to higher-cost medications because these medications give them higher rebates,” Comer said. “Without greater transparency of PBMs, it’s difficult to see how these tactics are benefiting patients at all.”

In response to the report, the Pharmaceutical Care Management Association (PCMA) defended PMBs and said lawmakers should instead focus on the “true drivers of higher drug costs.”

In a statement, PCMA said: “Any report that focuses only on pharmacy benefit managers (PBMs) seems to purposefully take a narrow view and is therefore going to miss the mark. PBMs are the only entity in the drug and payment supply chain that actually reduces prescription drug costs for patients. Instead, policymakers should focus on increasing affordability for patients through more competition, market forces, and a focus on getting value for scarce health care dollars.”

Looking Ahead

Despite the urgent pleas from constituents to members of Congress on both sides of the aisle, there still is not a large-scale plan to lower the cost of prescription drugs that has widespread support from both parties.

President Biden’s Build Back Better plan did include a proposal to allow Medicare to negotiate drug prices and it would have capped the cost of insulin at $35 a month for some people – but that proposal is all but dead in Congress.

Salango said she had this message for lawmakers as they work to come to a solution.

“This isn’t a partisan issue,” Salango said. “Diabetes didn’t ask me if I was Democratic or Republican. We’re all struggling, and you’ve got to listen.”

This is a developing story. Check back for updates as more information becomes available.

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