Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend and include extraneous material on the subject of my special order. Mr. Speaker, I rise and I hope to be joined by some of…
Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend and include extraneous material on the subject of my special order.
Mr. Speaker, I rise and I hope to be joined by some of my colleagues tonight to talk about an issue that I have been coming down to the floor of this House for more than 5 years to talk about.
That is the price that Americans pay for prescription drugs relative to the rest of the industrialized world, and I have often said that we as Americans are blessed and we should be prepared and willing to subsidize people in developing parts of the world, like sub-Saharan Africa. I do not believe, however, that we should be required to subsidize the starving Swiss, the Germans, the French and other industrialized powers.
In the last 5 years, I remember when we first started doing these Special Orders, and I would come down here, and it was basically just me and my charts and the chorus has been growing around the country and we have been joined by Republicans, by Democrats, by Independents and others.
Another point I always try to make is that this is not an issue of right versus left. It is not conservatives versus liberals. As I say, it is not right versus left. It is right versus wrong, and the issue really is that Americans are being held captive here in the United States; and the net result, very predictable result, is that whenever you have a captive market, particularly for a life-saving product like prescription drugs, it is inevitable that we, the world's best customers, would wind up paying the world's highest price.
I know there are some who believe that the answer is for the United States to have some kind of price controls. I am not one that shares that view.
About 4 years ago or 5 years ago now I guess, and one of the reasons I became very involved in this issue was something that happened that was totally unrelated to the price of prescription drugs. The price of live hogs in the United States dropped from about $37 per hundred weight to about $7, and these were the lowest prices for our hog farmers in 50 years. Many of my pork producers started calling me saying, Congressman, can you not do something about these incredibly low prices for these pigs? I said I do not know what I can do, and they said, well, could you at least stop all these Canadian hogs from coming across our borders, making our supply demand situation worse?
So, as their Congressman, I called the Secretary of Commerce, I called the Secretary of Agriculture, explained the situation that thousands of Canadian hogs were coming into our markets making the price of pigs in the United States even lower and can we not do something to at least stop all of these pigs from coming into American markets. The answer I got from both the Secretary of Agriculture and the Secretary of Commerce was essentially the same answer. They said that is called NAFTA. It is called free trade, and all of the sudden a light bulb went on over my head, and I said is it not ironic that we have open markets when it comes to pork bellies, not when it comes to Prilosec.
Literally, at that point, I moved from what Winston Churchill said the difference between a fan and a fanatic is, that a fanatic cannot change their mind and will not change the subject. I have become almost a fanatic on the issue of opening up markets to allow Americans to have world-class access to world-class drugs at world market prices.
I am joined by my friend from Illinois, and I would be happy to yield him some time; but I have a couple of charts.
Let me talk a little bit about this particular chart. A year ago right now I was in Munich, Germany, with one of my staffers. We were on our way home and stopped at the Munich airport pharmacy. As a matter of fact, the name of the pharmacy, if you want to check it out, is the Metropolitan Pharmacy at the Munich airport. Those of us that travel a lot know if you want to get a bargain, the last place you go to get that bargain is to buy at the airport, but we were on our way out of town. We bought then some of the most commonly prescribed drugs here in the United States, and these are the prices that we paid in April of 2003 in Munich, Germany.
When we returned, we went and asked here in Washington, D.C., what the price for those same drugs in the same dosages with the same number of tablets would be here in the United States, and let me show you some of the examples.
Coumadin is a drug that my father takes. Here in the United States, 100 tablets in the United States, about $92.66. In Germany, the price was $28.44.
Glucophage, a very effective drug, been around for a long time for diabetes. Over in Germany, 30 tablets, 850
milligrams, back in April, $15.50 American. Here in the United States, $45, three times more expensive?
Pravachol, I do not know much about that particular drug, but a commonly prescribed drug, $91 in Germany; $159 here in the United States, and the list goes on.
One of them we have talked a lot about, and these numbers have changed in part because of the change in the value of the dollar, but Tamoxifen, those numbers now have changed, and I see we have the updated price on the Tamoxifen as of today. Tamoxifen has come down a lot in the United States, but it is still more than twice as expensive in the United States as it is in Germany. Part of the reason the price has come down in the U.S. is because there is now a new drug that is taking the place of Tamoxifen.
Zestril, $39 in Germany; $75 in the United States. Zokor, $48 in Germany; $82 here, and I think is representative and we talk a lot about Canada, but what you will find is generally prices for prescription drugs in places like Germany are even cheaper, and hopefully we will talk about that as well because of parallel trading. And I would be happy to yield to my friend from Illinois.
