1 00:00:05,680 --> 00:00:08,800 Speaker 1: Hello, and welcome to It could happen here today. It's 2 00:00:08,840 --> 00:00:11,080 Speaker 1: just me because it's early and I live on the 3 00:00:11,119 --> 00:00:16,960 Speaker 1: West Coast, and today we are talking about America's drug problem. 4 00:00:17,000 --> 00:00:21,439 Speaker 1: And I'm joined by David Mitchell from Patients for Affordable Drugs, 5 00:00:21,560 --> 00:00:23,880 Speaker 1: and we're going to talk about the cost of medicines, 6 00:00:24,280 --> 00:00:27,200 Speaker 1: why it's so astronomically high, why I sometimes go to 7 00:00:27,240 --> 00:00:29,840 Speaker 1: Mexico to buy my incident, and why you probably know 8 00:00:29,960 --> 00:00:33,279 Speaker 1: someone who can't afford the medicines they need to survive 9 00:00:33,560 --> 00:00:37,440 Speaker 1: or maybe thrive. So, David, can you explain a little 10 00:00:37,479 --> 00:00:39,839 Speaker 1: bit about first, if you'd like to introduce yourself and 11 00:00:39,880 --> 00:00:43,000 Speaker 1: explain what Patients for Affordable Drugs does and the role 12 00:00:43,040 --> 00:00:46,599 Speaker 1: that you play there, that would be wonderful. I am 13 00:00:46,720 --> 00:00:51,000 Speaker 1: the founder and president of Patients for Affordable Drugs. Were 14 00:00:51,000 --> 00:00:57,280 Speaker 1: the only national patient organization that focuses exclusively on policies 15 00:00:57,320 --> 00:01:01,360 Speaker 1: to lower drug prices. We're independent, bipartisan. We don't take 16 00:01:01,400 --> 00:01:06,040 Speaker 1: money from any organizations that profit from the development or 17 00:01:06,160 --> 00:01:12,440 Speaker 1: distribution of prescription drugs. We do two main things. We 18 00:01:13,080 --> 00:01:18,440 Speaker 1: uh collect patients stories and we amplify those stories to 19 00:01:18,560 --> 00:01:22,440 Speaker 1: policymakers and elected officials. So we can bring home the 20 00:01:22,520 --> 00:01:27,279 Speaker 1: human impact of ridiculously high drug prices on the people 21 00:01:27,520 --> 00:01:30,680 Speaker 1: in the United States. And the second thing is that 22 00:01:30,720 --> 00:01:37,240 Speaker 1: we recruit and train patients to be advocates. UH. We 23 00:01:37,640 --> 00:01:44,360 Speaker 1: teach them about the policies, give them coaching on presentation, UH, 24 00:01:44,360 --> 00:01:50,320 Speaker 1: and UH prepare them two go tell their story and 25 00:01:50,480 --> 00:01:54,840 Speaker 1: deal directly with the people who set policy in this country. 26 00:01:54,880 --> 00:02:00,240 Speaker 1: And so we've had patients testify in state legislatures all 27 00:02:00,240 --> 00:02:04,600 Speaker 1: over the country. We've had patients to testifying Congress on 28 00:02:04,640 --> 00:02:09,559 Speaker 1: many occasions. Just last week, one of our patients, who 29 00:02:09,840 --> 00:02:13,320 Speaker 1: happens to be a Type one diabetic, I introduced the 30 00:02:13,360 --> 00:02:16,400 Speaker 1: President of the United States in the Rose Garden in 31 00:02:16,440 --> 00:02:21,280 Speaker 1: a speech the President made talking about the New Inflation 32 00:02:21,320 --> 00:02:23,800 Speaker 1: Reduction Act and how it's going to help lower drug 33 00:02:23,840 --> 00:02:27,320 Speaker 1: prices and out of pocket costs for people. So that 34 00:02:27,320 --> 00:02:30,120 Speaker 1: that's our work. I do this work because I'm a patient. 35 00:02:30,960 --> 00:02:34,400 Speaker 1: I have an incurable blood cancer. It's called multiple my looma. 36 00:02:35,240 --> 00:02:39,919 Speaker 1: It's incurable. That's not good, but it's treatable for some 37 00:02:40,000 --> 00:02:44,240 Speaker 1: period of time with very expensive drugs. Right now, my 38 00:02:44,360 --> 00:02:50,040 Speaker 1: oncologists have me on a four drug combination that carries 39 00:02:50,080 --> 00:02:54,040 Speaker 1: a list price of more than nine hundred thousand dollars 40 00:02:54,080 --> 00:02:58,960 Speaker 1: a year. These drugs are literally keeping me alive, and 41 00:02:59,000 --> 00:03:03,040 Speaker 1: I'm very grateful to have them, but they're wildly overpriced 42 00:03:04,440 --> 00:03:12,200 Speaker 1: and the the drug industry. Drug companies exploit UH patients 43 00:03:12,200 --> 00:03:15,760 Speaker 1: everywhere in the world, but especially here in the United States. 44 00:03:16,240 --> 00:03:20,959 Speaker 1: They use us as a piggy bank to hit their 45 00:03:21,000 --> 00:03:25,640 Speaker 1: targets for executive bonuses, to trigger executive bonuses, and they 46 00:03:25,680 --> 00:03:32,120 Speaker 1: had profit targets for their shareholders. UH. And the unfairness 47 00:03:33,000 --> 00:03:38,360 Speaker 1: is not acceptable. Anyway, When I got diagnosed and suddenly 48 00:03:38,400 --> 00:03:42,840 Speaker 1: I found myself with a disease UH through no fault 49 00:03:42,880 --> 00:03:47,040 Speaker 1: of my own, they required very expensive drugs. I began 50 00:03:47,080 --> 00:03:50,720 Speaker 1: this journey, and the journey taught me a fundamental point, 51 00:03:51,200 --> 00:03:53,760 Speaker 1: and that is that drugs don't work if people can't 52 00:03:53,800 --> 00:03:59,280 Speaker 1: afford them. And so I retired and decided to devote 53 00:03:59,360 --> 00:04:07,280 Speaker 1: myself UH as a patient UH to trying to change 54 00:04:07,280 --> 00:04:10,360 Speaker 1: a system in this country. There really is built to 55 00:04:10,600 --> 00:04:13,400 Speaker 1: benefit the people who profit from it at the expense 56 00:04:13,480 --> 00:04:16,520 Speaker 1: of the people that's supposed to serve. And I worked 57 00:04:16,520 --> 00:04:18,640 Speaker 1: for free as a volunteer, and I've been doing it 58 00:04:18,680 --> 00:04:21,680 Speaker 1: for six years. That's great. Yeah, let's say, I'm sorry 59 00:04:21,720 --> 00:04:23,800 Speaker 1: to hear about your own wealth, but I think it's 60 00:04:23,839 --> 00:04:27,440 Speaker 1: a very admirable thing you've done. So, David, can you explain, 61 00:04:27,640 --> 00:04:31,239 Speaker 1: because it does I think people sometimes maybe if they've 62 00:04:31,240 --> 00:04:33,760 Speaker 1: only lived in the US, they might not realize, or 63 00:04:34,279 --> 00:04:39,279 Speaker 1: perhaps they're extremely aware. Why are medicines so? Why can 64 00:04:39,400 --> 00:04:43,880 Speaker 1: I travel sixteen miles right, go across the border, flash 65 00:04:43,920 --> 00:04:47,520 Speaker 1: my passport at someone, have a bunch of scans taken right, 66 00:04:47,520 --> 00:04:50,000 Speaker 1: go through a bunch of machines, and then buy medicines 67 00:04:50,080 --> 00:04:52,520 Speaker 1: for less than half the price on any given day. 68 00:04:52,520 --> 00:04:55,880 Speaker 1: Why Why is it like that? It's like that because 69 00:04:56,040 --> 00:05:00,080 Speaker 1: we are the only developed nation in the world that 70 00:05:00,200 --> 00:05:04,800 Speaker 1: lets drug companies dictate the prices a brand name drugs 71 00:05:05,800 --> 00:05:11,320 Speaker 1: to the to their citizens. Every other developed country in 72 00:05:11,320 --> 00:05:15,240 Speaker 1: the world negotiates on behalf of their citizens directly with 73 00:05:15,279 --> 00:05:18,920 Speaker 1: the drug companies to get a better deal. Uh, And 74 00:05:19,160 --> 00:05:23,920 Speaker 1: we don't do that. The net result is that