On April 3, more than four million Americans received a COVID-19 vaccine — the largest single-day vaccination event in human history. For innovators across the pharmaceutical industry, these moments make the years — sometimes decades — of painstaking trial and error worth it.
I’m incredibly proud of our industry’s role in combating this pandemic. At the same time, our battle against COVID-19 has driven home an important reality: We need to build a better health care system that ensures scientific advances are accessible and affordable to everyone who needs them.
To that end, today we are releasing a series of policies we believe will help our country reach that goal. Our plan is based on three key pillars: ending the pandemic and building a more resilient system, making medicines more affordable and building a more just, equitable health care system.
Ending the Pandemic and Building a More Resilient System
America’s unique research and development ecosystem allowed our industry to develop COVID-19 vaccines and treatments at unprecedented speed. We need to preserve that ecosystem while enhancing our ability to quickly respond to future public health disasters.
That starts with collaboration among biopharmaceutical companies, government agencies and others in the public and private sector, which has been critical in our nation’s COVID-19 response. Future policy should avoid measures that would impede this collaboration, such as the erosion of intellectual property protections and reduced incentives for research and development.
A policy framework guided by innovation and collaboration will allow our industry to expand R&D and manufacturing infrastructure as well as build more diverse, reliable supply chains. And we are calling on our elected leaders to tackle a growing public health threat we know exists and before it’s too late: the spread of antibiotic-resistant superbugs. Last summer, our companies stepped up with a major commitment to help develop new antibiotics, and it’s time policymakers stepped up too.
While the development of new vaccines and treatments occurred in record time, the pandemic has highlighted weaknesses in our health care infrastructure, gaps that led to delays in testing, bottlenecks in the distribution of vaccines and other challenges. We are proposing a number of policies that will help address these weaknesses and ensure our health care system is more resilient in the face of future public health emergencies.
Making Medicines More Affordable
While biopharmaceutical companies make and set initial prices for medicines, middlemen, insurers, hospitals and others affect the prices that patients ultimately pay. In 2018, nearly half of the money spent on brand medicines went to someone other than the research companies that discover and manufacture medicines, like pharmacy benefit managers, insurers, hospitals and others in the biopharmaceutical supply chain. Meanwhile, a greater share of the cost of medicine has shifted onto patients. The system is working for everyone except patients, and we are ready to do our part to fix it.
Across the board, private insurance should work more like insurance is supposed to: spreading costs broadly and providing affordable coverage when people are sick. For example, insurers should cover more medicines from day one for patients with chronic illnesses who are often penalized by high costs.
Insurers should also pass on more savings to patients. When insurers don’t pay full price, patients shouldn’t either.
Additionally, insurance companies pocket rebates, while at the same time using tools like copay accumulator programs to punish patients who rely on copay assistance to help cover their out-of-pocket expenses. We need to prohibit insurance practices like this that are designed to trap patients in costly deductibles.
Changes to Medicare Part D, the Medicare prescription drug benefit program — such as capping annual out-of-pocket payments for prescription medicines, lowering cost sharing and making those costs more predictable — could dramatically reduce out-of-pocket costs for seniors. And for the Medicare Part B program, which covers some of the most innovative medicines and more vulnerable patients, we support finding ways to reduce costs. That is why we are proposing a market-based adjustment that would allow the program to receive more of the benefits of the lower prices negotiated in the commercial market. This would help save seniors hundreds – if not thousands – of dollars a year, while protecting access to their medicines.
Building a More Just, Equitable Health Care System
COVID-19 has disproportionately affected communities of color. People of color were less likely to have quality health care when the pandemic hit, and were much more likely to work and live in conditions that made social distancing nearly impossible. The impact has been tragic — and largely preventable.
That’s why, moving forward, we’re making diversity, equity and inclusion part of our mission. And we are already making progress. Today, voluntary principles adopted by our industry to encourage greater clinical trial diversity will go into effect. The principles will help ensure future clinical trials better reflect the intended treatment population.
We’re also supporting the collection of more robust data that will allow us to more quickly identify and address health disparities. Persistent disparities limit any gains we make in overall health and drive higher costs throughout the system. These steps are the beginning, not the end, of our equity efforts. We’ll continue to explore structural changes in health care that would create more incentives for equitable access and outcomes.