Mr. Speaker, reclaiming my time for a few minutes, this is a chart which appeared last week in newspapers around the country with an Associated Press story talking about how various groups are trying to save money on prescription drugs, including a lot of the big insurance companies and health medical plans of differing kinds. I think this chart tells a rather shocking story; and I do say this and I am sincere when I say this, unfortunately I think as we looked at the problem of prescription drugs, particularly for the elderly, in my opinion, we misdefined the problem. I think if you misdefine the problem, the chances of getting the right solution are not very good.
The problem is affordability, and I think this chart illustrates part of the problem. Since 1997 we have seen drug prices for name-brand prescription drugs in the United States according to the Segal Company, in a report that was published, an article that was published by the Associated Press last week, here is what drug prices have done just in the last 8 years. In 1997, average drug prices went up 12.9 percent; in 1998, 16.8 percent. They slowed down a little in 1999 to only 14.2. Then back up to 16.3, 16.9, 18.4; and the estimates for 2003 are 19.5 percent, and for this year, we are projecting that drug prices will go up 18.1 percent.
If I could just finish this, that means that in the last 8 years, when the core rate of inflation has been less than 24 percent, prescription drugs in the United States have gone up 133 percent. I am not all that good in math, but that is about six times more than the inflation rate. I do not have an MBA. I am not the world's smartest guy, but I know this: this is unsustainable. No matter how you do this, if you have the taxpayers pay for it, if you have our grandchildren pay for it, this is unsustainable. It is eating the United States up and this is the problem.
When people talked about the prescription drug problem, unfortunately too many people here in Washington talked about it as if it was a problem of coverage. Well, if you went to town hall meetings, and you and I have done a lot of town hall meetings with seniors, they will tell you the problem. The problem is not coverage, because they know that right now in any one of these years I believe they could have bought prescription drug coverage from any number of insurance carriers, including the AARP. So they could get coverage. The problem is affordability, and we really only have a couple of choices.
One of them that we use with virtually every other product, including products that we normally think of as being intellectual-property-type products, we have open markets. I mean, it costs a whole lot of money to develop that first chip when Intel brings a chip off the line; but they cannot use this differential pricing for customers in Japan get one price; customers in Germany get another price; oh, and by the way, customers in the United States get stuck with prices that are 40 or 60 percent higher.
I yield back to my friend from Illinois.
Five to six times.
Well, Mr. Speaker, one of the arguments we always get, and I want to follow up with something the gentleman just said, because I think it is important. Some people say, well, I do not want my mother-in-law buying her prescription drugs on line. You know what? Neither do we. What we want is parallel trading. What we want is our local pharmacists to be able to buy these drugs at 30 to 300 percent less so that our seniors and others can buy them at their local pharmacy and get those kinds of prices.
The gentleman talked about this, and I do not think most people understand it, I know a lot of our colleagues, still, this is like alchemy or something, but it happens every day in Europe. I wonder if the gentleman would not just share the story of how many drugs we actually import, like Lipitor. Perhaps the gentleman would share that story.
Every tablet.
Reclaiming my time for a moment, Mr. Speaker, when people talk about safety, we need to understand, and I am confident they do everything they can to make certain as they ship these drugs around the countries, from one country to the next, they are as safety conscience as they can be, but do understand they are not shipped in armored cars. These are going in big containers, generally in big barrels with a plastic bag on the inside. And the idea that they cannot sit on a loading dock in New Jersey or in Illinois or Oregon or wherever and somehow that is completely safe, but if a consumer in the northern suburbs of Chicago or in southern Minnesota decides they want to order their drugs from a reputable pharmacy in Canada and the package is delivered by FedEx or UPS, that somehow that is not safe, is laughable.
We have talked about this enough, but it just boggles my mind. And I think the gentleman's point is a good one, that here we are spending lots of money encouraging people to believe that the pharmaceutical drug plan that was passed by the Congress and signed by the President, this is a democracy, it is the law of the land. And I am not here tonight to be overly critical, but the point is, for all the money we are spending promoting this, we could have put in place a system that would be safe for American consumers.
Frankly, if they could buy their Glucophage for 300 percent less or if their pharmacist could buy it for 300 percent less and pass some of the savings along to them, they may not need a benefit from the Federal Government. They may not need our grandchildren to pay for those drugs.
If the drug companies can figure out a way to safely import and export drugs around the countries, then we ought to be able to. More importantly, if we can have parallel trading between Germany and France and England and Ireland and Spain, in other words, if a pharmacist in Germany can order their Coumadin from a pharmaceutical supply house in Spain and save his consumers or her consumers 75 percent, they do that.