Americans 75 00:05:23,960 --> 00:05:28,800 Speaker 1: are paying almost four times what other wealthy nations pay 76 00:05:28,839 --> 00:05:33,440 Speaker 1: for the exact same brand name drugs. And the impact 77 00:05:33,560 --> 00:05:37,720 Speaker 1: is that three out of ten Americans report that they 78 00:05:37,800 --> 00:05:43,000 Speaker 1: are not able to take their medications as directed because 79 00:05:43,160 --> 00:05:48,000 Speaker 1: of the cost. This has a direct impact on health. Uh. 80 00:05:49,120 --> 00:05:55,640 Speaker 1: And you know, I understand that you are the type 81 00:05:55,640 --> 00:05:58,480 Speaker 1: one and that you're insulin dependent, and so you know 82 00:05:59,200 --> 00:06:03,120 Speaker 1: this struggles and the high prices of insulin. But we've 83 00:06:03,240 --> 00:06:09,479 Speaker 1: had five people confirmed dead because they tried to ration 84 00:06:09,560 --> 00:06:14,880 Speaker 1: their insulin in the United States of America. This happens 85 00:06:15,279 --> 00:06:19,800 Speaker 1: because we grant the drug companies this incredible market power 86 00:06:20,520 --> 00:06:24,600 Speaker 1: and we let them dictate the prices to US, prices 87 00:06:24,720 --> 00:06:32,480 Speaker 1: that are completely unjustified. Uh. And patients suffer financially and 88 00:06:32,720 --> 00:06:39,119 Speaker 1: worse because of their health due to these high prices. Yeah, 89 00:06:39,200 --> 00:06:41,920 Speaker 1: I think it's it's heartbreaking this stuff, like, and I've 90 00:06:41,960 --> 00:06:44,680 Speaker 1: known people have died from from lack of access to insulin, 91 00:06:44,760 --> 00:06:48,560 Speaker 1: and it's it's just it's pretty horrific stuff. And can 92 00:06:48,640 --> 00:06:52,360 Speaker 1: you explain, because let's get into that lack of justification, right, 93 00:06:52,400 --> 00:06:55,760 Speaker 1: there's ways a drug. The things that make up the 94 00:06:55,760 --> 00:06:58,000 Speaker 1: cost of a drug would be the research and development 95 00:06:58,320 --> 00:07:03,760 Speaker 1: of the drug, the distribution of the drug, and the 96 00:07:03,839 --> 00:07:07,120 Speaker 1: marketing of the drug, and maybe something else I'm missing, 97 00:07:07,120 --> 00:07:10,720 Speaker 1: But can you explain, like, how do we arrive at 98 00:07:10,720 --> 00:07:13,720 Speaker 1: this insane price for insulin which was synthesized in a 99 00:07:13,800 --> 00:07:16,800 Speaker 1: lab more than a hundred years ago, Like what what 100 00:07:17,000 --> 00:07:19,280 Speaker 1: makes up that price structure and how much would it 101 00:07:19,280 --> 00:07:23,600 Speaker 1: actually cost to produce that insulin if we stripped away 102 00:07:23,600 --> 00:07:28,960 Speaker 1: some of those things. Well, you're asking a very intelligent 103 00:07:29,240 --> 00:07:34,440 Speaker 1: question about what should exist but doesn't, and that is 104 00:07:34,480 --> 00:07:38,440 Speaker 1: a framework to arrive at an appropriate price that will 105 00:07:38,480 --> 00:07:42,600 Speaker 1: provide a reasonable return to the drug maker and ensure 106 00:07:42,680 --> 00:07:45,400 Speaker 1: that drugs are affordable and accessible for the people who 107 00:07:45,440 --> 00:07:48,520 Speaker 1: need them. We don't have a system like that. The 108 00:07:48,600 --> 00:07:52,760 Speaker 1: drug companies charge as much as they think they can 109 00:07:52,760 --> 00:07:57,960 Speaker 1: get away with. Period. This was shown just last year 110 00:07:58,600 --> 00:08:01,880 Speaker 1: when one of the drug companies named Biogen tried to 111 00:08:01,880 --> 00:08:05,640 Speaker 1: bring a drug to market for Alzheimer's and proposed to 112 00:08:05,680 --> 00:08:08,960 Speaker 1: sell it at fifty six thousand dollars, even though there 113 00:08:09,040 --> 00:08:11,560 Speaker 1: was no proof it worked. And after it got big 114 00:08:11,560 --> 00:08:15,240 Speaker 1: pushback and no one wanted to pay for it, the government, 115 00:08:15,480 --> 00:08:20,520 Speaker 1: private employers, uh, they cut the price to twenty eight 116 00:08:20,600 --> 00:08:24,800 Speaker 1: thousand dollars. Now was it worth fifty six thousand. If 117 00:08:24,800 --> 00:08:27,560 Speaker 1: it wasn't, then why didn't you just price it at 118 00:08:27,560 --> 00:08:30,480 Speaker 1: twenty eight thousand to begin with? Why? Because they thought 119 00:08:30,520 --> 00:08:34,440 Speaker 1: they could get away with fifty six thousand dollars a 120 00:08:34,559 --> 00:08:38,640 Speaker 1: year for this draw now where insulin is concerned, it's 121 00:08:38,760 --> 00:08:43,720 Speaker 1: very unfortunate. There is an insulin cartel. Three companies control 122 00:08:45,320 --> 00:08:50,600 Speaker 1: of the global insulin market in the world and here 123 00:08:50,640 --> 00:08:55,440 Speaker 1: in the United States as well. And it's some people 124 00:08:55,480 --> 00:08:59,000 Speaker 1: would say, correctly, you know, you have to call it 125 00:08:59,040 --> 00:09:03,280 Speaker 1: correctly an alaga belie a small number of producers and 126 00:09:03,360 --> 00:09:09,040 Speaker 1: sellers who are controlling the market. Uh. At what happens 127 00:09:09,080 --> 00:09:15,400 Speaker 1: as a result of that problem. Well, insulin costs roughly 128 00:09:15,480 --> 00:09:19,160 Speaker 1: ten dollars of vile to produce. It sells for more 129 00:09:19,200 --> 00:09:22,600 Speaker 1: than three hundred dollars of ivisle. It has gone up 130 00:09:22,600 --> 00:09:27,400 Speaker 1: in price more than six in the last twenty years 131 00:09:27,400 --> 00:09:33,720 Speaker 1: because of this cartel that literally controls the insulin supply 132 00:09:34,640 --> 00:09:38,440 Speaker 1: in the world. I'll give you another example. I take 133 00:09:38,480 --> 00:09:43,520 Speaker 1: a drug. It's called for my cancer. It's called palmer List. 134 00:09:43,600 --> 00:09:47,839 Speaker 1: It's an oral drug that I get under Medicare Part D. 135 00:09:49,480 --> 00:09:53,160 Speaker 1: Palmerlus costs less than one dollar per capsule to make. 136 00:09:53,760 --> 00:09:59,520 Speaker 1: It sells for almost one thousand dollars per capsule. Christ 137 00:10:00,240 --> 00:10:04,120 Speaker 1: you cannot justify. You cannot tell me that there's justification 138 00:10:04,240 --> 00:10:11,040 Speaker 1: for a thousand percent margin. It's just ridiculous. But because 139 00:10:11,120 --> 00:10:14,920 Speaker 1: we do not use our power, our market power to 140 00:10:15,080 --> 00:10:19,439 Speaker 1: negotiate for a better deal. Um, they can get away 141 00:10:19,480 --> 00:10:22,240 Speaker 1: with it, and they do. And there there are many 142 00:10:22,280 --> 00:10:25,360 Speaker 1: examples of this. Now all of that is about to 143 00:10:25,440 --> 00:10:29,720 Speaker 1: change with some new legislation that has been enacted into law. 144 00:10:30,440 --> 00:10:34,040 Speaker 1: It's about to start to change. I should be more precise. 