A bipartisan consensus against ‘big pharma’ is growing in Congress

When President Trump, then candidate Trump, first fired a volley of insults and criticism at the pharmaceutical drug industry over their high drug prices, and pledged to use government to get a better deal, the reaction among the establishments of both parties was roughly comparable to that of the pope after reading the 95 Theses.

Unfortunately, if recent rumors about the president’s drug policy are any guide, Trump the president seems to have lost the courage of Trump the candidate on this issue. This is saddening, because the rest of Washington seems to have come candidate Trump’s way. The ground in Congress has unmistakably shifted on the question of drug pricing. With that shift has come some much-needed skepticism of the previously almost bulletproof pharmaceutical industry’s influence over debates on drug policy – skepticism which is slowly but surely making its way into not just op-eds and policy studies, but into actual legislation.

The most recent example of this is the bill that was just introduced by Reps. Gregg Harper (R-Miss.) and Peter Welch (D-V.T.) designed to close the so-called “orphan drug loophole” connected to the 340B drug-pricing program. “Orphan drugs” refer to a category of drug supposedly targeted at such a niche market (sufferers of a rare disease) that they could not be profitable without extra government incentives.

{mosads}PhRMA, the powerful interest group representing brand name drug makers, cut a deal with the Obama White House to prevent rural hospitals from fully benefitting from this much needed drug discount program. Big Pharma had threatened to pull their ads in support of the Affordable Care Act unless they got their way and the Obama administration caved. As a result, brand name drug makers can skirt the requirement that they sell drugs at more affordable prices to safety net hospitals, in exchange for access to the Medicaid and Medicare Part B drug market.

Obviously, the problem with a carve out like this is that it creates a perverse incentive to misclassify certain drugs as “orphan” drugs, regardless of their profitability or the size of the market they serve. Not that Pharma needed the encouragement, since orphan drug classification has already ballooned far beyond the categories of drugs it was intended to cover, with pharmaceutical companies attempting to spin even profitable drugs as “orphans” due to specific niche uses for those drugs, a practice called “salami slicing.”

This monopolistic, anti-market practice obviously hurts all consumers, but it particularly hurts the vulnerable people who rely on the often underfunded, understaffed hospitals that the 340B law is designed to help. The fact that both Republicans and Democrats are willing to consider enforcing the program more strictly is, therefore, a positive sign both for consumers and for those concerned about anti-market practices.

But while this is the most recent such bill, it is far from the only one. Earlier this year, the Senate narrowly voted down a bill that would’ve permitted drug importation from Canada: a bill that somehow managed the incredible feat of getting both Sen. Bernie Sanders (I-V.T.) and Sen. Ted Cruz (R-Texas) to support it, while losing centrist, pharma-backed Democrats like Corey Booker.

Further, the bipartisan Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act, which permits generic manufacturers to more effectively hold brand name companies engaging in anticompetitive behavior to account, comes with the support of everyone from veteran liberal Sen. Patrick Leahy (D-V.T.) to right-wing Sens. Mike Lee (R-Utah) and Charles Grassley (R-Iowa).

Now, one could argue that the support of progressive Democrats for anti-pharma causes is to be expected, due to the pervasive anti-corporate attitudes of those same figures. But what is less predictable, and thus more encouraging, is the character of the Republicans joining them. Sens. Mike Lee (R Utah), Chuck Grassley (R-Iowa), and especially Cruz form the absolute right flank of the Senate Republican caucus. Similarly, Rep. Gregg Harper (R-Miss.), co-author of the orphan drug loophole-closing bill, has racked up a 96 percent rating from the American Conservative Union for his voting record. Further, Harper votes with President Trump’s position 100 percent of the time in Congress, according to FiveThirtyEight.

Not only is this good for the Republican party, since such zealous members of the party frequently have outsized power to define its agenda, but it represents the depth of the sea change over drug prices that has taken place in Washington. When crunchy socialists and right-wing fire-breathers are uniting in favor of the very policies that the pharmaceutical industry fears will take away its gravy train, it’s time to consider that a political earthquake may be taking place.

Mytheos Holt (@MytheosHolt) is a senior fellow at the Institute for Liberty. He previously worked as a speechwriter for Sen. John Barrasso (R-Wyo.), and as a writer for publications including The Federalist.

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