PhRMA stands behind role in Healthcare negotiations

The following Publisher’s note is the opinion of Daniel Hines and RxforfAmericanHealth.blogspot.com, and does not reflect the viewpoint of Kaiser: The interview is reprinted here as a public service to offer insights into the workings of a powerful lobby within The Beltway. Gone are the days that legislation was shaped by citizen involvement, public hearings, and testimony from concerned citizens with specialized knowledge, not special interests: Yesterday we blogged about how PhRMA’s role in the behind-closed-door Healthcare Reform ‘negotiations’ and its supposed savings for Seniors in The Doughnut Hole really were a Magic Lantern Show. The following interview and PhRMA’s comments about not being able to identify the true extent of the savings provide, we believe, validity to our observations.

The complete, unedited interview/story follows:

PhRMA Chief Says Support For Health Law 'Was Right Decision'—The KHN Interview

By Bara Vaida

JUL 13, 2011

One year after John Castellani took control of PhRMA, the former manufacturing executive has steered the drugmakers' lobbying group to be ready for battle with the White House.

Gone are the days where the Pharmaceutical Research and Manufacturers of America, is making deals with a Democratic White House and spending $101 million on advertising to promote the new health law. That was the successful strategy of PhRMA’s previous leader, former Rep. Billy Tauzin, R-La. to ward off new regulations for the industry in the law. Now PhRMA has signaled that it will fight any attempt by congressional Democrats or the White House in the current deficit reduction talks to save money by cutting drug spending in government programs.

In a hastily scheduled press conference this week, Castellani made it clear that PhRMA opposes a Democratic proposal that would require drugmakers to pay rebates to the Medicare program for beneficiaries who qualify for both Medicare and Medicaid, known as the "dual eligibles." He said it would "do serious harm to the industry, serious harm to (pharmaceutical) jobs and we oppose it. … We opposed it in the context of the discussions around the [health law] and we oppose it now." And if the proposal succeeds, Castellani said there "would be the risk" that drug companies would begin to move their operations to countries outside the U.S.

Still, Castellani says the industry doesn’t regret supporting the health law because he says it "was the right decision under the political context at the time," although his group would like to see some changes in the law.

Castellani recently spoke with Kaiser Health News' Bara Vaida. Here is an edited excerpt:

Q. PhRMA made a $80 billion to $100 billion deal with the Obama administration during the health reform debate to stave off more regulations, angering many of your Republican allies in Congress. Are you sorry the industry made that deal?

A. No. No. It was the right decision under the political context at the time. You had a Democratic president and a Democratic Congress and sweeping legislation that affected our industry. The decisions that were made were appropriate given the political circumstances.

Q. How much was the final deal? $80 billion or $100 billion? What number is right?

A. I can't comment given the nature of how [the Medicare rebate] affects individual companies.

Q. You have said you would like to see the Independent Payment Advisory Board (IPAB) in the health law repealed. What are you doing specifically to lobby on that?

A. IPAB is fundamentally flawed. It has to be repealed in its existing form or mitigated. What we have been doing is talking to other groups that are affected by it and talking to members of Congress. There is a substantial bipartisan effort to repeal [IPAB] that is almost unrelated to what we are doing about it.

Q. The president targeted the drug industry in his recent deficit reduction plan, how do you feel about that?

A. The president proposed to shorten the period of data exclusivity for biologics. It was disappointing and a bit surprising. He talked in the State of the Union speech about owning the future and investing in technology, and (his efforts on biologics) is discouraging what he wanted to encourage.

Q. What about the deficit reduction plan proposed by Rep. Paul Ryan, R-Wis. Would you support or oppose that? Do you see any dangers to the drug industry?

A. We don't know enough about it. We do think we need to have a debate about how do you fundamentally change Medicare so that it can be affordable (for the future). All ideas ought to be on the table.

Q. What are you doing to manage the drug industry's reputation with the public? People feel drug companies charge too much for their products.

A. Obviously we need to be trusted by public policymakers and by patients and by clinicians, and that is something that we are committed to doing. The problem is the delivery system by which people get medicines. [The system] is designed to disproportionately show the cost of medicine, so even though we are only about 10 percent of total health care costs, we are 40 percent of out-of-pocket expenses. That makes people think that we are the most expensive part of the health care, when in fact we may have the most value and be much less expensive than acute care. The other problem is that we haven't done a good enough a job of explaining the scientific process in how difficult and potentially rewarding it is and we need to help people understand where we fit in the economy and the kinds of jobs we produce and the kinds of value-added we provide.