145 00:10:34,880 --> 00:10:39,000 Speaker 1: Um uh, And we can talk about that. Yeah, let's 146 00:10:39,000 --> 00:10:42,040 Speaker 1: talk about that. One thing I want to get into first, 147 00:10:42,120 --> 00:10:45,240 Speaker 1: I think is this. I think sometimes we have this impression, 148 00:10:45,280 --> 00:10:49,520 Speaker 1: certainly with new and novel compounds, that there's this massive 149 00:10:49,600 --> 00:10:53,080 Speaker 1: lab and it's entirely funded by the money that's made 150 00:10:53,080 --> 00:10:55,520 Speaker 1: from selling other drugs, and in that lab people are 151 00:10:55,520 --> 00:10:58,040 Speaker 1: just all day cooking up curious to the MOOTI virus 152 00:10:58,240 --> 00:11:02,440 Speaker 1: or these various very deadly conditions. And so I wanted 153 00:11:02,480 --> 00:11:05,960 Speaker 1: to explain. I wanted you to explain who pays for 154 00:11:06,040 --> 00:11:08,800 Speaker 1: the R and D for the most part, and who 155 00:11:08,840 --> 00:11:11,640 Speaker 1: decides what that R and D focuses on, because I 156 00:11:11,679 --> 00:11:17,120 Speaker 1: think those are both very important topics. Yeah. Well, it 157 00:11:17,240 --> 00:11:20,440 Speaker 1: turns out that every single drug approved by the FDA 158 00:11:20,559 --> 00:11:25,360 Speaker 1: from two thousand ten to two thousand nineteen was everyone 159 00:11:25,720 --> 00:11:29,360 Speaker 1: was based on in some part on science paid for 160 00:11:29,480 --> 00:11:35,960 Speaker 1: by taxpayers through the National Institutes of Health, another organization 161 00:11:36,040 --> 00:11:39,280 Speaker 1: and the government called BARTER, and another organization in the 162 00:11:39,360 --> 00:11:44,160 Speaker 1: government called DARPA. DARPA's who invented the Internet, for example, 163 00:11:44,880 --> 00:11:54,360 Speaker 1: and GPS. UM. UH, we pay taxpayers billions of dollars 164 00:11:54,400 --> 00:11:59,640 Speaker 1: every year to finance basic scientific research that lays the 165 00:11:59,679 --> 00:12:03,160 Speaker 1: found anation for all these drugs. And when a drug 166 00:12:03,240 --> 00:12:10,360 Speaker 1: company sees the drug that has promised UH, it will 167 00:12:11,120 --> 00:12:14,720 Speaker 1: try and acquire from the NIH or the other government 168 00:12:14,840 --> 00:12:18,480 Speaker 1: agencies that do this work fund this work UH the 169 00:12:18,559 --> 00:12:24,040 Speaker 1: intellectual property UH, and then they'll finish the job of 170 00:12:25,360 --> 00:12:30,920 Speaker 1: running UM late stage clinical trials and going through the 171 00:12:30,960 --> 00:12:38,079 Speaker 1: process of gaining FDA approval. I'm gonna say a couple 172 00:12:38,120 --> 00:12:43,120 Speaker 1: of things here that are critically important to understand. To 173 00:12:43,200 --> 00:12:49,520 Speaker 1: try and illustrate this, the drug industry TIES tries to 174 00:12:49,559 --> 00:12:52,560 Speaker 1: take credit for the m r NA vaccines that were 175 00:12:52,559 --> 00:12:57,520 Speaker 1: developed to fight COVID nineteen and these are the vaccines 176 00:12:57,600 --> 00:13:01,800 Speaker 1: that are marketed by Visor and its partner in Europe, 177 00:13:01,800 --> 00:13:08,120 Speaker 1: by on Tech, and by Moderna here in the United States. UM. 178 00:13:08,160 --> 00:13:12,080 Speaker 1: It turns out that in the eighties, nineties, and early 179 00:13:12,160 --> 00:13:17,319 Speaker 1: two thousand's drug companies weren't investing in vaccines because it 180 00:13:17,400 --> 00:13:20,840 Speaker 1: didn't produce They didn't produce a big return, so the 181 00:13:20,840 --> 00:13:24,800 Speaker 1: federal government invested through a ni H dar Ambarda. All 182 00:13:24,840 --> 00:13:30,200 Speaker 1: of them two developed the technology that we now call 183 00:13:30,840 --> 00:13:34,560 Speaker 1: m r n A so that when the virus hit, 184 00:13:35,360 --> 00:13:39,800 Speaker 1: that technology was ready for MODERNA and Visor to run with. 185 00:13:40,400 --> 00:13:44,720 Speaker 1: But they didn't make the big investment. We did, we 186 00:13:44,880 --> 00:13:51,480 Speaker 1: being taxpayers, to get that technology ready to go. And 187 00:13:51,520 --> 00:13:54,840 Speaker 1: in the case of MODERNA, we paid for everything. And 188 00:13:54,880 --> 00:13:58,280 Speaker 1: I'm not exaggerating. They had never produced a drug, so 189 00:13:58,320 --> 00:14:02,640 Speaker 1: we stood up manufacturing capacity for them, We paid for 190 00:14:02,679 --> 00:14:06,560 Speaker 1: their late stage clinical trials, and we signed advanced purchase 191 00:14:06,600 --> 00:14:11,040 Speaker 1: agreements to completely de risk the enterprise. But they will 192 00:14:11,040 --> 00:14:14,240 Speaker 1: tell you that they saved us, It's not true. We 193 00:14:14,360 --> 00:14:22,680 Speaker 1: saved ourselves. There's a reason that the president, who cares 194 00:14:22,720 --> 00:14:26,600 Speaker 1: deeply about trying to reduce the death toll from cancer, 195 00:14:27,520 --> 00:14:33,440 Speaker 1: has to have this new organization called h which is 196 00:14:33,440 --> 00:14:35,840 Speaker 1: going to be funded with billions of dollars to try 197 00:14:35,840 --> 00:14:42,720 Speaker 1: and do something to accelerate cancer research. Why, DoD, Why 198 00:14:42,720 --> 00:14:44,720 Speaker 1: do we have to pay for that? Because the drug 199 00:14:44,800 --> 00:14:49,240 Speaker 1: companies will not pay for the high risk, early stage 200 00:14:50,720 --> 00:14:57,760 Speaker 1: research that goes into getting really breakthrough new drugs to market. 201 00:14:58,520 --> 00:15:03,840 Speaker 1: So who who does this? Who pays for it? By 202 00:15:03,840 --> 00:15:09,080 Speaker 1: and large, taxpayers are underpinning all the basic science. Drug 203 00:15:09,120 --> 00:15:13,520 Speaker 1: companies are taking drugs that show promise, acquiring the intellectual property, 204 00:15:14,240 --> 00:15:19,200 Speaker 1: and then charging whatever they want for the drugs. Um. 205 00:15:19,280 --> 00:15:23,280 Speaker 1: So that's our system in the United States of America. 206 00:15:23,400 --> 00:15:27,760 Speaker 1: It's completely screwed up. Uh. We need to have a 207 00:15:27,800 --> 00:15:33,880 Speaker 1: process more like what you described imposing this question, which is, well, 208 00:15:34,280 --> 00:15:37,560 Speaker 1: shouldn't we look at what the government invested, what the 209 00:15:37,600 --> 00:15:43,400 Speaker 1: company invested? Uh? You know what would be what does 210 00:15:43,400 --> 00:15:46,240 Speaker 1: it cost to manufactured the drug and distribute the drug 211 00:15:46,720 --> 00:15:48,800 Speaker 1: and all of that, and then arrive at a price 212 00:15:49,280 --> 00:15:53,680 Speaker 1: that provides a fair return uh for investment in risk 213 00:15:53,760 --> 00:15:56,880 Speaker 1: to the drug company, but not any price they want 214 00:15:56,920 --> 00:16:00,200 Speaker 1: to dictate. That's what we have not is they get 215 00:16:00,200 --> 00:16:03,120 Speaker 1: the drug from us and they get to dictate the press. 216 00:16:03,680 --> 00:16:10,440 Speaker 1: We don't have a system like the one you referenced. Yeah, 217 00:16:10,600 --> 00:16:13,120 Speaker 1: and it's it's much to a detriment, right, And I 218 00:16:13,240 --> 00:16:15,280 Speaker 1: was that It's interesting you talked about how like this 219 00:16:15,320 --> 00:16:17,960 Speaker 1: profit driven model tends to focus on certain conditions and 220 00:16:18,040 --> 00:16:21,000 Speaker 1: not others. And I know that you focus mainly on 221 00:16:21,040 --> 00:16:23,040 Speaker 1: the United States. But perhaps we could get into a 222 00:16:23,080 --> 00:16:26,360 Speaker 1: little bit what that means for neglected diseases on a 223 00:16:26,400 --> 00:16:30,600 Speaker 1: global scale. Right, how looking at only patients who can 224 00:16:30,640 --> 00:16:34,000 Speaker 1: afford to pay these inflated prices means that we're drug 225 00:16:34,080 --> 00:16:37,840 Speaker 1: companies are sort of tacitly saying, well, we're okay with 226 00:16:37,880 --> 00:16:40,640 Speaker 1: people dying from conditions that people don't get in America. 