Here is the thing about the Europeans. They are not intrinsically smarter than we are. If they can figure out how to do this safely, I have every confidence our pharmacists and our FDA can do this safely. It is a bogus argument. It gets thrown in our face, but here is the interesting thing. No one believes it. Consumers do not believe it, and we have some evidence that there have not even been complaints filed.
There is another article, and I am sending this out to all my colleagues in the next couple of days, again from last week's paper. It says, ``Pharmacy complaints slow none on Canadian imports.'' In fact, in the State of Minnesota over the last 5 years, there have been 473 complaints to State regulators about pharmacies and/or pharmacists. In the last 5 years. Not one alleged an error by a foreign pharmacy, according to a review conducted by the Associated Press.
In other words, if there is a huge problem, and literally in some areas of my home State half of the seniors are now getting their prescription drugs from Canada, so if this was a huge safety hazard, you would think that we would be getting lots of calls, lots of complaints, and yet the answer is zero.
Mr. Speaker, I yield to my colleague.
Mr. Speaker, I thank the gentleman.
As my colleague knows, people are voting with their feet; and the gentleman alluded to how much we are really talking about, ultimately.
Now I am not saying this is a panacea. I do not think this is the silver bullet that will solve all of our problems with seniors being able to afford their medications. Clearly, there will still be seniors that fall through the cracks, and I think there legitimately is a role for government to play to help those people who cannot otherwise afford the health saving products they need. But the bottom line is, if we could at least guarantee them they had fairer prices, fewer and fewer of our seniors would need this.
Let me also say this is not just about seniors. There are a whole lot of working families in my colleague's district and my district that have children that have very serious medical conditions that are now paying thousands of dollars per month for some of these medications where these companies are willing to sell those same drugs for a lot less in some of these other countries.
Let me put a pencil on this, because an estimate done by Dr. Steve Schondelmeir, a professor of pharmacology at the University of Minnesota, his estimate is Americans will spend about $200 billion on prescription drugs this year. That is not just seniors, that is all Americans.
Now I am not saying we are going to be able to take advantage of all of the differences that we see on some of these charts. I think, as time goes forward, we will see if we do open the markets we will see prices come down in the United States, and we will see prices in other industrialized countries start to level off. At least we will not have to subsidize it.
But my estimate is that we will save at least 30 percent, and no one has challenged me on that number. I have had some of the pharmaceutical folks say, oh, no, no, no, it is not nearly that. I have said, okay, what is the number? Well, we do know, and some of it has to do with currency and some of it has to do with other problems. But, my colleagues, 30 percent of $200 billion is $60 billion.
Now that is $60 billion that American consumers could spend on a lot of other things. They could be buying things that might improve our manufacturing sector. They could be taking their kids to baseball games. They could be paying for violin lessons for their grandchildren. $60 billion would amount to the largest single tax cut in the history of the world.
I, as a supply-sider, think that is a good thing. That is money that could be spent on other things. They say, well, if we do that, there will be no more research. I do have to give the pharmaceutical industry credit. They are turning out new products, a lot of them we see advertised every day, and there is some health advantage to all of these that help some of the older men in the United States still enjoy a more vigorous life. Let us say it that way for prime time here. But at the end of the day, many of the things that the drug companies are spending their research dollars on are not necessarily on the miracle cures that they sometimes talk about. They are on new products that are slight improvements over existing products. For example, they changed a couple of molecules in Prilosec which was going off patent and they call it Nexium. Prilosec can now be bought over the counter for about $15, but they wanted to convert all the Prilosec users to Nexium because that sells for about $130 a month. It is not exactly about improving the quality of people's lives as much as it might be about making certain that they can guarantee a profit stream.
Let me just add one more point, because some people say, well, if this happens, it is going to really have a devastating impact on America and American industry and American companies. Let me just point out that some of the largest pharmaceutical companies in the world are not based in the United States. Bayer, the maker of Cipro, is a German company. Glaxo is actually a British company. Astro-Zeneca and Roche and Novartis, I believe, are all Swiss companies. So many of these pharmaceutical companies not only do business under the European model; they are based in Europe. And so the idea that somehow this is going to devastate America and American industry again is sort of a specious argument.
So we talk about safety. We talk about research. I am proud of the fact that we as Americans, and this is a number that I try to share with people, as the vice chairman of the Committee on Science, this is a number we should all be proud of. Americans represent less than 6 percent of the world's population; but between what the taxpayers pay for, what foundations and voluntary contributions pay for, and what
we pay for in the high prices for our prescription drugs in the United States, Americans pay for over half of the basic research that is done in the world. We are 6 percent of the world's population, and over half of the basic research is done by and paid for by Americans.