Q. What about PhRMA's political reputation? Some Republicans remain angry over your support for health reform?

A. People try to portray us as Democrat or Republican. We are not. We are pro PhRMA. Lawmakers that recognize the value of PhRMA to their states and the economy and the costs of medicine are the people we support. The grumbling will always be there. There will always be someone who will find a reason why we should be doing something differently than we are going to do.

Q. You've acknowledged the industry spent about $25 million in the 2010 election cycle to get candidates elected. How much will you spend in the 2012 cycle?

A. We will support the candidates that support the industry, and I don't know who that is yet. It's too early. Really. I am not playing hide the peanut. I will tell you when I know (how much) it is.

Q. You say 75 percent of all prescriptions filled are generics rather than brand-name, what does that mean for PhRMA and the industry's business model?

A. Generics are an important part of the medicine life cycle. We produced all of them. They are our children. But if you are going to continue to innovate, you have to continue to support returns for the inordinate investment it takes to find new medicines. It is $1 billion to $1.3 billion over 10 to 12 years to develop a new medicine, so you have to have the mix of patent protections if you are going to have the rewards for that innovation. If you don't want to pay for the innovation, then you have to say to American patients, we have invented everything that we can invent. But we don't believe that. There are still discoveries out there. The problem with what the president proposed and when people say we ought to go to all generics, is generic companies don't spend money on research and development. We do.

Q. What about comparative effectiveness. PhRMA on its blog says it is a good thing, but the industry fights it.

A. Here is one of the issues that is difficult to deal with. The discovery process is an iterative one. Let's take some of the work done on HIV/AIDS. When (researchers) started out, you were talking about extending life for six months, then a year, then 18 months and then over years it turned HIV into a chronic disease. Clinicians learned, and the results got better over time. Comparative effectiveness can be good if it looks at the spectrum of the options available over a long enough period of time to know what the real value is.

Kaiser Health News reporter Mary Agnes Carey contributed to this article.

Americans' access to personal importation of brand-name prescription medicines from Tier One Countries threatened by proposed legislation

As the debate continues over what is commonly referred to as ‘Obamacare’, one would think that there would be universal support for an effort that has a more than decade long record of lowering health care costs, providing vital, safe—and affordable medicines—that have contributed to the health and well-being of millions of Americans, and done so at no cost to local, state or Federal governmental agencies.

We’re talking about the right of Americans to purchase brand-name prescription medicines from licensed, registered pharmacies in Tier One countries outside the U.S. whose standards and oversight of safety and efficacy meet or exceed those in the U.S.

But, instead of support of this recognition of the right—and ability—of Americans to make responsible decisions in the selection of these legitimate pharmacies for the purchase of brand name prescription medicines at savings of as much as 60 percent compared to what they would have to pay for the very same medicines if purchased in the U.S., the U.S. Senate is advancing legislation that could empower the Pharmaceutical Industry (Pharma) to use what many believe are Constitutionally questionable legal maneuvers to deny more than one million Americans the ability to order safe, affordable brand-name medicines from outside the U.S. via the Internet.

The Protect Intellectual Property Act (Protect IP) has been introduced by Senator Frank Leahy (D-VT), the chair of the Senate Judiciary Committee, to supposedly protect American Intellectual property such as Copyrights from being used in counterfeit items.

Protect IP was authored by Senator Leahy after there was a vigorous outcry of opposition to an earlier anti-counterfeiting bill advanced by the Senator because fears that its vagueness could be used to tread upon legitimate debate on public issues. The first proposal never came to a vote in the Senate because Senator Ron Wyden (D-OR)exercise a personal objection that prevented a vote.

Senator Leahy’s solution to the objection has been to bring forth an even more onerous proposal that contains specific language of the type supported by the Pharmaceutical Research and Manufacturers of America (PhRMA) in its ongoing campaign against Americans exercising their right to the health and cost benefits of purchase of brand-name medicines from reputable pharmacies with the highest standards of safety and efficacy.

The Protect IP Act would create a situation in which the Obama Administration's Justice Department would abdicate its responsibility to 'enforce' intellectual property rights to the private sector.

This means that Pharma could not only initiate legal action against anyone it believes has 'infringed' upon its intellectual property s, it could extend that action to websites whose advertising support includes pharmacies involved in personal importation. Many believe that the proposal would allow Pharma to initiate action against a website that supports the concept of personal importation, thereby limiting free speech and open debate.

