Congress, You Are to Blame for EpiPen Prices

Stop the CEO-Shaming and Take a Stand Against the TPP

Yesterday morning, I stood handcuffed to the wall at the Capitol Police headquarters. I had been arrested at a protest against the Trans-Pacific Partnership (TPP), with a simple message: Congress should oppose the TPP because it would lock in policies that lead to obscene prices for medicine.

Meanwhile, members of Congress prepared to grill Mylan CEO Heather Bresch about skyrocketing EpiPen prices.

I have advanced breast cancer, so you might think I would congratulate Congress for exposing another case of the endless pharmaceutical company greed that contributes to high prices and cuts out some patients from treatment.

No, Congress, I do not congratulate you.

Here’s why: As Bresch told CNBC, “Congress and the leaders of this country need to … fix this system…The system incentivizes higher prices.”

No doubt, Bresch was morally wrong to jack up prices for the EpiPen. She was wrong to let greed get in the way of the chance to save more lives. And she was wrong to rip off taxpayers, who ended up paying for a good share of of those overpriced EpiPens.

But Bresch was not wrong about the incentives. By U.S. law, she had the right to maximize profits even when it might lead to death for more patients. In fact, as CEO, her job was to increase profits. Her employees, shareholders, and board would have probably fired her if she didn’t. The current regulations are now set up in a way that rewards Pharma CEOs who inflate prices to the max, and who game the system to create de-facto monopolies on their drugs.

Earlier this month, my own insurance denied me access to Herceptin, a medicine my doctor prescribed. It would have cost me $54,000 a year if I had to pay for it out of pocket because it is still in monopoly status in the United States, so we can’t access the biosimilar (generic) version that is available more cheaply in India. After ten long days of treatment delays, unhealthy stress, and way too many hours of advocacy by my doctor and oncology nurse, the decision was reversed. Countless cancer patients are not so lucky; in 2015, the Mayo Clinic Proceedings found that 10–20 percent of cancer patients don’t take their medicines as prescribed, largely due to excessive costs.

My anger about these problems was first directed at the greedy CEOs, some of whom make millions of dollars a year while patients and their families suffer. But when I researched the root causes of the price gouging, I learned that Congress is responsible for the policies that incentivize these ridiculous prices — and that undemocratic international pacts like the TPP lock in those bad policies. And it is Congress that can stop them by passing laws that end extended monopolies and promote competition, including a faster track for generics and biosimilars. That requires policy space that the TPP would take away.

So I am sick of hearing Members of Congress say “Tsk, Tsk, high drug prices. Tsk Tsk, bad CEO.” It sounds like a broken record — or rather, like a corrupted MP3 of a bad rap song.

Pharma Bro Martin Shkreli, jacks up prices, smirks in hearing, Congress says: Tsk Tsk

Michael Pearson, heart med price hike, angers all, Congress says: Tsk Tsk

Heather Bresch, pop-up pricing, Epi-Panic, Congress says: Tsk Tsk

I’d like Congress to stop pretending that hearings and CEO-shaming are what our nation needs to deal with systematic price gouging. Yes, the shame might help one CEO lower the price of one med for some patients, as it may have done for EpiPens. But what about the other meds that costs tens or hundreds of thousands of dollars a year? That hurts sick people, our families, and everyone who pays insurance premiums or taxes.

What we need is policy change.

If Congress passes the TPP, we won’t be able to change some of these policies. You heard me right. The TPP would restrict Congress’s ability to implement certain cost-saving legislation here in the United States — unless all the other 11 TPP signatory countries including Mexico, Vietnam, Japan, and Brunei agree, no provision in the TPP can ever be changed. That means if the TPP is enacted, all those other countries’ political systems would have to approve if we want to change any of our policies that go against the extreme provisions in the TPPs.

Specifically, the TPP would restrict U.S. ability to change laws that allow for extended evergreening of patents on old medicines, leading to ongoing monopolies. It would legally enshrine the ability of Big Pharma lobbyists to intervene in government pricing decisions. It would not let the United States go below a minimum of 5–8 years of extra monopolies for emerging biologic medicines that give hope to so many. And, outrageously, the TPP would empower multinational drug corporations to challenge our health laws outside our courts in private tribunals of three corporate lawyers.

In other words, the TPP would lock in many of the policies that create incentives for drug companies to jack up prices for vital medicines. It would make $600 EpiPen packs sound like small change.

We can’t afford to lock in this system.

Big Pharma cries crocodile tears that the TPP fell short of locking in the 12 year extra monopolies for biologics. But Big Pharma will laugh all the way to the bank if the TPP is enacted, and Congress handcuffs itself to the wall by restricting its own ability to make deep policy changes on medicine prices in the future.

My very life depends on keeping medicines affordable. There many more exciting biological medicines in the pipeline to keep me alive. But what good are these drugs if Congress won’t have the guts to make sure that everyone who needs them can afford them?

The White House is hoping to push the TPP through Congress in the unaccountable “lame-duck” period after the election.

So, Congress, if you care about drug prices, take a public position against the TPP and the lame duck vote. Then dive into changing the policies that led to $600 EpiPens and $54,000 biologic drugs like Herceptin.

No excuses, Congress. No more Tsk Tsk.

Zahara Heckscher is a mom, a breast cancer thriver, and the co-founder of Cancer Families for Affordable Medicines, CancerFAM.org. She lost her mom to cancer when she was 11 and wants to create a world where no children have to lose a parent because medicine prices are too high, so she is working to defeat the TPP.