227 00:16:41,800 --> 00:16:44,240 Speaker 1: Are you comfortable talking about that a little bit? Well, 228 00:16:44,280 --> 00:16:48,400 Speaker 1: we only work in the United States because that is 229 00:16:48,440 --> 00:16:53,440 Speaker 1: a big enough challenge for us. I will say that 230 00:16:55,160 --> 00:16:58,800 Speaker 1: drug companies want to invest only in drugs that produce 231 00:16:58,960 --> 00:17:04,040 Speaker 1: a big a turn their profit maximizers their corporations, and 232 00:17:04,680 --> 00:17:07,200 Speaker 1: we don't have a way that we balance that out 233 00:17:07,359 --> 00:17:11,800 Speaker 1: where we say yes, but but, but but taxpayers are 234 00:17:11,880 --> 00:17:15,920 Speaker 1: are doing the foundational research that leads to these drugs, 235 00:17:16,000 --> 00:17:20,480 Speaker 1: and and these are in that sense public goods, and 236 00:17:20,640 --> 00:17:22,600 Speaker 1: we need to figure out how, yeah, you can have 237 00:17:22,640 --> 00:17:25,080 Speaker 1: a fair return, but we also make sure that they're 238 00:17:25,119 --> 00:17:30,960 Speaker 1: priced to maximize affordability and accessibility. And in this plays 239 00:17:31,000 --> 00:17:34,840 Speaker 1: out of overseas with neglected tropical diseases which you reference, 240 00:17:35,440 --> 00:17:40,199 Speaker 1: which you know, drug companies don't want to spend a 241 00:17:40,240 --> 00:17:42,879 Speaker 1: lot of money on because those countries don't have a 242 00:17:42,880 --> 00:17:45,560 Speaker 1: lot of money to pay for them. Because all the 243 00:17:45,640 --> 00:17:48,960 Speaker 1: companies care about is honest to god, you know, they 244 00:17:49,000 --> 00:17:51,960 Speaker 1: they want us to believe that they're all about looking 245 00:17:52,040 --> 00:17:56,640 Speaker 1: after our well being. They are corporations, and corporations by 246 00:17:56,720 --> 00:18:01,080 Speaker 1: law have to maximize profits for their shareholders shareholders, and 247 00:18:01,119 --> 00:18:05,320 Speaker 1: that's what they do. Um. You know who invests in 248 00:18:05,920 --> 00:18:11,359 Speaker 1: neglected tropical diseases, The Gates Foundation and other foundations that 249 00:18:13,080 --> 00:18:17,879 Speaker 1: put the money out to do that early stage research 250 00:18:18,320 --> 00:18:24,320 Speaker 1: that changes the pricing equation. Should should change the pricing equation, um, 251 00:18:24,400 --> 00:18:29,320 Speaker 1: so that we can still develop the drugs that people 252 00:18:29,400 --> 00:18:35,960 Speaker 1: abroad would benefit from tremendously. Uh if if only we 253 00:18:36,200 --> 00:18:39,560 Speaker 1: made the effort and made the investment, which they're not 254 00:18:39,640 --> 00:18:44,440 Speaker 1: inclined to do. You then answer your question yes, very well, 255 00:18:44,520 --> 00:18:46,600 Speaker 1: very well. I think people are like looking for evidence 256 00:18:46,600 --> 00:18:48,160 Speaker 1: on this. They could look at the speed at which 257 00:18:48,200 --> 00:18:51,840 Speaker 1: we started to develop a bola treatments of vaccines once 258 00:18:51,880 --> 00:18:54,000 Speaker 1: that became a threat to us versus once it became 259 00:18:54,040 --> 00:18:57,720 Speaker 1: a threat to people in the global periphery. By the way, 260 00:18:57,760 --> 00:19:00,159 Speaker 1: I will say one more thing, Yeah, of course not 261 00:19:00,320 --> 00:19:05,240 Speaker 1: the drug companies only hurt people in poorer countries in 262 00:19:05,280 --> 00:19:11,160 Speaker 1: the world. It is that drug companies insist on high 263 00:19:11,200 --> 00:19:18,520 Speaker 1: prices everywhere. And for example, UM, the disease system fibrosis 264 00:19:19,200 --> 00:19:24,119 Speaker 1: is incurable, and UM there are new drugs that help 265 00:19:24,200 --> 00:19:31,000 Speaker 1: people live longer UH. They are marketed by Vertex. Interestingly, 266 00:19:31,960 --> 00:19:36,399 Speaker 1: the gene that all of these UH drugs are built on, 267 00:19:37,880 --> 00:19:42,000 Speaker 1: the genetic component, was identified by the former head of 268 00:19:42,040 --> 00:19:45,240 Speaker 1: the ni H, Francis Collins, when he was doing research 269 00:19:45,280 --> 00:19:48,920 Speaker 1: paid for by the NIH at the University of Michigan. 270 00:19:50,200 --> 00:19:54,800 Speaker 1: His his discoveries were seminal UH, but still the drug 271 00:19:54,840 --> 00:19:59,840 Speaker 1: companies wouldn't invest. So the Systic Fibrosis Foundation raised money 272 00:20:00,200 --> 00:20:04,679 Speaker 1: from its community to do more early stage research, and 273 00:20:04,760 --> 00:20:09,520 Speaker 1: when it showed promise, Vertex bought the intellectual property from 274 00:20:09,560 --> 00:20:14,840 Speaker 1: them UH and UH brought these drugs that are built 275 00:20:14,840 --> 00:20:19,520 Speaker 1: on that genetic discovery to market. But in countries that 276 00:20:19,560 --> 00:20:23,080 Speaker 1: have said, we can't afford the price you're demanding because 277 00:20:23,160 --> 00:20:25,200 Speaker 1: we only have so much money to pay for our 278 00:20:25,240 --> 00:20:28,560 Speaker 1: citizens for healthcare. Because we provide health care to all 279 00:20:28,560 --> 00:20:34,240 Speaker 1: our citizens, Vertex will let people kids because it generally 280 00:20:34,240 --> 00:20:39,080 Speaker 1: affects kids and younger adults, will let them die if 281 00:20:39,080 --> 00:20:42,040 Speaker 1: the company if the countries won't agree to the price 282 00:20:42,640 --> 00:20:47,360 Speaker 1: that they are insisting on, literally let them die and say, look, 283 00:20:47,440 --> 00:20:49,000 Speaker 1: you know, if you won't strike a deal that has 284 00:20:49,080 --> 00:20:50,960 Speaker 1: high and the price for us, we're not going to 285 00:20:51,040 --> 00:20:54,119 Speaker 1: sell the drug in your in your country. So it 286 00:20:54,320 --> 00:20:58,960 Speaker 1: isn't only the poor people, uh, you know, the poorer 287 00:20:59,000 --> 00:21:04,159 Speaker 1: countries around world. It's patients who are stuck with a 288 00:21:04,280 --> 00:21:08,080 Speaker 1: drug disease that requires a high class drug and maybe 289 00:21:08,119 --> 00:21:11,680 Speaker 1: they can't get access to it because it's not affordable 290 00:21:12,000 --> 00:21:17,920 Speaker 1: for their country or them. Yeah, it's it's pretty pretty 291 00:21:18,320 --> 00:21:31,080 Speaker 1: bleak stuff in that sense. Let's get onto a little 292 00:21:31,080 --> 00:21:33,960 Speaker 1: bit then, of how we can make this better. And 293 00:21:34,000 --> 00:21:37,560 Speaker 1: I know that there are approaches that are incremental and 294 00:21:37,600 --> 00:21:41,120 Speaker 1: their approaches that are more revolutionary or sort of making 295 00:21:41,160 --> 00:21:43,680 Speaker 1: these big leaps. So let's let's start with talking about 296 00:21:43,760 --> 00:21:47,600 Speaker 1: how this legislation that we've just seen, the Inflation Reduction Act, 297 00:21:47,720 --> 00:21:49,520 Speaker 1: does that make a difference. How much of a difference 298 00:21:49,520 --> 00:21:51,520 Speaker 1: does it make, and how does it make that difference. 