 And to the reporters on this call, thank you for your work to report on this critical issue of prescription drug pricing. There's obviously a lot to talk about and we're really pleased that you came to join us today. I'm Jen Taylor. I'm the Senior Director of Federal Relations at Families USA. It is my honor to kick us off. As we all know, last week, the Biden administration announced the first 10 drugs that the Secretary of HHS will negotiate for, for fair prices as part of the new Medicare negotiation authority provided under the Inflation Reduction Act. These drugs are gonna be the very first drugs that Medicare has ever had the authority to negotiate for. So this is a monumental step towards lowering drug costs, certainly for the millions of older adults and people with disabilities that rely on Medicare and hopefully really taking us in a new direction for the entire country and achieving affordable prescription drug pricing. These are drugs that we're gonna be talking about today that so many of us and our families and friends rely upon to treat chronic conditions. They cost people who rely on Medicare thousands upon thousands of dollars for just routine treatment. Among these drugs are blood thinners, diabetes medication, treatments for heart failure, cancer drugs, taken all together. These drugs cost the Medicare program $50 billion over the last year, representing 20% of total part D drug spending over that time. So perhaps it's not surprising then that we see that seven drug companies, the US Chamber of Commerce and the National Infusion Center Association have all filed suits against Medicare negotiation in order to protect these profits. But as it's so clear that drug pricing negotiation is gonna have tangible, meaningful benefits both for the Medicare program writ large and most importantly for the millions of people who rely on Medicare for their prescription drugs. We have to also be clear that any company seeking to upends negotiation is seeking to protect their profits at the expense of people who rely on these medications for their health and their livelihoods. So you didn't come here today to hear from me. We've got three incredible advocates for prescription drug pricing reform who can speak from their different perspectives on the critical importance of this new step of Medicare negotiation and what's at stake in getting this right. So first up is a man who perhaps needs no introduction but I'm giving him one anyways. Senator Pater Welch from the great state of Vermont is elected to serve in the US Senate in 2022. And so while he may be a relatively new member of the upper chamber, he's certainly not new to Congress or to work on prescription drug pricing as a longtime member of the House of Representatives and a senior member of the House Committee on Energy and Commerce, he's been at the table for the better part of two decades on federal drug pricing reform work. He was a champion of the IRA when he voted for it in the House of Representatives. And now in the Senate, while he's accomplished much he's still not resting on his laurels. He's introduced the Strengthing Medicare and Reducing Taxpayer or SMART Prices Act which would build on the success of the IRA and give HHS enhanced authority to negotiate for drug prices in Part D. So we are beyond honored and thrilled to spend this time with you today. Sir, I know you have votes so we're gonna kick it over to you. Appreciate you making it all work. And with that, I turn it over to the Senator from Vermont. Thank you very much and I wanna thank Family to USA. I wanna thank my partners in crime, Sarah to Sylvie and David Mitchell and Bailey you're there. I really appreciate, it's a big day. But here's the question, okay? What is more important to any country than to have a healthcare system that takes care affordably of the healthcare needs of its citizens? That's the question. That's much more important than the particulars of what a procedure cost or who does it or whether it's private, whether it's public. It's about a country coming together to do its best to have a healthcare system that delivers affordable and accessible care. And that is to every citizen, whether they're poor or rich, whether they have a job where the employer provides healthcare or it doesn't. That's the ongoing challenge. What has happened, of course, in healthcare is that medications have become more and more important in the treatment, in the pain relief for our citizens. And we have a situation here that's unique to America where the pharmaceutical companies who do good things. So all of us here, either personally or a loved one has had the benefit of pharmaceuticals that have extended life for relief pain. But what is happening where this country is unique in that it's the only country where the government that is to represent the objective of affordable and accessible healthcare stands on the sidelines and seeds to the pharmaceutical companies, total pricing power. And of course it starts out with the patent where by law the inventor of the medication can charge whatever they want. And none of us here oppose that. That's to protect the incentive. But what has happened is that our drug companies have essentially abused the patent system. And then when there was the passage of the Medicare Part D, stopped the government on behalf of people from doing what every other government does. When it buys wholesale, it wants to pay wholesale. We're the only government where we buy wholesale and we have to pay retail. I mean, it's really that simple. So why is it if you ask a person that embryo, just as an example, if you need it in the US, it costs $5,000, right? We're right, Sarah, you and I, we're right on the Canadian border. We cross the line, we pay $1,000 in Canada. And why is that? It's because the US essentially says to the pharma companies charge what you want, we'll pay it at the expense of taxpayers, at the expense of our employers who want their employees to have access to healthcare but are constantly dealing with these premium increases that then mean lower pay increases for people who need to pay the bills. And it doesn't have to be that way. Now, the Medicaid price negotiation essentially brings us the United States of America through the Medicare program into the same situation that the Pentagon's in and that every other country is in. If you're buying huge quantities, whether