Biden and Sanders Address Efforts to Lower Healthcare Costs

Thank you. Thank you. Let me begin by telling you what you and the American people know, and that is our nation is politically divided. Nobody doubts that. But there is one issue that the American people, whether they are Republicans, Democrats, or Independents, whether they're conservative or progressive, are you united on. And that is that we are sick and tired of paying by far the highest prices in the world for prescription drugs. (00:52) On average, we pay over three times as much as the people of other major countries for brand name prescription drugs. And in some cases, we are paying 10 or 20 times more than people around the world for the exact same product. Meanwhile, what we are getting ripped off, 10 top drug companies made over $110 billion in profit last year, and their CEOs make tens and tens of millions of dollars in compensation. The result of the high cost of prescription drugs is obvious. One out of four Americans cannot afford to purchase the prescriptions that their doctors write, and some of them will die as a result. Others get much sicker than they should, and they end up in emergency rooms or they end up in hospitals at great cost to our already bloated health healthcare system. Further, the very high cost of prescription drugs is not just an individual issue, what you pay it. Is a taxpayer issue. It impacts all of us. It drives up the cost of Medicaid, Medicare and other public health programs as well as private insurance. (02:34) The truth is that politicians have been talking about the high cost of prescription drugs for years, including me. I've been on this issue for probably 20 years, maybe more. But the other truth is that during that time, not much has happened. A lot of talk, yep, but no real progress. The drug companies continue to go along their merry way and raise prices anytime they wanted to, any level that they wanted, for any reason that they wanted, just do whatever they wanted. (03:20) Well, here is some good news. Despite all of the incredible wealth and political power of the pharmaceutical industry, believe it or not, they have over 1800 well-paid lobbyists right here in D.C. Despite all of that, the Biden administration and Democrats in Congress are beginning to make some progress. What have we accomplished over the last several years? As a result of the Inflation Reduction Act that not one single Republican voted for, seniors with diabetes are paying no more than $35 a month for the insulin that they need. Beginning next year ... That's right, and God knows how many lives that alone will save. Beginning next year, and this is a very big deal. Seniors will be paying no more than $2000 a year out of pocket for prescription drugs. (04:38) And we all know, we all know seniors who have chronic illnesses, more than one. And are running up huge prescription drug costs that they can't afford. Well, the cap next year will be $2000. Further, and very importantly, pharmaceutical companies can no longer increase the price of prescription drugs above inflation for seniors without paying a substantial penalty. And maybe most importantly, for the first time in American history, Medicare is negotiating with the pharmaceutical industry to lower some of the most expensive prescription drugs in America. Now, we must confess this is not a novel idea. In fact, it's done in every other major country on earth. But finally, we're catching up. The Biden administration has also taken executive action to make sure that when American taxpayer dollars help fund the development of certain tests, treatments, and vaccines to deal with public health emergencies, pharmaceutical companies must charge reasonable prices for those products. (06:04) And that's not all. In December, the Biden administration proposed that if a drug made using taxpayer funds is not reasonably available to Americans because of its exorbitant prices, the government reserves the right to allow a low-cost manufacturer to sell the product for a fraction of the price. The President called this, "An important step toward ending Big Pharma price gouging." And he is exactly right. I look forward to the Biden administration implementing this provision to substantially reduce prescription drug prices. I am also proud of the accomplishments, the Senate Committee on Health, Education, Labor, and Pensions, which I happen to chair, has made to bring down the cost of prescription drugs. Less than three months ago, the Health Committee launched an investigation into the outrageously high cost of inhalers that 25 million Americans with asthma, and 16 million Americans with COPD need in order to breathe. And what we learned from that investigation is that the American people were paying in many cases, not 10 times more than the people of other countries, not 50 times more, in some cases, 70 times more for inhalers than the people were paying in Canada and Europe. After talking to the CEOs of the four major inhaler manufacturers, three of them have made a commitment to cap the cost of all of their brand name inhalers, Boehringer Ingelheim, AstraZeneca, and GlaxoSmithKline. Teva, the smallest of the four companies that manufacture inhalers has not yet made that commitment, but we hope to hear from them in the very near future. What all of that means is that within a very short time, in two out of the three companies starting on June 1st, the vast majority of Americans will pay no more than $35 at the pharmacy counter for the inhalers they purchase. A Vermont resident recently told my office that she has to pay $320 a month for Boehringer Ingelheim's, Meriva HandiHaler. As a result of