299 00:21:52,880 --> 00:21:56,280 Speaker 1: The Inflation Reduction Act is really historic legislation that is 300 00:21:56,320 --> 00:21:59,720 Speaker 1: going to save millions of people in America millions of 301 00:21:59,760 --> 00:22:06,160 Speaker 1: dollars over time. It does for big things it does 302 00:22:06,240 --> 00:22:11,200 Speaker 1: many Moore, but for big things. One, for the first 303 00:22:11,200 --> 00:22:13,920 Speaker 1: time ever, Medicare is going to be able to use 304 00:22:14,040 --> 00:22:18,600 Speaker 1: it's it's purchasing power as the largest purchaser of drugs 305 00:22:18,600 --> 00:22:23,800 Speaker 1: in this country to UH negotiate lower prices for people 306 00:22:23,800 --> 00:22:28,720 Speaker 1: on Medicare. For the first time ever, we are going 307 00:22:28,800 --> 00:22:37,400 Speaker 1: to curb price gouging by forcing companies that raise prices 308 00:22:37,520 --> 00:22:40,280 Speaker 1: faster than the rate of inflation to pay a rebate 309 00:22:41,200 --> 00:22:45,040 Speaker 1: UH to Medicare. We're gonna that will curb their their 310 00:22:45,119 --> 00:22:51,760 Speaker 1: price increases. H Third, we are going to limit the 311 00:22:51,840 --> 00:22:56,120 Speaker 1: amount of out of pocket annually a Medicare patient can 312 00:22:56,240 --> 00:23:00,520 Speaker 1: pay under the Medicare Party prescription drug down fit. Right now, 313 00:23:00,600 --> 00:23:03,120 Speaker 1: there is no annual out of pocket limit I pay 314 00:23:03,200 --> 00:23:05,800 Speaker 1: for that drug I described to you before the costs 315 00:23:05,840 --> 00:23:09,320 Speaker 1: of almost a thousand dollars of capsule, I pay out 316 00:23:09,320 --> 00:23:14,400 Speaker 1: of pocket more than sixteen thousand dollars a year. There 317 00:23:14,400 --> 00:23:18,680 Speaker 1: will be a limit of two thousand dollars. No Medicare 318 00:23:18,720 --> 00:23:21,199 Speaker 1: beneficiary will pay more than two thousand dollars out of 319 00:23:21,200 --> 00:23:28,440 Speaker 1: pocket for Medicare Party drugs. And four for the first time, 320 00:23:28,640 --> 00:23:33,080 Speaker 1: starting next year, people who depend on insulin in Medicare 321 00:23:33,520 --> 00:23:36,119 Speaker 1: will pay no more than thirty five dollars per prescription 322 00:23:36,160 --> 00:23:42,760 Speaker 1: per month for their insulin um. These are all truly 323 00:23:43,000 --> 00:23:51,160 Speaker 1: significant changes UH and begin to shift UH drug policy 324 00:23:52,080 --> 00:24:01,280 Speaker 1: UH in this country, begin to uh break the dictatorial 325 00:24:01,480 --> 00:24:06,479 Speaker 1: pricing ability that the drugs drug companies have. And I 326 00:24:06,520 --> 00:24:09,440 Speaker 1: wanted to take a minute to explain why Medicare negotiation 327 00:24:09,960 --> 00:24:13,720 Speaker 1: in itself is such a big breakthrough very quickly, when 328 00:24:13,720 --> 00:24:16,720 Speaker 1: the Medicare prescription drug Benefit was enacted into law in 329 00:24:16,800 --> 00:24:21,240 Speaker 1: two thousand three, the drug companies, in the dark of 330 00:24:21,359 --> 00:24:26,280 Speaker 1: night got stuck into that law something called the non 331 00:24:26,320 --> 00:24:30,080 Speaker 1: interference clause that said that the Secretary of Health and 332 00:24:30,160 --> 00:24:34,080 Speaker 1: Human Services could not negotiate directly with drug companies period. 333 00:24:34,680 --> 00:24:36,959 Speaker 1: It got stuck in in the dark of night by 334 00:24:37,000 --> 00:24:39,840 Speaker 1: a man named Billy Tausend, who was then share of 335 00:24:39,880 --> 00:24:44,000 Speaker 1: the Energy and Commerce Committee in the US House of Representatives. 336 00:24:44,080 --> 00:24:48,439 Speaker 1: And within months after doing that at the behest of 337 00:24:48,480 --> 00:24:51,120 Speaker 1: the big drug companies, he went to work to run 338 00:24:51,600 --> 00:24:55,080 Speaker 1: the big trade association for the drug companies it's called Pharma, 339 00:24:55,520 --> 00:25:00,320 Speaker 1: at a salary of two million dollars a year. Another words, 340 00:25:00,480 --> 00:25:04,560 Speaker 1: they bought the prohibition on Medicare being able to negotiate, 341 00:25:04,840 --> 00:25:08,439 Speaker 1: and they have spent hundreds of millions of dollars to 342 00:25:09,000 --> 00:25:14,320 Speaker 1: keep that prohibition in place ever since then, just in 343 00:25:14,359 --> 00:25:19,080 Speaker 1: the last two years, in fighting to not let Medicare 344 00:25:19,119 --> 00:25:23,080 Speaker 1: negotiate over any drugs ever directly with the drug companies, 345 00:25:23,119 --> 00:25:26,919 Speaker 1: they spent uh north of two hundred million dollars to 346 00:25:27,000 --> 00:25:32,120 Speaker 1: try and stop that legislation from passing. UM. So these 347 00:25:32,160 --> 00:25:37,800 Speaker 1: are all big, significant, important changes, they are not enough. 348 00:25:38,800 --> 00:25:42,240 Speaker 1: Uh if if if we wrote the world, we would 349 00:25:42,240 --> 00:25:48,919 Speaker 1: have written legislation that negotiated over more drugs and the 350 00:25:49,000 --> 00:25:52,480 Speaker 1: pricing for which extended into the private sector and to 351 00:25:52,600 --> 00:25:58,240 Speaker 1: people without insurance. But we had to do that. To 352 00:25:58,359 --> 00:26:01,520 Speaker 1: extend it to the private sector and people without insurance, 353 00:26:01,880 --> 00:26:05,119 Speaker 1: we needed sixty votes in the Senate because of the 354 00:26:05,119 --> 00:26:09,680 Speaker 1: filibuster rules, and we couldn't get one, not one Republican vote, 355 00:26:10,520 --> 00:26:13,320 Speaker 1: So it had to be passed under a special procedure 356 00:26:13,359 --> 00:26:17,439 Speaker 1: called reconciliation. The Democrats used it. They stood up the 357 00:26:17,480 --> 00:26:21,160 Speaker 1: pharmah and they passed the bill. God bless him. Uh 358 00:26:22,040 --> 00:26:26,760 Speaker 1: We in the course of it had um a vote 359 00:26:27,320 --> 00:26:31,200 Speaker 1: trying to extend the thirty five dollar insulin monthly co 360 00:26:31,400 --> 00:26:34,240 Speaker 1: paid to the private sector. We could only get seven 361 00:26:34,320 --> 00:26:39,160 Speaker 1: Republican votes um and so we couldn't take it all 362 00:26:39,200 --> 00:26:41,680 Speaker 1: the way there. So there's much more work to do, 363 00:26:41,920 --> 00:26:47,479 Speaker 1: but this breakthrough is truly historic. Yeah, it's good. It's 364 00:26:47,760 --> 00:26:50,160 Speaker 1: it's good to see some progress because there hasn't been 365 00:26:50,200 --> 00:26:53,359 Speaker 1: progressed for a very long time. Let's talk about the 366 00:26:53,400 --> 00:26:55,679 Speaker 1: difference in between a cost and a cope because I 367 00:26:55,680 --> 00:26:59,840 Speaker 1: think it's easy for politicians sometimes you know, tweet and 368 00:27:00,000 --> 00:27:02,159 Speaker 1: to them will cost you x, and in fact it 369 00:27:02,240 --> 00:27:07,560 Speaker 1: only costs you x if y and is that are true? 370 00:27:08,440 --> 00:27:10,400 Speaker 1: So can you explain for folks what a co pay 371 00:27:10,560 --> 00:27:12,680 Speaker 1: is and why sometimes these claims are made about co 372 00:27:12,800 --> 00:27:15,679 Speaker 1: patients as are not the same as costs. Well, the 373 00:27:15,920 --> 00:27:22,440 Speaker 1: big difference is the word price versus cost. In our system, 374 00:27:22,520 --> 00:27:26,520 Speaker 1: we in order to lower out of pocket costs for people, 375 00:27:27,040 --> 00:27:32,439 Speaker 1: we have to lower price. Why if you we're paying 376 00:27:32,480 --> 00:27:36,000 Speaker 1: a hundred dollars out of pocket for your medicine and 377 00:27:36,200 --> 00:27:41,080 Speaker 1: we zero that out to nothing, but we don't lower 378 00:27:41,119 --> 00:27:44,679 Speaker 1: the price. The overall price that hundred dollars has to 379 00:27:44,720 --> 00:27:47,760 Speaker 1: be paid for it by someone, And what happens is 380 00:27:48,440 --> 00:27:55,280 Speaker 1: patients wind up paying higher premiums or higher taxes or 381 00:27:55,520 --> 00:27:58,600 Speaker 1: getting less money in their paychecks. You know, half of 382 00:27:58,680 --> 00:28:01,920 Speaker 1: more than half of all Americans get their drug coverage 383 00:28:02,080 --> 00:28:05,760 Speaker 1: and healthcare through their employers. So if that hundred dollars 384 00:28:05,840 --> 00:28:10,840 Speaker 1: still has to be paid by somebody, then we wind 385 00:28:10,920 --> 00:28:14,480 Speaker 1: up paying for it either with higher premiums, higher taxes, 386 00:28:15,000 --> 00:28:18,280 Speaker 1: or getting less money in our paycheck because someone needs 387 00:28:18,320 --> 00:28:22,080 Speaker 1: to absorb that hundred bucks. This is very important for 388 00:28:22,119 --> 00:28:26,240 Speaker 1: people to understand. There's no free lunch unless we lower prices. 389 00:28:27,040 --> 00:28:30,880 Speaker 1: That's why pharma will always say, the big drug companies 390 00:28:30,920 --> 00:28:33,239 Speaker 1: will always say, well, what we need to do is 391 00:28:33,520 --> 00:28:35,639 Speaker 1: we just need to lower everybody's out of pocket make 392 00:28:35,720 --> 00:28:37,560 Speaker 1: it zero and let them have all the drugs they 393 00:28:37,600 --> 00:28:41,560 Speaker 1: want and let us continue to charge any price we want. 394 00:28:42,040 --> 00:28:45,400 Speaker 1: But that's not there's there's no free lunch. It would 395 00:28:45,400 --> 00:28:49,960 Speaker 1: still have to be paid and UM so we fight 396 00:28:50,240 --> 00:28:54,160 Speaker 1: very hard at pages for affordable drugs to help patients 397 00:28:54,320 --> 00:28:59,400 Speaker 1: and policymakers understand that we need to do both. We 398 00:28:59,480 --> 00:29:02,320 Speaker 1: need to or out of pocket costs for people and 399 00:29:02,600 --> 00:29:04,960 Speaker 1: we need to lower the price in order to do that. 400 00:29:05,280 --> 00:29:08,280 Speaker 1: Co payments. Co payments are what you pay when you 401 00:29:08,360 --> 00:29:13,720 Speaker 1: go to UM the pharmacy counter and they tell you 402 00:29:13,760 --> 00:29:19,040 Speaker 1: that your share of this prescription is five dollars or 403 00:29:19,040 --> 00:29:24,920 Speaker 1: ten dollars or twenty dollars. And lots of times employers 404 00:29:25,720 --> 00:29:29,760 Speaker 1: and the insurance companies they hire to run their programs 405 00:29:30,440 --> 00:29:32,840 Speaker 1: will use co payments to try and steer you to 406 00:29:33,720 --> 00:29:37,520 Speaker 1: a less expensive drug at generic. Right, So if you 407 00:29:37,560 --> 00:29:39,640 Speaker 1: want a brand, you're gonna have to pay fifty bucks, 408 00:29:39,960 --> 00:29:42,720 Speaker 1: but if you'll take the generic, you pay five bucks. 409 00:29:43,040 --> 00:29:47,720 Speaker 1: For example, they're trying to steer YouTube and equally effective drug. 410 00:29:47,800 --> 00:29:51,920 Speaker 1: Generics are by definition the same exact drug, and they 411 00:29:51,920 --> 00:29:54,200 Speaker 1: are trying to steer you to the less expensive but 412 00:29:54,320 --> 00:29:58,800 Speaker 1: equally effective drug. The problem with our country big time 413 00:29:59,360 --> 00:30:01,920 Speaker 1: is that some times they are not used for that purpose. 414 00:30:03,400 --> 00:30:07,280 Speaker 1: In my case, I have co payments on all my drugs, right, 415 00:30:07,920 --> 00:30:10,000 Speaker 1: but I don't have a choice. I don't have a 416 00:30:10,080 --> 00:30:13,400 Speaker 1: cheaper chair. I gotta I gotta take the drugs they're 417 00:30:13,400 --> 00:30:19,280 Speaker 1: telling me to take. Um. And so when we misuse 418 00:30:19,440 --> 00:30:23,840 Speaker 1: co payments like that, we are hurting patients. Uh, And 419 00:30:23,920 --> 00:30:27,120 Speaker 1: it's how we also need to change. It points to 420 00:30:27,520 --> 00:30:30,840 Speaker 1: how we also need to change our benefit design in 421 00:30:30,880 --> 00:30:35,160 Speaker 1: this country. If if we can steer a patient to 422 00:30:35,240 --> 00:30:40,360 Speaker 1: a healthier or as healthy least less expensive option, that 423 00:30:40,400 --> 00:30:43,320 Speaker 1: makes sense. But if you're charging me for something that 424 00:30:43,440 --> 00:30:48,280 Speaker 1: I can't do anything about, that makes no sense at all. Uh. 425 00:30:48,320 --> 00:30:51,240 Speaker 1: And so these are changes that we at p F 426 00:30:51,360 --> 00:30:53,840 Speaker 1: a D work on and will continue to work on 427 00:30:54,160 --> 00:30:57,440 Speaker 1: in our benefit design in this country. Yeah, I can 428 00:30:57,440 --> 00:30:59,560 Speaker 1: see that trying to give you a price incentive to 429 00:30:59,560 --> 00:31:01,480 Speaker 1: what no by you a drug in your case or 430 00:31:01,560 --> 00:31:04,200 Speaker 1: be poor or or be sick because you can't afford it, 431 00:31:04,200 --> 00:31:16,600 Speaker 1: which is not the function of the incentive, And it's silly. 432 00:31:17,800 --> 00:31:20,920 Speaker 1: Can you explain how why do some drugs have generate 433 00:31:20,960 --> 00:31:27,080 Speaker 1: since some don't. So, boy, you're asking some really good questions. Um, 434 00:31:27,120 --> 00:31:31,120 Speaker 1: you're going right to the heart of our system. Thank you. 435 00:31:31,760 --> 00:31:35,600 Speaker 1: A long time ago in the eighties, eight three or 436 00:31:35,640 --> 00:31:39,840 Speaker 1: eighty four, a bill was passed called the Hatch Waxman Bill, 437 00:31:40,480 --> 00:31:45,800 Speaker 1: and since then everyone effer refers to a concept called 438 00:31:45,880 --> 00:31:49,800 Speaker 1: the Hatch Waxman barbin. And the bargain is this, if 439 00:31:49,800 --> 00:31:52,000 Speaker 1: you're a drug company and you bring a valuable new 440 00:31:52,040 --> 00:31:57,200 Speaker 1: drug to market, you get a period of exclusivity along 441 00:31:57,240 --> 00:32:01,320 Speaker 1: with your you have a patent already probably, but upon approval, 442 00:32:01,720 --> 00:32:04,840 Speaker 1: we give you a period of exclusivity where for sure 443 00:32:04,920 --> 00:32:07,920 Speaker 1: no matter. If your patent is old and only has 444 00:32:07,960 --> 00:32:12,200 Speaker 1: a year left, we give you additional years of exclusivity 445 00:32:12,240 --> 00:32:15,520 Speaker 1: where you have a monopoly on that drug. But at 446 00:32:15,560 --> 00:32:19,440 Speaker 1: the end of that period of exclusivity, generics and biosimilars. 