Sanders vows to oppose NIH nominee until Biden produces drug-pricing plan

By Dan Diamond; The Washington Post 

Sen. Bernie Sanders (I-Vt.), chair of the Senate health panel, is vowing to not move forward with President Biden’s nominee to lead the National Institutes of Health — or any health nominee — until he receives the administration’s “comprehensive” plan on lowering drug prices.

“I will oppose all nominations until we have a very clear strategy on the part of the government … as to how we’re going to lower the outrageously high cost of prescription drugs,” Sanders said in an interview with The Washington Post.

Sanders, who leads the Senate’s Health, Education, Labor and Pensions Committee, controls when his panel reviews nominees for positions in the Department of Health and Human Services. Without the Vermont senator’s support, the Biden administration will not be able to confirm current and future health agency nominees.

This isn’t the first time Sanders has said he would oppose Biden’s health nominations over drug-price concerns. The Senate health leader this year warned the White House that he would not support health agency nominees who would not “stand up and fight” the drug industry.

Biden last month nominated Monica Bertagnolli, a cancer surgeon who runs the National Cancer Institute, to lead the NIH. Sanders declined to say whether he would support Bertagnolli, who was not one of the three officials the Vermont senator had recommended to the White House for the NIH post.

The White House said in a statement Monday that Biden shared Sanders’s concern on drug pricing — “which is why he signed into law the Inflation Reduction Act, the most consequential law addressing the high cost of prescription drugs.”

Federal officials, advocates and researchers have repeatedly warned that the nation’s drug prices outpace those in other countries, causing harm to patients and increasing federal spending.

“High prescription drug prices create affordability challenges for patients and the health care system,” according to an HHS reportreleased last year that tracked price increases of prescription drugs between July 2021 and July 2022. According to officials, prices for more than 1,200 products outpaced inflation during that period, with an average price increase of more than 31 percent.

The drug industry has said it is committed to lowering costs for patients through coupons and other initiatives. 

“We have a responsibility to not just develop treatments and cures, but to also help patients access them,” the Pharmaceutical Research and Manufacturers of America says on its website, blaming middlemen such as pharmaceutical benefit managers for helping drive up prices. The industry also has fought some of the Biden administration’s efforts to lower drug prices.

To bolster his case that more must be done to tackle the root causes of high U.S. drug costs, Sanders on Monday released a report by his staff that reviews two decades’ worth of drugs that NIH scientists helped develop. The report concludes that Americans consistently pay higher prices for NIH-backed drugs than people in other countries and argues that federal officials are missing opportunities to rein-in those costs for taxpayers who helped fund those innovations.

“The federal government should reinstate and strengthen a ‘reasonable pricing clause’ in all future collaboration, funding, and licensing agreements for biomedical research,” Sanders’s report recommends, a reference to a clause that NIH created to contain the price of HIV drugs in the early-1990s before it was dropped amid pressure from the drug industry.

“The federal government should also stop giving away monopolies on public inventions,” the report adds, offering examples of how health officials “appea[r] to have handed over taxpayer technology while obtaining little in return.”

The Biden administration has already pursued efforts to address drug prices, including policies contained in last year’s Inflation Reduction Act that capped annual Medicare out-of-pocket drug costs at $2,000, barred companies from charging seniors more than $35 a month for insulin and imposed new penalties on drug companies that raised prices faster than the rate of inflation. The legislative package also allowed Medicare to negotiate the prices of some drugs. The pharmaceutical giant Merck this month sued the Biden administration over the drug-price negotiation policy, arguing it was a form of “extortion” that would discourage research and development.

Biden in October 2022 issued an executive order calling on his administration to develop additional policies to combat high drug prices, such as using new government payment models through an innovation center at the Centers for Medicare and Medicaid Services.

Health officials in February released a report on their initial progress developing those models. “As President Biden has made clear, we must build on the new prescription drug law with further action,” HHS Secretary Xavier Becerra said in a statement at the time.

Biden officials have promised to do more to combat the issue.

“I think the prices of drugs are too high in the U.S.,” Food and Drug Administration Commissioner Robert Califf said at a meeting of biotech executives last week.

Drug pricing has emerged as a signature issue for Sanders, who has used his position as Senate health chair — a role he assumed in January — to hold hearings with drug companies and pharmaceutical benefit managers, open investigations into the pharmaceutical industry and repeatedly pressure administration officials.

The Vermont senator has met with White House Chief of Staff Jeff Zients and Becerra, urging them to take broader actions on drug pricing, according to officials who spoke on the condition of anonymity to describe internal conversations. Asked about when he would move forward with health nominees, Sanders said there first needed to be a “public discussion” about a government-wide plan to lower drug prices, and he would not accept private reassurances from senior officials that they are working on it.

Sanders said he was not worried that delaying the NIH nominee and other potential nominees would harm the health department’s operations, adding that Lawrence A. Tabak, the acting NIH director, was “doing a good job” and that he would support the NIH as some Republicans debate whether to limit its funding.

“My goal is to change government in general, policy in terms of the pharmaceutical industry and demand that the cost of prescription drugs in this country are significantly lowered,” Sanders said. “Politicians for years have talked about the high cost of prescription drugs, relatively little has been done, and it’s time that we act decisively.”