... Of these decisions, she could save more than $3,000 a year on the inhaler she needs to breathe. Millions of others will see similar benefits. Now, my impression is that these companies, as well as many others in the pharmaceutical industry, are beginning to catch on to the fact that the American people are tired of being ripped off and paying astronomical prices for the prescription drugs they need to stay alive, or to ease their pain. And let me also take this moment to thank Lena Kahn, the chair of the Federal Trade Commission, for taking on the greed of the pharmaceutical industry. (09:49) Last November, the FTC challenged how drug companies manipulate and play games with patents to keep low-cost generic drugs off the market, including asthma inhalers. By standing up to the drug companies, the FTC has helped deliver this major victory for the American people. And it's not just inhalers. Last year, the CEO of Moderna committed during a help committee hearing that his company would set up a patient assistance program so that no one in America would have to pay for their vaccines out of pocket. (10:31) In a separate health committee hearing last May, the CEO of Eli Lilly committed that his company would not raise prices on existing insulin products after announcing very substantial price cuts for these products. These efforts will improve life for millions of Americans. They will prevent unnecessary deaths, ease suffering, and save substantial sums of money for working-class families. (10:59) But let us be clear, despite all that we have accomplished up to now, it is not enough. Much, much more needs to be done. In his State of the Union address, president Biden called on Congress to pass legislation to cap out-of-pocket prescription drug costs for all Americans at no more than $2,000 a year, and to substantially increase the number of drugs that can be negotiated with the pharmaceutical industry. I strongly agree with him. (11:43) And think of what that will mean to the people in our country, many of whom have a myriad of chronic illnesses, no more than $2,000 out of pocket. That is a very significant step forward. And as chairman of the health committee, I intend to push that legislation as aggressively as I can. In my view, we can no longer tolerate companies like Novo Nordisk charging the American people $1000 a month for Ozempic, a drug that costs less than $5 to manufacture. When that same exact product is sold in Germany for $59. 1000 bucks in America, $59 in Germany. Unacceptable. (12:37) We can no longer tolerate Astellas and Pfizer charging Americans with prostate cancer over $165,000 for Xtandi, when the exact same product can be purchased for just $20,000 in Japan. Even more disturbing is the reality that over half of the new drugs coming onto the market today cost $300,000, and a number of them actually cost over a million dollars. (13:11) This is an issue that we must, must get a handle on. Working together, we can take on the greed of the pharmaceutical industry and substantially lower the cost of prescription drugs in America. And when we do that, we will be lowering the cost of healthcare in our country, which is double the cost of any other major nation on earth. (13:42) I want to thank President Biden for what he has done on this issue up to now, and I look forward to working with the president as we go forward. I would now like to introduce to you Chris Garcia from Littleton, Colorado. Even though Mr. Garcia has health insurance through his employer, he and his family cannot afford the outrageous price of his medications. (14:12) Mr. Garcia has asthma and several bleeding disorders, and relies on multiple inhalers and specialty drugs just to stay alive. Even with insurance, the co-pays for his inhalers and other medications total more than $450 per month. He has been paying $163 per month for just one inhaler, Advair. And starting soon Mr. Garcia will be able to get Advair for $35 a month. Thank you, Mr. Garcia.

Good morning. My name is Christopher Garcia and I'm from Littleton, Colorado. I'm 47 years old, and work as a ramp agent at the airport, loading and unloading luggage in cargo and helping guide and park our aircraft. I am also a husband and a father of four. And if that's not enough to worry about, I was born with four bleeding disorders, several allergies, and chronic asthma. (15:19) These medical conditions leave me in a constant state of uncertainty, and can spiral into both a health and financial crisis at any time. The treatments I need just to stay alive cost $800 a month, even after my insurance coverage. I work four extra shifts a month to help offset the costs, and even then, that's often not enough. I'm constantly forced to split my medications or decide which medications to forgo altogether because I simply can't afford them. Every morning I hope I have enough meds just to make it through the day without a medical issue. (15:54) And I know millions of Americans grapple with similar decisions when it's time to refill our inhaler prescriptions at the pharmacy counter. For too long, inhaler manufacturers have prioritized profits over patients, leaving people struggling to afford the very medications that they need to survive. I never imagined things could change, but President Biden has shown us all that they can. (16:18) The things he's done to cut healthcare costs are literally saving the lives of so many Americans, myself included. I can't describe how grateful I am and what it means for me and my family to know that we have a president who thinks every day about how to improve the quality of life for people like me. To know that we have a president who cares about giving me a chance to spend less time worrying about surviving and more time with my kids as they grow. And now it is my greatest honor to introduce the President of the United States, Joe Biden. Thank you.