447 00:32:19,840 --> 00:32:24,920 Speaker 1: Biosimilars are the generic name or the name for generics 448 00:32:25,000 --> 00:32:31,160 Speaker 1: for biologic drugs, they're more complicated drugs. But at the 449 00:32:31,280 --> 00:32:35,200 Speaker 1: end of that period of exclusivity, a generic I'm not 450 00:32:35,240 --> 00:32:40,200 Speaker 1: a generic. Generics and biosimilars come to market, and we 451 00:32:40,360 --> 00:32:44,880 Speaker 1: use the competition from the generics and biosimilars to drive 452 00:32:44,920 --> 00:32:51,440 Speaker 1: down the price. When you have one generic that comes 453 00:32:51,520 --> 00:32:56,160 Speaker 1: to compete, the price goes down about fifteen or two generics, 454 00:32:56,200 --> 00:33:02,400 Speaker 1: the price goes down three generics. You know, by the 455 00:33:02,440 --> 00:33:05,240 Speaker 1: time you get five generics in the market, the price 456 00:33:05,600 --> 00:33:10,240 Speaker 1: is roughly five to of the original brand name price. 457 00:33:11,280 --> 00:33:14,720 Speaker 1: So the Hatchwaxon argain was you got a good drug, 458 00:33:15,280 --> 00:33:17,760 Speaker 1: you bring it to market. We give you a time 459 00:33:17,760 --> 00:33:21,080 Speaker 1: where you you can charge whatever you want. You have 460 00:33:21,120 --> 00:33:23,840 Speaker 1: exclusivity in the market, but at the end of that 461 00:33:24,960 --> 00:33:28,560 Speaker 1: we have competition from generics and biosimilars to lower price. 462 00:33:28,880 --> 00:33:32,680 Speaker 1: Why aren't there generics and biosimilars that was your question 463 00:33:33,040 --> 00:33:35,880 Speaker 1: for all drugs, while some drugs are still in their 464 00:33:35,920 --> 00:33:41,160 Speaker 1: period of exclusivity. But the drug companies don't let competition 465 00:33:41,520 --> 00:33:45,160 Speaker 1: come to market the brand dr companies they fight, they 466 00:33:45,200 --> 00:33:53,200 Speaker 1: file additional patents. They they sign deals with generic companies 467 00:33:53,760 --> 00:33:56,000 Speaker 1: not to bring a drug to market, a competitive to 468 00:33:56,080 --> 00:34:02,000 Speaker 1: market and pay them not to um uh it. They 469 00:34:02,280 --> 00:34:06,400 Speaker 1: make small changes in the drug and then file additional patents. 470 00:34:06,760 --> 00:34:12,319 Speaker 1: There is something called a patent thicket. Um Humorra, the 471 00:34:12,360 --> 00:34:14,680 Speaker 1: best selling drug in the world, has like a hundred 472 00:34:14,680 --> 00:34:19,399 Speaker 1: and thirty two patents, a hundred and thirty two which 473 00:34:19,400 --> 00:34:22,200 Speaker 1: were filed after the drug came to market. What are 474 00:34:22,200 --> 00:34:28,120 Speaker 1: they for, Well, they could be for the packaging, the instructions, 475 00:34:29,760 --> 00:34:34,560 Speaker 1: the color of the capsule, the patent everything and why 476 00:34:34,760 --> 00:34:38,879 Speaker 1: because Generica buys some other competitor has to fight its 477 00:34:38,920 --> 00:34:42,520 Speaker 1: way through all of them to bring a drug to market. 478 00:34:42,560 --> 00:34:45,560 Speaker 1: So we call them patent thickets. You know, if you 479 00:34:46,480 --> 00:34:51,040 Speaker 1: grew up anywhere near you know a place where there 480 00:34:51,040 --> 00:34:52,919 Speaker 1: were thickets, you know, it's very hard to get through 481 00:34:52,920 --> 00:34:58,719 Speaker 1: a thicket. Um. And so in some cases there is 482 00:34:58,840 --> 00:35:02,279 Speaker 1: no competitor. Guys, they're in the period of exclusivity. But 483 00:35:02,400 --> 00:35:06,360 Speaker 1: in far too many cases, there are no competitors to 484 00:35:06,480 --> 00:35:09,920 Speaker 1: drive down the price because the drug companies are manipulating 485 00:35:09,920 --> 00:35:15,919 Speaker 1: our system. And they're very good at manipulating our system. Yeah, yes, 486 00:35:15,960 --> 00:35:19,000 Speaker 1: they are exceptionally good, and that has terrible results. Okay, 487 00:35:19,040 --> 00:35:22,320 Speaker 1: So we've spoken about that, the way that they've manipulated 488 00:35:22,360 --> 00:35:25,360 Speaker 1: this system, the way that maybe that's beginning to change. 489 00:35:25,680 --> 00:35:27,759 Speaker 1: One thing that I'm interested in I've written about it 490 00:35:27,760 --> 00:35:30,719 Speaker 1: a little bit is these ways that are perhaps more revolutionary, 491 00:35:31,200 --> 00:35:35,640 Speaker 1: if not always as like a cast iron safe. And 492 00:35:35,719 --> 00:35:39,640 Speaker 1: one of those is obviously people making their own medicines, 493 00:35:39,840 --> 00:35:44,120 Speaker 1: which is something that will see unfortunately increasingly in this 494 00:35:44,280 --> 00:35:48,520 Speaker 1: country because of bands on access to reproductive healthcare. And 495 00:35:48,560 --> 00:35:51,720 Speaker 1: I wonder how you think that has the potential to 496 00:35:51,800 --> 00:35:55,880 Speaker 1: change this that's we've seen, like the epipencil, we've seen 497 00:35:56,000 --> 00:35:59,040 Speaker 1: these homebrew abortion drugs, things like that. Do you think 498 00:35:59,080 --> 00:36:03,720 Speaker 1: that has the capacity to change access? Remember I'm a patient, 499 00:36:04,440 --> 00:36:10,080 Speaker 1: mm hmm and um it scares the hell out of me. Yeah. 500 00:36:10,400 --> 00:36:12,920 Speaker 1: And the reason is there was a time in the 501 00:36:13,000 --> 00:36:16,560 Speaker 1: United States and in most of the world when drug 502 00:36:16,560 --> 00:36:22,440 Speaker 1: companies were not regulated. Uh, and they brought patent medicines 503 00:36:23,680 --> 00:36:28,720 Speaker 1: uh and uh, you know, mix it at home, bruise 504 00:36:29,600 --> 00:36:32,839 Speaker 1: and sold them, and we had no way to make 505 00:36:32,880 --> 00:36:36,120 Speaker 1: sure that those didn't hurt people. They killed people in 506 00:36:36,200 --> 00:36:41,440 Speaker 1: some cases. Uh. And then uh. In the twentieth century, 507 00:36:43,600 --> 00:36:49,680 Speaker 1: the government realized and and our Congress and our elected 508 00:36:49,760 --> 00:36:53,480 Speaker 1: officials realized we needed a way to regulate this industry, 509 00:36:54,120 --> 00:36:58,879 Speaker 1: which would you know, sell poison in some cases, and 510 00:36:58,960 --> 00:37:02,720 Speaker 1: they created what is now called the Food and Drug Administration. 511 00:37:03,200 --> 00:37:08,040 Speaker 1: Food and Drug Administration is charged with making sure drugs 512 00:37:08,120 --> 00:37:12,320 Speaker 1: are safe and effective. I'm a patient. I want the 513 00:37:12,360 --> 00:37:15,479 Speaker 1: Food and Drug Administration to do its job. I want 514 00:37:15,600 --> 00:37:20,680 Speaker 1: drugs that are safe and effective. I do not like 515 00:37:21,760 --> 00:37:30,080 Speaker 1: drugs that are not subjected to some scrutiny um to 516 00:37:30,200 --> 00:37:33,360 Speaker 1: make sure that they do what those who are selling 517 00:37:33,400 --> 00:37:38,880 Speaker 1: them claim they do. So Remember, I'm not big on 518 00:37:39,080 --> 00:37:43,759 Speaker 1: taking chances with my life. Uh. And I if the 519 00:37:43,840 --> 00:37:48,600 Speaker 1: drugs don't work, I'll die. That's that simple. I'll die 520 00:37:48,680 --> 00:37:51,480 Speaker 1: of cancer. Not not to mention, I could drive to 521 00:37:51,560 --> 00:37:55,279 Speaker 1: die from a drug that's no good. Some drugs cause harm, 522 00:37:55,360 --> 00:38:00,680 Speaker 1: you know, even drugs approved by the FDA cars harms sometimes. 