If that is not disturbing enough, Pharma could seek an immediate injunction against anyone it

'believes' has committed infringement in some form or another, all the while doing so

free of any action against it should its suit be found to not have merit.

In the past decade, Congress has repeatedly passed legislation over the supporting the concept of personal importation of these medicines as the only viable option available to lowering the cost of prescription medicines in this country.

Such initiatives have faltered in the face of extensive lobbying by Pharma as it uses its vast resources to deter final passage with such gimmicks as ‘poison pills’ amendments that would place unnecessary restrictions upon personal importation such as ‘certification’ in addition to the rules and laws of the country from which the prescription was dispensed by adding a layer of ‘oversight’ which was really nothing more than the U.S. Congress responding to the intensive lobbying of Pharma lobbyists.

That’s why RxforAmericanHealth.com has launched an on-line petition supporting access for more than one million Americans to personal importation of safe, affordable brand-name prescription medicines. We must let Congress and other policy-makers know that this concerted effort by Pharma to protect its ability to continue to charge Americans the highest prices for prescription medicines in the world is totally unacceptable.

Instead, it is time for Congress and the Obama Administration to remove the ‘Safe Haven’ that Pharma enjoys to continue its predatory pricing practices and make the health and well-being of hard-pressed Americans for whom personal importation can provide not only improved health that access to a regimen of vital medicines provides, as well as offering the best strategy to relief from the high prescription medicine prices that are a major driver of the cost of healthcare in the United States.

Stop Pharma from denying access for Americans to safe, affordable prescriptions

If you agree with this position, write your Congressman or Senator to let them know of your support of the right of Americans to purchase safe, affordable—and vital—medicines from licensed, registered pharmacies in Tier One countries.

· Personal Importation of safe, affordable prescription medicines from countries outside the U.S was spurred more than a decade ago as a reaction to the fact that the U.S. has the highest prescription drug prices in the world.

· Personal importation of prescription medicines is the only option available to provide lower-cost brand name medicines for Americans.

· These medicines—from licensed, registered pharmacies in Canada and other countries with standards of oversight that meet or exceed those of the U.S.—have provided health benefits and financial relief to hundreds of thousands of Americans.

· The U.S. Congress has through repeated votes in the House and Senate expressed its support of the concept of making personally imported medicines available to U.S. citizens from pharmacies in Canada and 22 other countries whose standards of oversight for safety and efficacy equal or exceed those of the U.S.

· While a rash of bogus pharmacies and counterfeit medicines has arisen on the Internet, legitimate on-line pharmacies have taken extraordinary steps to distinguish them from bogus pharmacies.

· The pharmaceutical industry and its trade group (PhRMA) have targeted the right of personal importation of prescription medicines, which , ironically, they themselves have manufactured.

· The latest attempt to curtail access to personal importation is to define any online pharmacy from outside the U.S. as ‘bogus’ , even if an online pharmacy has met the standards of safety and efficacy of its practice required by the appropriate regulatory agency of its government.

· Opponents of personal importation have taken steps that indicate they hope to use the anti-counterfeiting intent of S 3804 as a rationale to claim that even licensed, registered pharmacies would be guilty of infringement of Copyright and Intellectual property rights.

· This would make the pharmacy liable to enforcement provisions of S 3804 which include, but are not limited to, the shutting down of domains and websites not only of the pharmacy, but could be extended to the sites of advocacy groups and individuals that support personal importation.

· Because of that, specific legislative language should be included in S 3804 to ensure that the legislation meets its intended purpose, and cannot be co-opted by special interest groups that would utilize the bill to meet their own narrow interests.

· Without the inclusion of language to more carefully define the intent of S 3804, the stage would be set for the pharmaceutical industry to take actions to restrict the right of Americans to enjoy the health benefits provided by safe, vital medicines that they otherwise could not afford.

· We believe that Americans have the right to make personal healthcare decisions including the right to purchase safe, affordable medicines from licensed, registered pharmacies, and that they have the capability to make such informed decisions in a responsible manner, free of governmental interference, and that current efforts to define legitimate pharmacies as bogus is an attempt by the pharmaceutical industry to extend its influence to impose its predatory pricing practices upon American citizens with regard only for industry profits, not the health and well-being of American citizens.