I want to thank the gentleman for joining me tonight in this Special Order because I think this is an issue that is just simply not going to go away. I think a lot of folks here in Washington and some of the folks who represent the pharmaceutical industry thought, now that we have passed the prescription drug benefit, this issue about affordability and competition and open markets will just go away. We are here tonight to report that the issue is not going to go away and that Americans are still concerned.
As I say, it is not a matter of right versus left. It is right versus wrong. It is simply wrong to hold American consumers captive so that we pay the highest prices in the industrialized world. As the gentleman just said, we subsidize the pharmaceutical industry and the research in three separate ways. First of all in the Tax Code. Not only do they write off every dollar that they spend on research; in some cases they actually get a research and development tax credit. So the costs to the company are very negligible. In addition to that, we subsidize them through the NIH, the CDC, and even through the VA and the Defense Department. So I think the real number that we spend on basic research that ultimately benefits the pharmaceutical companies actually is closer to 27 billion taxpayer dollars per year.
Again, in some respects I am very proud of that. When we talk about some of these miracle drugs like Tamoxifen, that was developed by the NIH, the National Cancer Institute. It was taken through phase-2 trials. Then they licensed it to the pharmaceutical company and our reward, at least until just the last several months, is American consumers were paying six times more for that drug than consumers were paying in Germany and in England and in the industrialized West. And I agree with the gentleman. It is not so much shame on the pharmaceutical industry. Essentially they have been given a market opportunity here in the United States with a captive market, and they have taken advantage of it. I do not say shame on the pharmaceutical industry as much as I say shame on us. Because we create the rules, and the rules here are heavily stacked against American consumers.
We are not asking them to give away their drugs. I would not say to Intel, and they deal in intellectual property, we understand that first chip off an Intel line may cost them $500 million. The next chip may cost 5 cents. We do not tell them what they should sell their chips for, but we do not stand idly by if they want to take advantage of American consumers or American users of their products while they sell them for much lower prices in other parts of the world.
All we are really asking for is basic fairness. I think at the end of the day, the American people understand this. This is an issue the American people get. Part of the reason the gentleman and I have been traveling around the country and speaking to various groups and at least raising the attention and elevating the debate about this issue is because it is such an important issue to so many people. I was in Oklahoma City, and I had a lady come up to me at the end of the meeting there. I spoke at a senior expo down there. A lady came up, she was probably in her thirties. She said, I work for the local bank. I said, really. You could tell she had something more she wanted to tell me. She said, Congressman, what I do is reverse mortgages at the bank. You would not believe the number of seniors who come in and get a reverse mortgage on their house because they cannot afford their prescription drugs.
I say, shame on us. That kind of thing, we could do something about. In fact, I am proud of the fact that we in the House have done something about it. When people call me and say, well, what can we do? What can we do, Congressman, to make certain that something like this happens this year? I always say, the House has done its work. If people would like more information about what they can do to make this a reality, to allow Americans to have access to world-class drugs at world market prices, they can leave me an e-mail, just go to my Web site at gil.house.gov and I can give them more information, we can give them more charts, we can show them what we have learned.
We know, for example, in terms of the safety, and the gentleman alluded to it in his remarks, the CDC and others all keep records, we know that not a single American has died as a result of taking a drug from another country. We also know that, on average, 6,000 Americans die in hospitals in the
United States from getting the wrong prescription drug, the wrong dosage, or they get a reaction to a prescription drug. That is happening now. We know, for example, you are much more likely to get sick and die from eating onions from Mexico. In Pittsburgh alone, we had 500 Americans who got seriously ill, three died, from onions from Mexico. Nobody has died from taking Coumadin from Germany.
Mr. Speaker, I thank the gentleman for joining me tonight. I think it would be fair to say we do not agree on every issue, but we agree on this, and that is Americans should not be held captive. The House has done its work, and I was never prouder than when this bill passed the House Chambers here against a withering attack by the pharmaceutical industry and sometimes by our own FDA. But this is the people's House, and that night the people finally ruled.
I am not asking for the pharmaceutical companies to give away their companies. I am not asking them to change the way they do research. It may well be they have to adjust how much they spend on advertising and marketing, because there is growing evidence they are now spending more money on advertising than they are on research. I do not know if those numbers are true, but I think perhaps we can have some hearings here in the House and find out.
But, at the end of the day, all we are asking for is basic fairness. It is not right versus left. It is simply right versus wrong. It is wrong to hold Americans captive.
We are not going to go away. This issue is not going to go away. I believe that before this Congress adjourns the chances are very good that our friends on the other side of this Capitol will follow the lead of the U.S. House of Representatives. They will pass a bill that will allow Americans to have access to world-class drugs at world-market prices.