523 00:38:01,200 --> 00:38:04,560 Speaker 1: So I am I am. I am not a fan 524 00:38:05,239 --> 00:38:08,400 Speaker 1: of homebrew drugs. I'm a fan of a system that 525 00:38:08,520 --> 00:38:12,000 Speaker 1: protects me and ensures that drugs are safe and effective. 526 00:38:12,560 --> 00:38:16,600 Speaker 1: But that's one man's perspective. Yeah, and I think it's 527 00:38:16,640 --> 00:38:19,160 Speaker 1: reasonable to say that, like, we have a way to 528 00:38:19,239 --> 00:38:21,719 Speaker 1: make drugs that are safe and effective, and it's the 529 00:38:21,840 --> 00:38:24,880 Speaker 1: lord legislation or a system that's getting in between people 530 00:38:24,920 --> 00:38:27,880 Speaker 1: and the life saving medicines that they need, and we 531 00:38:27,920 --> 00:38:32,920 Speaker 1: should certainly struggle to fix that instead of looking for 532 00:38:32,920 --> 00:38:35,319 Speaker 1: ways around it, even though I understand why, especially with 533 00:38:35,320 --> 00:38:38,760 Speaker 1: things like reproductive healthcare, that doesn't seem like it's getting 534 00:38:38,800 --> 00:38:45,399 Speaker 1: fixed anytime soon. Sadly, No, it's it's terribly sad. It's heartbreaking. Yeah, 535 00:38:45,560 --> 00:38:49,680 Speaker 1: this whole thing is extremely and I know you've obviously 536 00:38:49,719 --> 00:38:53,040 Speaker 1: seen it too, but my previous life, I've worked with 537 00:38:53,080 --> 00:38:55,799 Speaker 1: one of someone who works for you now in diabetes 538 00:38:55,800 --> 00:38:59,759 Speaker 1: nonprofit and seen firsthand the consequences of this, and it's 539 00:38:59,760 --> 00:39:03,200 Speaker 1: really heartbreaking stuff to look at, and I wish it 540 00:39:03,320 --> 00:39:05,879 Speaker 1: just seems so unnecessary in the world where like these 541 00:39:05,880 --> 00:39:10,680 Speaker 1: pharmaceutical companies make we should say, like billions of dollars. Right, 542 00:39:10,719 --> 00:39:13,000 Speaker 1: It's it's not as if these people are driving to 543 00:39:13,040 --> 00:39:16,160 Speaker 1: work in a second hand toy to Corolla, like they 544 00:39:16,360 --> 00:39:20,799 Speaker 1: they are doing very well for themselves of this system, right, yep. 545 00:39:22,719 --> 00:39:27,719 Speaker 1: People will be familiar with like farmer Bro Martin Screlly 546 00:39:27,960 --> 00:39:32,239 Speaker 1: the guy. Yeah. Yeah, but it's just one example of 547 00:39:32,239 --> 00:39:35,400 Speaker 1: a very problematic industry. I think you've done an excellent 548 00:39:35,440 --> 00:39:37,879 Speaker 1: job of explaining it. David, Is there anything else you'd 549 00:39:37,880 --> 00:39:41,080 Speaker 1: like to get to before we finish up here? Just 550 00:39:41,600 --> 00:39:44,120 Speaker 1: Martin screll you call to mind. I won't take you 551 00:39:44,160 --> 00:39:48,000 Speaker 1: back to MODERNA and the m RNA vaccine effect that 552 00:39:48,040 --> 00:39:51,400 Speaker 1: we not only developed the m r A technology to 553 00:39:51,480 --> 00:39:55,840 Speaker 1: taxpayer money, but we brought the MODERNA vaccine to people 554 00:39:56,480 --> 00:39:59,640 Speaker 1: with textpayer money. And in the course of doing that, 555 00:40:00,280 --> 00:40:06,120 Speaker 1: we minted three new MODERNA billionaires. Um, you're talking about 556 00:40:06,160 --> 00:40:08,880 Speaker 1: I'm not driving to work and you uh, you know 557 00:40:09,160 --> 00:40:14,680 Speaker 1: secondhand Toyota Corollas. Oh, far from it. Yeah, these are 558 00:40:14,719 --> 00:40:16,600 Speaker 1: the people whose yachts I've see in the bay. I 559 00:40:16,640 --> 00:40:19,440 Speaker 1: think that's disgusting. Three new millionaires off the back of 560 00:40:19,560 --> 00:40:24,440 Speaker 1: billionaires billionaires. God? Yeah, God, it's grass, isn't it. Yeah. 561 00:40:25,200 --> 00:40:27,320 Speaker 1: It can't be said enough. Not only does the NAH 562 00:40:27,400 --> 00:40:30,359 Speaker 1: fund their research, but often the taxpayers will fund the lab. 563 00:40:30,440 --> 00:40:32,799 Speaker 1: Right if it's at a university, you pay for it 564 00:40:32,840 --> 00:40:36,480 Speaker 1: twice before before you try and pay for it again 565 00:40:36,760 --> 00:40:39,600 Speaker 1: at SEC. Yeah, it's a very broken system, David. How 566 00:40:39,640 --> 00:40:43,120 Speaker 1: can people find p F A D How can people 567 00:40:43,160 --> 00:40:48,080 Speaker 1: find us? Our website? Twitter? Facebook? Where should they go? 568 00:40:48,080 --> 00:40:53,759 Speaker 1: Go to our website Patients for Affordable Drugs dot org. 569 00:40:54,040 --> 00:40:57,520 Speaker 1: Just like it sounds, you can leave your story if 570 00:40:57,560 --> 00:41:01,200 Speaker 1: if you or someone you love care about has struggled 571 00:41:01,280 --> 00:41:05,160 Speaker 1: with high drug prices, give us your email address. We 572 00:41:05,200 --> 00:41:09,680 Speaker 1: don't ask patients for money, but the stories and email 573 00:41:09,680 --> 00:41:15,600 Speaker 1: addresses are our power. Uh. There the there the currency 574 00:41:16,200 --> 00:41:20,480 Speaker 1: we trade on to make sure that the voices of 575 00:41:20,920 --> 00:41:25,799 Speaker 1: people in this country are heard, uh, to counter the 576 00:41:25,840 --> 00:41:32,040 Speaker 1: propaganda ana lies that are put out by the drug companies. Okay, yeah, 577 00:41:32,040 --> 00:41:34,440 Speaker 1: that's that's very important stuff that people can hopefully do. 578 00:41:34,520 --> 00:41:37,240 Speaker 1: Even if they are struggling sort of materially to afford 579 00:41:37,239 --> 00:41:39,640 Speaker 1: their drugs. Maybe they have some time. So that's great. 580 00:41:39,680 --> 00:41:42,000 Speaker 1: It's four f O R right, not the number four. 581 00:41:42,560 --> 00:41:45,080 Speaker 1: That's correct. All right, great, Thank you so much, David. 582 00:41:45,080 --> 00:41:47,480 Speaker 1: It's been a pleasure. You've done excellent job of explaining 583 00:41:47,480 --> 00:41:51,120 Speaker 1: a very convoluted and broken system. Thank you, James, your 584 00:41:51,440 --> 00:41:55,160 Speaker 1: your patient. Man. I try to be sometimes I'm very 585 00:41:55,239 --> 00:41:57,799 Speaker 1: much not that, but yeah, I do appreciate your time 586 00:41:57,840 --> 00:42:00,759 Speaker 1: on this Monday morning. Thank you very much, David, Thank you. 587 00:42:05,560 --> 00:42:07,920 Speaker 1: It Could Happen Here as a production of cool Zone Media. 588 00:42:08,160 --> 00:42:10,840 Speaker 1: For more podcasts from cool Zone Media, visit our website 589 00:42:10,880 --> 00:42:13,000 Speaker 1: cool zone media dot com, or check us out on 590 00:42:13,040 --> 00:42:15,560 Speaker 1: the I Heart Radio app, Apple Podcasts, or wherever you 591 00:42:15,640 --> 00:42:18,399 Speaker 1: listen to podcasts. You can find sources for It Could 592 00:42:18,400 --> 00:42:21,399 Speaker 1: Happen Here, updated monthly at cool zone media dot com 593 00:42:21,440 --> 00:42:23,360 Speaker 1: slash sources. Thanks for listening.