Thread by @RepMaloney

For nearly 3 years a dedicated team of staff on @OversightDems has been investigating Big Pharma’s pricing and business practices.

Today we're releasing our final report. Everything you need to know about how Big Pharma abuses our system for profit at the expense of patients👇

The companies we investigated raised prices 250+ times on the 12 drugs examined during the time they've marketed them.

Those drugs are now priced at a median of almost 500% ⬆️ than when they came to market.

Mallinckrodt’s drug H.P. Acthar is 𝟭𝟬𝟬,𝟬𝟬𝟬%⬆️THAN AT LAUNCH 2/

Net prices—prices after accounting for rebates and other discounts—of nearly all of the drugs ⬆️ year over year.

This data, which hasn't been public before, undermines Big Pharma's claims that price increases are primarily due to, and offset by, rebates and discounts. 3/

Price increases = $$$ for Big Pharma.

The 10 companies generated $38.5B in U.S. net revenues from the sales of just 12 drugs in 2019 alone.

We found evidence that execs made pricing decisions to meet revenue targets and earnings goals, not for research and development. 4/

Why is this important?

At least 2 companies, would've missed revenue targets and execs wouldn't have gotten bonuses... had they not⬆️prices.

@OversightDems found the fmr Celgene CEO received $500K+ in bonuses in 2016&17 solely because of price⬆️for cancer drug Revlimid. 6/

We also obtained non-public pricing data revealing that taxpayers could have saved more than $25B over 5 years for just 7 drugs-if private Medicare Part D plans received the same discounts as other federal health programs that can negotiate, according to our analysis.7/

Docs show several companies targeted Medicare to boost revenues. An internal Novo Nordisk slide deck emphasized, “Part D is the most profitable market for the Novo Nordisk insulin portfolio.” 8/

Evidence shows that companies use patent protections and market exclusivities granted by FDA to suppress generic competition and keep prices high.

Just look at this chart 👇

A shameful abuse of the system. 9/

Every company engaged in 1 or more strategies to suppress competition from generics or biosimilars. 10/

What does this look like? Contracting and marketing strategies like: 11/

We also uncovered new evidence of “shadow pricing,” where would-be competitors follow each other’s price increases. Internal docs show that the 3 largest insulin makers raised prices in lockstep to maintain “pricing parity.” 12/

Again, just look at the charts 👇

So how does Big Pharma respond to this criticism?

They point to the generosity of their patient assistance programs.

BUT, new evidence shows that companies emphasized the significant ROI from these programs in the form of increased sales.

Big Pharma, "help you, help me." 13/

What's more, companies’ investments in R&D are far outpaced by revenue gains, and the companies spend more on stock buybacks and dividends than on R&D.

I have an entire thread about this 👇 14/

https://twitter.com/RepMaloney/status/1413215938246324234?s=20

So what can we do about this?

4 VERY BIG THINGS:

1) Pass the #BuildBackBetter Act

2) Address Anticompetitive Practices

3) Prohibit Anticompetitive Pay-for-Delay Agreements

4) Ensure Transparency of R&D Costs

15/

𝗣𝗔𝗦𝗦 𝗧𝗛𝗘 𝗕𝗨𝗜𝗟𝗗 𝗕𝗔𝗖𝗞 𝗕𝗘𝗧𝗧𝗘𝗥 𝗔𝗖𝗧: We need the #BuildBackBetter Act, to let Medicare negotiate prices and limit out-of-pocket costs for insulin and other drugs. 16/

The Build Back Better Act would reduce beneficiaries’ share of costs for prescription drugs, set caps on out-of-pocket spending, and realign the cost distribution in the catastrophic coverage phase from the Medicare program to Part D plan sponsors and manufacturers. 17/

It would also disincentivize companies from taking price increases by applying an inflation penalty when a manufacturer raises a drug’s price faster than the rate of inflation. 18/

You can read about all the way the #BuildBackBetter Act will lower drug prices here: 19/ oversight.house.gov/sites/democrat…

𝗔𝗱𝗱𝗿𝗲𝘀𝘀 𝗔𝗻𝘁𝗶𝗰𝗼𝗺𝗽𝗲𝘁𝗶𝘁𝗶𝘃𝗲 𝗣𝗿𝗮𝗰𝘁𝗶𝗰𝗲𝘀: We must address anticompetitive practices like targeting docs to prescribe branded drugs instead of generics.

@RepCicilline's Affordable Prescriptions for Patients Through Promoting Competition Act does just that

𝗣𝗿𝗼𝗵𝗶𝗯𝗶𝘁 𝗣𝗮𝘆-𝗳𝗼𝗿-𝗗𝗲𝗹𝗮𝘆: we must address anticompetitive tactics to maintain monopoly pricing, like entering settlement agreements that delay access to generics.

@RepJerryNadler's Preserve Access to Affordable Generics and Biosimilars Act does just that. 20/

𝗘𝗻𝘀𝘂𝗿𝗲 𝗧𝗿𝗮𝗻𝘀𝗽𝗮𝗿𝗲𝗻𝗰𝘆 𝗼𝗳 𝗥&𝗗 𝗖𝗼𝘀𝘁𝘀: Cost transparency would provide valuable data about companies’ investments in innovation and their claims that high costs of R&D justify the skyrocketing prices of their drugs. 21/

You can read @OversightDems' full report (warning it's 192 pages) or a more manageable executive summary (16 pages) here: oversight.house.gov/news/press-rel…