If you agree with this position, write your Congressman or Senator to let them know of your support of the right of Americans to purchase safe, affordable—and vital—medicines from licensed, registered pharmacies in Tier One countries. We will be posting email addresses for the new session of Congress in early January 2011.

American Public has common sense answer to lowering drug prices…just do it!

The failed vote in the U.S. Senate on the Dorgan Amendment to ‘allow’ lower-cost prescription medicines from licensed, registered pharmacies located in countries that have standards of oversight that meet or exceed those of the U.S. was both tragic and unnecessary.

It was tragic to watch the tremendous courage of Senator Byron Dorgan (D-ND), a man whom I greatly admire, who has been a champion of lowering prescription drug prices through ‘reimportation’ for nearly a decade, as he pleaded, cajoled and passionately made the point that the amendment was truly the only one that would have the effect of providing savings.

It was equally tragic to see him victimized by the deal-making of the Obama Administration with PhRMA. The snake that the President has decided to pick up may still bite him, as we warned in a previous entry.

At the same time, the spectacle was unnecessary. There are several reasons:
• As we have noted before, and even though we strongly support the right of personal importation, the bill, popularly called Dorgan-Snowe, was unworkable. It relied upon assumptions that simply were not possible to achieve:
• The first-year limitation upon medicines coming only from Canadian mail-order pharmacies was naive.
• There simply are not enough mail-order pharmacies left in Canada to provide the hoped-for funding;
• By restricting the ability to purchase medicines immediately from Australia, New Zealand and Great Britain for one year, and then limiting even those purchases to U.S.-based wholesalers and pharmacies, the bill’s supporters failed to acknowledge that as much as 80 percent of the sourcing for the Canadian mail-order pharmacies comes from Australia, New Zealand, and Great Britain.
• This was not the case when ‘reimportation’ first became an issue, but while the situation has changed, the language of the amendment reflected a situation that simply no longer exists, that of several years ago. It appears that the hoped-for impact was that since President Obama had co-sponsored a bill with virtually the same language two years ago, as had his Chief of Staff Rahm Emanuel on the House side, that they would be so flattered as to support the reincarnation of ‘their’ bill, a surprising bit of naivete.
• There was no opportunity for public input into the formation of the language. Supporters were given a ‘love it or Lump it’ choice. Some accepted this direction. I never did, not because I did not support the concept of importation, but because after years of hard work and support for personal importation, my responsibility remains the health benefits and savings that personal importation generates for seniors, workers, and others, not the mere passage of a bill.
• Many of the supporters of importation failed to ask themselves a very basic question: Why should Canada, which is a sovereign nation, and which through Health Canada has standards of oversight that meet or exceed those of the U.S. FDA, allow its pharmacies, operating completely within the laws of Canada and the provinces to be subject to U.S. inspections. Rather, why was there not a move made for reciprocal agreements?

But, in addition to being unworkable, there is another reason the amendment as written and the punishment heaped upon importation supporters was unnecessary: Importation of safe,affordable medicines is well-established through the common sense of the American public.

As the pharmaceutical industry continues to raise its prices, making deals with the Obama Administration that will lead to even greater costs for Medicare Part D payments by the government, growing numbers of Americans will be able to make wise, independent evaluations of safety and efficacy, as well as costs of medicines from safe, easily identifiable sources, not only from Canadian pharmacies, but through other pharmacies in Tier One Countries.

This is yet another example that all wisdom does not generate from within The Beltway but lies with the common sense of the American people.

For years, we have contended that individual, personal importation is allowed because the FDA itself has stated that a medicine that is not available in this country may be ordered in 90-day supplies for personal use, and any medicine that is not affordable is equally unavailable.

Also, that same common sense, enables Americans to evaluate the sources of their medicines for safety and efficacy as well as price. Those who believe that the FDA is the sole source of drug or product safety need to only look at the sorry record of the agency on a number of fronts ranging from Peanuts to Heparin.

As one who supported President Obama during his Presidential quest, I must admit to a deep sense of chagrin on a number of fronts. The deals with PhRMA are just the latest in a series of failed pledges for transparency and openness in government.

If Senator Dorgan wants to proceed with his quest, I encouraged him take actions that reflect the realities of the moment, rather than a bill with language that, while deserving support in a different time, is no longer relevant…irrespective, we shall increase our efforts to help the American people have the information to make informed, wise decisions, step forward, and exercise their common sense with the selection of safe, affordable medicines from pharmacies in other countries that meet or exceed the standards of those in the U.S.