Chris. Thank you, thank you, thank you. First of all, thank you for the courage you've shown over the years dealing with your health issues, but also for standing up here before the whole nation and explaining to us what you've gone through. It's not easy to do. Trying to afford your expensive medications, from blood disorders to asthma. (17:31) Millions of Americans, millions have similar stories, lying in bed at night, literally staring at the ceiling, wondering what in God's name will happen if their spouse gets cancer, or if their child gets sick or something happens to them. If they're going to have enough insurance. Can they afford the medical bills they're going to have? Will they have to sell the house to keep things moving? When you find out the big reason why we're lying awake at night with these questions is because the drug companies are charging

... using exorbitant, exorbitant prescription drug prices. Higher prices than anywhere in the world and Bernie said it, I was listening in the back, Bernie, you and I have been fighting this for 25 years. Finally, finally, we beat big pharma. Finally. I'm serious. I'm proud. I'm proud of my administration has taken on big pharma in the most significant ways ever. And I wouldn't have done without Bernie and Bernie got it. Look, Bernie was the one who was leading the way for decades in which we're, why we're here today. Bernie mentioned that Americans pay more for prescription drugs than any other advanced nation in the world. If you walk into a local drug store here in America, the prices are at least two to three times more for the exact same prescription made by the exact same pharmaceutical company in Canada, France, Italy, and even in Eastern Europe, all around the world, but not anymore. For years, people have talked about how Medicare has the power to negotiate for lower drug prices, prescription drug prices the government pays for, just like the VA does when they're able to negotiate medicines and needs for the veterans. (19:16) But we've tried and tried and tried. And finally with Bernie's help, I finally got my Inflation Reduction Act, which passed. Bernie helped get it passed. Not one Republican in the entire Congress. This did surprise me I have to admit to you, not one single Republican voted for it, not one single one to give us authority to take on and beat big pharma. Take insulin for people with diabetes. It costs 10 bucks to make. If you add everything in terms of packaging and all the rest, you can argue maybe $12 total. And they're charged as much as $400 a month. Not anymore, not anymore. Seniors with diabetes will only have to pay $35 a month from this point on. And by the way, when I first got the law passed, guess what? It applied to every American. Every American. But the... was able to cut back on the fact that only, they only were not able, the only thing they couldn't defeat was the seniors. But I want those savings to be for every single person in America, no matter what their age. No one should pay more than 35 bucks a month for insulin, period. And by the way, drug companies still make a significant product, excuse me, significant profit because I said 10 bucks to make. By the way, the guy who invented the drug didn't want a patent it because he wanted it available to everybody. Well, it's available all right. Look, folks, there's a whole lot of prescription drugs that are ongoing, undergoing the process of lower pricing. Medicare is now able negotiate lower prices for some of the costliest drugs that treat everything from heart disease to arthritis. This year alone, the law that's already passed, it's in the law now, that we signed, Medicare's negotiating 10 of the most costly drugs next year, and they'll do that every year. Goes well beyond 50 drugs. (21:20) Next year it'll be 15. Isn't just saving seniors money, along with other reforms it's taxpayer money and we're cutting the federal deficit. And people say, "Well, it's costing money." Guess what? It's costing drug companies money. It cuts the deficit by $160 billion. $160 billion. I'm serious. Think about it. The next 10 years, because Medicare will no longer have to be, pay those exorbitant prices. Instead of paying 400 bucks, they're paying 35 bucks. But I think we should be more aggressive. It's time we negotiate lower prices for at