In many respects, the idea of returning to a pre-pandemic life is exhilarating. As we continue our efforts to bring the pandemic to an end, we should not miss the opportunity to learn from it and use those lessons to build a stronger, more resilient, affordable and equitable health care system. To learn more about our plan to build that better health care system for all Americans, visit here.
Stephen J. Ubl
Stephen J. Ubl is president and chief executive officer of the Pharmaceutical Research and Manufacturers of America (PhRMA), which represents America’s leading biopharmaceutical research companies. The U.S. biopharmaceutical sector directly employs more than 800,000 Americans and invests more than $100 billion in research and development annually – more than any other industry in America.
Ubl leads PhRMA’s work preserving and strengthening a health care and economic environment that encourages medical innovation, new drug discovery and access to life-saving medicines. Ubl is recognized around the world as a leading health care advocate and policy expert who collaborates successfully with diverse stakeholder groups – including patient and physician groups, regulators, public and private payers, and global trade organizations – to help ensure timely patient access to innovative treatments and cures. The New York Times writes, “If anyone can find areas of agreement with the critics, or at least work productively with them, it may be Mr. Ubl. He is more conversant with the intricacies of health policy, and more adept at the politics."
Previously, Ubl served as president and CEO of medical technology association AdvaMed, where he helped facilitate landmark reforms related to the U.S. Food and Drug Administration product review process and Medicare’s coverage and reimbursement of medical technologies. He led the industry’s defense of breakthrough R&D, successfully delaying an innovation-stifling device tax, and, in 2013, was recognized by a leading industry publication as one of 10 people to have a lasting impact on the medical technology industry.
Ubl has worked extensively with patient advocacy organizations in health policy, including longstanding service on the board of the National Health Council, a leading umbrella organization for voluntary health care organizations and has been personally involved with JDRF (formerly known as the Juvenile Diabetes Research Foundation).
He is routinely recognized as one of Washington’s most effective advocates. Ubl has been recognized on Business Insider’s “DC Healthcare Power Players” and Modern Healthcare’s “100 Most Influential People in Healthcare.” He is identified as a top health influencer by Medical Marketing & Media and PR Week magazines.
https://www.linkedin.com/in/steveubl/
President and Chief Executive Officer
Analysis: States can help patients save nearly $1,000 annually on their medicines
Veterans Affairs 101: Three charts show how the VA system differs from Medicare
Medicaid 101: Three charts on access and spending
Government price setting won’t stop insurers from shifting costs to patients
Patients need to pay less for their medicines. States can help.
It’s a new year, but sadly Congress is still pursuing flawed price setting policies
New poll of all 50 states and 435 Congressional Districts shows perils of so-called Medicare “negotiation”
CBO reaffirms our innovation ecosystem leads to improved lives, long-term savings
New study finds more than half of brand medicine spending goes to the supply chain and others
Making medicines more affordable: Preserving safety-net programs like 340B
Post-approval research save lives. Why is Congress trying disincentivize it?
A price control by any other name would still put patients at risk and threaten innovation
Making medicines more affordable: Making insurance work like insurance
3 things to know about the importance of post-approval research and development
Insurance design barriers can impact patient adherence and can lead to poor health outcomes
What is missing in the current drug pricing plan
ICYMI: PhRMA CEO speaks at STAT Summit about government price setting
Making medicines more affordable: Sharing savings at the pharmacy counter
Three things to know about so-called Medicare negotiation polling
In the current health care debate, Congress has lost sight of what matters to U.S. voters
Making medicines more affordable: Modernizing Medicare
Making Medicines More Affordable: Making coupons count
What they are saying: Government price setting for medicines is not the answer
The patient experience: Insurance design hurdles lead to access issues for too many Americans
ICYMI: New study confirms policies like H.R. 3 could significantly reduce drug development
Government “negotiation” could have devastating consequences for Medicare enrollees
Protecting Medicare from government interference
3 factors impacting medication adherence for patients with diabetes
Data shows voters strongly support protecting access to their medicines
Medicare “negotiation” proposals threaten Americans’ access to medicines
Building a better health care system: A conversation with Mark Reisenauer, President of Astellas US
Four solutions Americans support to make health care more affordable
The FDA Office of Minority Health and Health Equity: Working to advance health equity through diversity in research
H.R. 3 threatens access to medicines, future innovation and American jobs
Our three-part approach to build a better health care system
Proactive Agenda
Our three-part approach to build a better health care system
Our three-part approach to build a better health care system