Perhaps the President can then redeem himself by directing HHS to take steps to lead to reciprocal agreements with those countries for the benefit of the health care needs of untold numbers of people in this country. But, it is not necessary to wait for him or others within The Beltway to take action.

The American people have already spoken and as they are faced with the tremendous price increases initiated by pharma, we urge advocates of lower drug prices to help provide them with the information that will help them make the purchase decisions that will solidify the role of vital medicines in their healthcare regimen.

President should have known pharma was a snake when he picked it up

For the past three weeks, we have posted blogs wondering what the payback of the Obama Administration was to PhRMA in return for its 'support' of 'price cutting' for Medicare Part D Doughnut Hole prices, generating a claimed $80 billion savings.

We were among the first to suggest that the pattern of backroom dealing violated Candidate Obama's pledges of greater transparency and openness in government, and an end to the special relationship between industry groups and policy-makers. We noted with regret that the President had invited healthcare industry groups, including PhRMA, the trade association for the pharmaceutical industry, headed by Billy Tauzin, the former-Louisiana Congressman who not only engineered the restriction against price negotiation in Part D before resigning his elected post shortly afterward to accept a $2 million annual salary position as head of PhRMA. To some, including me, it appears that a case might be made that there could be a conflict between representing a Congressional district while leading a legislative effort that was going to reap billions of dollars in benefits for an industry that was soon going to offer you a $2 million salary. This was why we bemoaned the new found alliance of the Obama Administration with PhRMA.

We asked: What is the payback to the industry? It is an honored guest at The White House; it is praised by the President as he speaks to Seniors, praising pharma's largess in reducing their pain with the 'offer' to reduce the cost of medicines for those stuck in The Doughnut Hole; it negotiates with Senator Max Baucus, (D-MT), chair of the influential Senate Finance Committee (and the recipient of large contributions from the healthcare industry); it has the audacity to 'demand' that the White House 'clarify' its 'agreement' that the Administration will 'honor' its agreed-to commitment to not allow price negotiation--and it gets its way, as the White House quickly falls in line, even to the point of having Press Secretary Robert Gibbs flounder as he had to admit he really didn't know the details.

But then, in a complete flip-flop, the next day, a new stance emerges, largely due to opposition from House members such as Rep. Henry Waxman, chair of the influential House Energy and Commerce Committee, which included price negotiation in its markup of HR3200. Waxman put it bluntly--neither he nor the Committee were bound by the negotiations with the Administration or with Senator Baucus.

Apparently others had the same concerns at about the same time we started asking questions about the relationship of this Administration with the pharmaceutical industry. There is an increasing number of stories asking questions about details of the agreement.

This is a fortunate turn of events. During the campaign, Candidate Obama made two pledges regarding prescription medicines: (a) to lower prices for Medicare by removing the restriction on price negotiation and (b) to allow Americans to expand their freedom of choice by legislation that would allow personal importation of safe, affordable medicines from licensed, registered pharmacies in Tier One countries, those that have standards of safety and efficacy that meet or exceed those of the United States.

It is interesting to note that earlier this year--at about the time that the White House was starting its outreach with industry reps, including PhRMA, that seizures by the FDA of vital medicines from Tier One countries picked up. The question must be asked, was this another part of the deal being cut with PhRMA? It is well-known that in addition, the other monster under the bed for PhRMA is importation of medicines at affordable prices. Interestingly, these are the same medicines that the industry ships into this country at prices 60 to 70 percent higher.

After a concerted effort,including appeals directly to the President by publishers of leading websites for seniors, and news releases about the seizures, they declined.

The continued concern about seizures was the reason that we hailed the successful legislative maneuvering of Senator David Vitter (R-LA) for an amendment restricting such seizures, a stance that reaffirmed the banning of such seizures by Congress in 2006. Still, even the Senator has said that he is not confident that the Amendment will stick in conference, perhaps reflecting the feeling that many share that the reach of pharma is such that it can have its way.

And therein lies the moral of the dilemma that the President faces. Will legislation affecting the price and availability of vital medicines be conducted in the bright sunlight of openness and opportunity for total and equal participation by all? Or will we be subjected to the special interests of groups such as PhRMA?

If it should be the latter, we would like to remind our elected policy-makers of the old tale that so amply illustrates the consequences of bad decisions...the fable of the snake and the little girl:

A young girl was trudging along a mountain path, trying to reach her grandmother's house. It was bitter cold, and the wind cut like a knife. When she was within sight of her destination, she heard a rustle at her feet.