least 50 drugs a year. The law only requires 10 now and then 15 and moves up. Along with other actions, we're not only saving lives, but if we move that number up, we'll save taxpayers another $200 billion on top of the $160 billion because Medicare will not be paying these exorbitant costs. It is a gigantic... and by the way, the other guy talks about cutting the deficit. He increased his deficit more than any president has in history. And we've cut it. (22:33) Look, in addition to the law we passed, we'll cap prescription drug costs for seniors and Medicare starting in 2025. It's already the law. It doesn't require anything else because when I say these things, you're thinking you get it done. It's already the law. Your drugs will not cost you if you're a senior on Medicare, will not have to pay more than $2,000 a year no matter what the drug costs. And as you know, many of you unfortunately know, with [inaudible 00:23:00], some of the cancer drugs cost 10, 12, $15,000 a year combined, combined. They'll not have to pay a penny beyond $2,000 a year. And the drug companies will still make a lot of money. Folks, Bernie and I want to cap prescription drug cost of $2,000 for every American, not just seniors. We're here today to talk about how we're lowering prices and cracking down on unfair competition and prescription drugs. I'm a capitalist. Capitalism though without competition isn't capitalism, it's exploitation. That's what's going on. Exploitation. When big pharma doesn't play by the rules, competitors can't offer lower prices for generic drugs and devices that carry that medication so prices are raised artificially. I thank Bernie for leading the charge to do something about this. For example, asthma is one of the most common respiratory illnesses in America. 27 million Americans have asthma including four million children. Asthma causes about one million visits to hospital emergency rooms every year. Nationwide, the cost of treating asthma is estimated to be $50 billion a year, for treating asthma, not the drug, treating the asthma. If you have asthma, you're likely to need an inhaler to breathe. (24:26) Now, this spring is here. The seasons and allergies are upon us or on the rise even more. More people with asthma need inhalers to breathe. Many asthma medications may have been on the market for more than 25 years. They cost less than $5 to make. It costs less than $5 to make but the medication hadn't changed at all. Theoretically, if the drug company came with a new medicine that they invested a lot of money to find a better way, they could argue another price. But drug companies have increased prices for asthma drugs up to eight times more than the original cost. And the mechanisms attached to the inhaler, the thing that makes it go into your nose or mouth, that is a device that Medicare hasn't changed much either. Look, these big companies try to keep generic companies away from getting patents on devices that deliver the medicine through the inhalers. So there's two pieces. It's not just what's in the inhaler. It's the mechanism that allows it to go into your body. (25:37) For example, they slightly changed the cap of inhaler and they use the new patent on that cap to block generic drug companies from being able to enter the market. It's a big deal. Playing these games with patients and pricing, big pharma is able to charge Americans significantly higher prices and pad their profits. Senator Sanders has pointed out one company sells an inhaler for 49 bucks in the United Kingdom. You know how much it's charged in the United States for that one inhaler? $645. So I take... $645. If you need that inhaler, you get in Air Force One and the next time you go to London, you can get off and you can get it for... I'm serious. Think about that though. Just think about that. For the same exact medicine and the same exact device. It's outrageous. Another company sells an inhaler for $9 in Germany. $9 in Germany, and we pay $286 here in the United States. Nine bucks in Germany, same outfit, same company, same device. And so 30 times more, 30 times more I repeat. It's outrageous. (26:48) We're doing something about it finally. Why in God's name should an American pay $645 for the same inhaler sold in the United Kingdom for $49 by the same outfit? The same outfit. Bernie called

