Under Bernie Sanders’s Glare, Pharmaceutical Chiefs Defend Their Prices

The chief executives of three main pharmaceutical corporations defended the costs of their medication in entrance of the Senate well being committee on Thursday, drawing them additional right into a confrontation with lawmakers and the Biden administration over the price of among the most generally used prescription drugs.

Lawmakers, together with Senator Bernie Sanders of Vermont, the panel’s chairman, famous that the businesses charged extra within the United States than in different rich international locations, accusing them of profiting on the expense of American sufferers. The pharmaceutical executives — from Johnson & Johnson, Merck and Bristol Myers Squibb — conceded that sufferers within the United States paid an excessive amount of however mentioned that new drugs arrived there sooner than anyplace else on this planet.

Mr. Sanders, an impartial who has made reining in drug costs a signature reason behind his late-career years in Congress, acknowledged that the businesses had produced lifesaving medication. But he singled out a number of extensively used drugs, together with Bristol Myers Squibb’s blood thinner Eliquis, which he famous may very well be bought for a lot much less in Canada than within the United States.

“Those drugs mean nothing to anybody who cannot afford it,” Mr. Sanders mentioned, including that “millions and millions of our people cannot afford the outrageously high cost of prescription drugs in this country.”

The three executives who testified — Joaquin Duato of Johnson & Johnson, Robert M. Davis of Merck and Christopher Boerner of Bristol Myers Squibb — acknowledged that drug costs had been typically larger within the United States than in different rich international locations.

But they mentioned decrease costs in Europe and Canada, the place governments are extra centered on constraining prices, got here with essential downsides, like lengthy waits for brand new medication and restricted insurance coverage protection.

“The United States has built a health care system that prioritizes patient and physician choice as well as the broad and rapid availability of cutting-edge medicines,” Mr. Boerner mentioned.

At one level, Mr. Sanders, who accused the businesses of utilizing their drug earnings to complement executives and shareholders whilst sufferers struggled to pay for drugs, tried to solicit a promise from Mr. Boerner that the corporate would decrease the U.S. sticker value of Eliquis to that in Canada. Mr. Boerner declined, citing the variations in Canada’s well being system.

The listening to befell as a brand new federal program authorizing Medicare to barter the costs of some expensive drugs is getting underway. Federal well being officers final week made their preliminary provides to the makers of the primary 10 medication chosen for negotiations, an inventory that features Eliquis and 4 different medication offered by the businesses whose executives testified on Thursday. Drugmakers, together with all three corporations represented on the listening to, have filed a flurry of lawsuits arguing that the negotiation program is unconstitutional.

As the pharmaceutical executives sat earlier than them, lawmakers described anguished selections that sufferers with excessive drug prices had confronted. Mr. Sanders talked about a girl in Nebraska who he mentioned had died of most cancers after she arrange a GoFundMe marketing campaign to pay for Keytruda, a blockbuster most cancers drug from Merck.

Senator Christopher S. Murphy, Democrat of Connecticut, mentioned that certainly one of his constituents on Eliquis had to decide on between the price of the medication, meals and lease.

Republicans on the committee pointed to what they mentioned had been the rightful market incentives that the businesses used to cost their medication.

“In capitalism, if you’re running an enterprise where you have a fiduciary responsibility to your owners, you try and get as high a price as you can,” mentioned Senator Mitt Romney, Republican of Utah. He added: “You think Chevrolet sits back and says, ‘Gosh, how can we get the price of this Chevrolet down?’ No, it’s like, ‘How high a price can I get and maximize the profit for my shareholder?’”

The listening to got here after a standoff between Mr. Sanders and two of the pharmaceutical executives, Mr. Duato of Johnson & Johnson and Mr. Davis of Merck, who agreed to testify solely after being threatened with subpoenas. The two corporations urged final month that Mr. Sanders was in search of to retaliate for his or her lawsuits difficult the Medicare value negotiation program.

Senator Bill Cassidy of Louisiana, the highest Republican on the committee, mentioned the panel’s technique had been to “threaten a subpoena when C.E.O.s are suspicious that they won’t get a fair shake, hold the hearing, get sound bites, then pick another set of C.E.O.s for a show trial.”

“But we don’t pass meaningful legislation,” he mentioned.

Prices for brand-name medication within the United States in 2022 had been on common not less than 3 times as excessive as these in 33 different rich international locations, a latest report funded by the Department of Health and Human Services discovered, even when bearing in mind reductions that scale back how a lot American well being plans and employers pay.

Comparing drug costs within the United States with these in different international locations will be difficult as a result of the well being care methods are so totally different. While European international locations depend on a centralized negotiator, the U.S. system is fragmented, with tens of hundreds of well being plans and employers counting on intermediaries to deal with their negotiations.

While many prescribed drugs will be purchased for a lot much less at European pharmacies, insurance coverage protection is commonly broader within the United States, that means that American sufferers typically face decrease out-of-pocket prices than Europeans for a similar drugs.

At the listening to, the drug firm executives blamed middlemen referred to as pharmacy profit managers for saddling sufferers with excessive out-of-pocket prices. Those companies procure reductions from producers that scale back the invoice for American well being plans and employers however not for sufferers. Benefit managers earn more money when the sticker value of a drug is larger, however sufferers typically need to pay extra. Lawmakers have proposed making modest adjustments to the practices of profit managers.