Looking down, she saw a snake. Before she could move, the snake spoke to her. He said, "I am about to die. It is too cold for me up here, and I am freezing. There is no food in these mountains, and I am starving. Please put me under your coat and take me with you."

"No," replied the girl. "I know your kind. You are a rattlesnake. If I pick you up, you will bite me, and your bite is poisonous.”

"No, no," said the snake. "If you help me, you will be my best friend. I will treat you differently."

The little girl sat down on a rock for a moment to rest and think things over. She looked at the beautiful markings on the snake and had to admit that it was the most beautiful snake she had ever seen.

Suddenly, she said, "I believe you. I will save you. All living things deserve to be treated with kindness."

The little girl reached over, put the snake gently under her coat and proceeded toward her grandmother's house.

Within a moment, she felt a sharp pain in her side. The snake had bitten her.

"How could you do this to me?" she cried. "You promised that you would not bite me, and I trusted you!"

"You knew what I was when you picked me up," hissed the snake as he slithered away.

The moral of the fable is that things are not always as the seem. PhRMA has not shed its skin. Americans pay the highest prices for prescription medicine in the world. The industry's predatory pricing has contributed to the costs that now are the biggest obstacle to necessary healthcare reform, and the 'savings' of the brokered arrangement carry a heavy price...we can only hope that it will not be a snakebite that creates a climate of an industry group dictating to the Administration and Congress, thereby throwing into question the need for and benefits of healthcare reform.

What is pharma's motive, payback for its cooperation?

The plan negotiated between the Senate Finance Committee and PhRMA, the trade association for the pharmaceutical industry is becoming increasingly troublesome as the debate over healthcare reform continues to drag on and on.

Many people worried about the new-found spirit of cooperation by the pharmaceutical industry when it was a guest/participant with others in the medical/insurance and healthcare industry at The White House.

This was after all the industry that had benefited from the last-minute engineered by then-LA Congressman Billy Tauzin that excluded negotiations for Medicare Part D prescription medicines, gave us the legacy of The Doughnut Hole, and helped pharmaceutical companies gain windfall profits.

And, it was former Congressman Tauzin who became a poster boy for pharma payback when he was rewarded with the $2 million a year job as head of PhRMA.

During the election, candidate Obama supported price negotiation for Part D medicine prices, and personal importation of safe, affordable prescription medicines from licensed, registered pharmacies in Tier One countries. While in the Senate, he was even a co-sponsor of personal importation legislation and early in his administration provided budget support for importation.
Now, these positions seem to have been replaced with "outreach" to the drug companies, which have shown their appreciation by pledging to cooperate with health care reform, and even to reduce prescription drug prices for seniors in The Doughnut Hole by as much as $80 billion.

So sure of its position is PhRMA that during the President's meetings in Europe, with the Pope and then his African visit, that Tauzin boasted that at a meeting at The White House an unnamed aide had told him that importation might not be necessary since the industry was being so cooperative and that the other savings from the reforms might be so great as to make lower drug prices unnecessary.

In other words, even though pharma has imposed upon the American public the highest drug prices in the world, that's "OK" and it will be allowed to continue its predatory pricing rather than having to reduce prices.

It is a bold move by Tauzin to make statements about Administration policy. Our attempts to identify the source of the statement about no need for importation have elicited no reaction from The White House press office, even though we were promised two weeks ago that the inquiry had been directed to the proper people and that we would receive an answer. So much for transparency and open government.

We should have had an inkling of the possibility that an Obama administration might crumble on importation when, during the election, Dora Hughes, a medical advisor for the Obama campaign, said that the candidate, if elected, might be willing to change his position of support of importation.
At that time, we sought clarification from campaign spokespersons and were assured that candidate Obama's support of importation was as strong as ever.

Back to the present: policy-makers and many advocates continue to point to The Doughnut Hole offer by PhRMA as 'good' for seniors. But, there is confusion about details of the arrangement. And, as some have noted, by lowering prices for those in The Doughnut Hole, they will only be in many instances the same lower prices for a temporary time as the regular, everyday prices paid by citizens in other countries. Why shouldn't such prices be negotiated for all medicines.