...called out the drug companies during the congressional hearings. And you just heard from Lina Kahn, the chair of the Federal Trade Commission, who's working with the Food and Drug Administration to crack down on these drug companies and it's a big deal. As a result of all this action, some drug companies have withdrawn their abuse of patent listings for inhalers and other common products like EpiPens. The last few weeks, some of the big drug companies have gotten the message to reduce the prices for some asthma drugs. Bernie is a big reason why that's happened. (27:32) In fact, three of the four largest companies are capping the cost of inhalers. For many patients, that can be up to $600 out of pocket at $35. There's some progress going on beyond what we've done in the law, but it's about time. And going forward with more competition and more generic drugs in the market, the price could even be less than it is now coming down. (27:56) But that's not all. Because of all of you, our Inflation Reduction Act, drug companies that raise prices more than inflation are going to pay back Medicare the difference between what they charged and the inflation rate. This is based on the price of their drugs in 2021. That means consumers will pay less for prescription drugs and that it'll save taxpayers money and discourage companies from hiking prices faster than inflation in the first place. (28:25) But we want to do more. It's time that drug companies pay rebates when they increase prices faster than inflation, not just for seniors, but for every single American. Every single American. And today's announcement follows action we've already taken to significantly reduce the healthcare costs for average Americans. We took action to reduce the cost of hearing aids for millions of Americans by as much as $3,000, repair a hearing aid. (28:58) In addition, my administration is banning junk fees on health insurance plans. These are the plans that stick consumers with big unexpected charges instead of covering the care they need. Look, they ended up with surprise medical bills so hospitals that are in-network can't send you a bill for an out-of-network doctor you didn't choose or you haven't even consulted. I was in the hospital for a while years ago and that happened. (29:25) Kamala and I are protecting and expanding the Affordable Healthcare Act, known as Obamacare, which I might add is still a big deal today. Thank God my mother wasn't here. Today, 21 million Americans are covered through the Affordable Care Act, 9 million more than when I took office. (29:51) We enacted tax credits to save an average of $800 per person per year, reducing healthcare premiums for millions of working families who have coverage under the Affordable Care Act. These tax credits though expire, you can only get through this year. And I'm calling on Congress to make tax credits permanent, permanent for this process. (30:18) And folks, all of our progress is in stark contrast to my predecessor and MAGA Republicans in Congress. They want to quote, I love their word they love, they want to terminate the Affordable Care Act. I love it, terminate. As my predecessor says, kicking millions of Americans off their health insurance. And by the way, the vast majority of these people would not be able to get insurance because they have a preexisting condition. (30:43) They also want to eliminate the Inflation Reduction Act, eliminate the savings to lower prescription drug prices and so much more. During the last administration, my predecessor exploded the national debt more than any previous president in history in a four-year term. More than any previous. He talks about the debt, he exploded more than any other president in a four-year term with his $2 trillion tax cut that overwhelmingly benefited the very wealthy and the biggest corporations in America. (31:13) Now, he and his Republicans in Congress want to cut social security, raise the age, and cut Medicare while they cut taxes for the very wealthy again. I've got a better idea. I'm going to protect Social Security and Medicare along with Bernie and other members of Congress to make sure the wealthy begin to pay their fair share to keep these programs solvent. It's not hard. (31:44) And let me repeat what I said, that even some people like Bernie didn't like at the beginning, I don't blame them. But I said in day one to make a point, no one in America will pay a single penny more in federal taxes if they make less than $400,000 a year. I wish I was able to do that. I was listed, and Bernie used to kid me about it, I was listed as the poorest man in Congress for 36 years. I didn't think I was poor, I got a good salary, but I was the poorest man in Congress. (32:15) Trump brags about he's the reason Roe V. Wade was overturned. Here's his quote, "I did something no one thought possible. I got rid of Roe V. Wade." End of quote. And now he and his MAGA officials are calling for a national ban on the right to choose in every state. I promise you, with a Democratic Congress, Kamala and I will make Roe v. Wade the law of the land again. I promise you, (32:46) I'm talking too long here, let me close with this. I'm excited about this. I'm really proud of what we've been able to do. I really am. Bernie and I have been doing this work for a long time. I know we don't look it, but we've doing it a long time. Bernie and I have something else in common, we both married way above our stations. But any rate, but we know we've made historic progress in the last three years. 35 bucks for insulin for seniors. $35 a month for inhalers for asthma. $2,000 a year total cap on cost for seniors. We're lowering the cost of some of the most expensive prescription drugs for seniors. (33:23) And what I want to do next, what we want to do next is these caps and costs for everyone. Everyone, not just seniors. With Bernie's help, we're showing how healthcare ought to be a right, not a privilege in America. And that's why I've never been more optimistic about it. I really mean it. You've heard me say this very room how optimistic. I am optimistic because the laws we got passed are now coming into effect, whether it's the infrastructure or whether it's this. I mean, there's so much more. (33:51) And I've said this many times and I'll get out of your hair, we have to remember who we are. We're the United States of America. I mean, this is from the bottom of my heart. There's nothing beyond our capacity when we do it together. We're the only nation in the student history that I can find that's come out of every crisis we've entered stronger than we went in, every single time. So let's remember who we are, the United States of America. God bless you all and may God protect our troops. Thank you.

Please welcome back to stage Senator Bernie Sanders.

[inaudible 00:34:35]. Thank you all. I think it's yours. I think the podium is yours.

[inaudible 00:34:40] responsible for the World Central Kitchen strike, Mr. President, would you consider desisting military aid?