The question must also be asked: Since there is a proven record of personal importation of safe, affordable medicines from licensed, registered pharmacies in Tier One Countries (those whose oversight and regulations of pharmaceutical medicines and pharmacies meet or even exceed those of the U.S, why shouldn't such personal importation be a part of public healthcare policy? Or has PhRMA, as indicated by Tauzin's statement after his White House meeting, negotiated restrictions on such importation, perhaps even seizures of vital medicines, which was banned by the U.S. Congress in 2006 and which has arisen more recently as Senator David Vitter (R-LA) successfully sponsored an amendment to ensure that U.S. customs is forbidden to engage in such seizures? Added to this, since the 'full price' as set by PhRMA will be credited towards satisfying The Doughnut Hole, it means that seniors who have been unable to purchase medicines while in the Hole will hopefully be able to continue their medications and will get out of The Doughnut Hole where they can has catastrophic coverage.

At that point, the medicines return to full price with the U.S. government paying 95 percent of full costs, generating a government-supported windfall for pharma. Is this what PhRMA negotiated with the U.S. Senate? And is this a part of the price we must pay for such 'cooperation?' In the next few postings, we show why this might only be the tip of the iceberg.

Seniors Website Publisher expresses 'dismay' at purported White House stance on medicine reimportation

Publisher of leading information website for America's seniors,caregivers, advocates, policy-makers says purported White House stance on prescription medicine importation needs to be rebuked

Jul 08, 2009 – St. Louis, MO—The publisher of www.TodaysSeniorsNetwork.com, a leading informational website on aging issues for America’s seniors, caregivers, advocates and policy-makers, has expressed his ‘dismay’ at the announcement by a pharmaceutical industry representative that the Obama Administration has said that access to safe, affordable medications from licensed, registered pharmacies in Tier One countries might not be necessary to reduce the cost of prescription medicines for Americans.

Daniel Hines
, publisher of www.TodaysSeniorsNetwork.com, was responding to a statement by Billy Tauzin, president of the Pharmaceutical Research and Manufacturers of America (PhRMA) after an industry meeting with White House Staff, Tauzin is a former Louisiana Congressman, most noted as the Congressman who made possible provisions in Medicare Part D that ensured windfall profits and locked-in markets for the pharmaceutical industry, free of price negotiation, and establishing the ‘Doughnut Hole’. Upon resigning from Congress, Tauzin was named to his current PhRMA position at a $2 million annual salary.

“Tauzin implies that the White House believes that claimed savings of $80 billion over 10 years ‘negotiated’ with the Senate Finance Committee to reduce the costs of drugs sold to seniors in the Doughnut Hole, and other hoped for savings from comprehensive healthcare reform will be so great as to make individual importation ‘unnecessary’ “ Hines observes. “This is a fantasy that the American public should reject.”

Hines notes that the claimed Part D savings come on the heels of windfall profits made possible by price increases by the pharmaceutical industry over the life of Part D that have been so great as to force untold numbers of America’s elderly to either split their medications, or even quit taking vital medicines.

“:Also, the Congressional Budget Office is expected to score the drug companies’ ‘deal’ as saving far less than the claimed $80 billion,” Hines notes. “And, one must question, what is the leverage of the pharmaceutical industry to ‘negotiate’ legislation from the U.S. Congress, elected by the American citizenry.”

He urged President Obama to reaffirm his stance during the election campaign of support for the inclusion of individual purchases of safe, affordable prescription medicines from Tier One countries (those that are recognized as having standards of safety and oversight of licensed, registered pharmacies in their countries that meet or exceed those of the U.S. FDA).

“This could greatly reduce individual costs, while, at the same time, keeping the pharmaceutical industry ‘in-line’ rather than giving it a free-hand to raise prices and control supplies as it wishes,” Hines says. “By directing the Secretary of Health and Human Services to enter into some form of reciprocal arrangements, it would be possible to designate Tier One countries and to identify licensed pharmacies in those countries from which U.S. citizens may purchase their medicines, all the while confident of the safety and efficacy of the medicines, as well as the standards of the pharmacy filling the prescriptions.

“At the same time, the Administration should take two steps to further lower prescription prices: (1) Allow the inclusion of lower-cost personally imported prescription medicines into Part D plans to further lower costs to plan enrollees, generating savings for the government, and (2) keep its election campaign pledge to negotiate with the pharmaceutical industry, rather than accepting a deal by the industry to lower prices on the conditions of enactment of provisions within any legislation that will actually further increase and guarantee their markets at the expense of the American public.”