it's aspirin or emerald, you get to negotiate a bulk price discount. It's as simple as that. That's what's called capitalism in the market system, but we had a law here that we had to overcome that says we're gonna be the suckers, the government is just gonna go to the taxpayers and stick it to the employers whose premiums are gonna go up and we'll just stand by and let the pharma charge whatever it wants. And what's heartbreaking to me about that, we all have our stories of people who are in these horrible situations. And it's always more severe when it's not about you, it's about your child, it's about your partner where they need this and it's right within reach, but they literally can't afford it. And they start cutting the pills in half, they start missing, taking the doses. That is a result of public policy. It's not necessary. But the reason I'm so upbeat about this is that this law more than anything else recognizes that the government that is for the people has an obligation to stand up and defend when there's been really an abuse, in this case of the patent system. We've got to make healthcare accessible, that means it has to be affordable. Now, the big pushback from pharma, it's the standard one, this'll decrease innovation and the logic that they have is that let us charge whatever we want, no matter how much it bankrupts an employer or government, because we won't innovate unless we can rip you off. That's literally what it comes down to. But you know what? It doesn't have to be that way. Why is it that we pay 5,000 and in Canada it's 1,000 for that drug, Emeril? So the business model of pharma is to just stick it to American taxpayers and American consumers and the American medical system. You know what? Even out, let the folks share the cost of the research and development. So this is significant because we do have to bring the cost down in service of making healthcare affordable to every single person. And we're seeing the big pushback and if our pharma executive making $20 million a year and the delivery of the shareholders, I'd probably be a little bit nervous too because now I'm actually gonna have to earn my salary, but earn it by actually coming up with innovation, having to find a business model that doesn't stick it to American taxpayers and consumers and folks who are in desperate need of healthcare. So this is very affirming because I see this is fundamentally about making healthcare affordable. And in no way do I see this as a threat to innovation. So it's been a long and tough battle and the effort goes on. There's a lot of litigation. And basically the litigation premise is that we should be, it's uninstitutional for us to have to negotiate the price. And I think they're gonna lose the litigation. And I think as people start seeing the benefits of this is gonna be embedded. And I hope we can deal with this and addressing other cost issues in healthcare to make it more accessible and affordable. So thank you all very much for your leadership and the fight continues. It does indeed. And we are very, very lucky to be able to have you as a champion and a partner in that fight. So thank you, Senator for joining us today. I know you're gonna try to stick around for some questions if you don't get pulled away to vote. So with that, I'm gonna kick over to Sarah to Sylvie. Thank you again for joining us, literally during your clinic hours up in Vermont. So I will keep this brief. Sarah is a Vermont based nurse practitioner working at Georgia Health Center for the last decade. She practices full-factor rural family practice, pediatrics to geriatrics, taking care of many four generation families. She went back to school to get her doctorate in health systems leadership and quality and loves taking care of patients and working to take care of patients better. I think we all can agree we would love to have a provider just like you. When she is not at the health center, she leads a national collective charged with developing language and data standards to address social determinants of health. So she is well versed both in the day-to-day impacts of what we're talking about today and what it looks like from a policy perspective. So Sarah, with that, I give you the floor. Thank you so much. First off, I wanna say I'm just grateful to be here speaking on this very, very important topic. It's one of those that's mission-driven for me. So if there's ever an opportunity to speak to it, you know, I'll be there. I'm gonna build off of Senator Welch who's speaking of and lean into a topic that I think is very near and dear when it comes to this area is called moral distress. There's this term that we have in healthcare, which is when you know the right thing to do, the ethical thing to do, but you're constrained from doing it. And it's such a crucial concern that we name it and talk about it. And there's very clear applications of that feeling of moral distress when it comes to the conversations that we have to have on a regular basis with patients who have Medicare coverage regarding the difference between what we know we should be doing for them, the medications that they should be on, and the medications that they can afford. The list, this first, which I hope a first of many medications that are on this list for negotiations are the best in class recommended medications for some of the highest risk concerns that I see on a daily basis. My patients with heart failure, my patients with diabetes, my patients with different kinds of inflammatory arthritis disease. And each of these medications has a very clear space on the guidelines for what I am supposed to do for you. But I sit with patients every day and I say, I know we're supposed to give you this medication. I tried, it's too expensive for you. So what do we do next? Even simple insulin is on this list as well. So I just wanna hold that up that what we're really talking about is like an ethical problem that is not necessary, right? In order to address that, it's very simple. Do we just need to be able to negotiate on these and many more medications to come because this is what we should be doing for patients. It's what the evidence says we should be doing. These are the patients that we're trying to keep well and living their lives and out of the hospital, but simply we cannot afford to do it. And that's an ethical problem. And I think that's really the heart of it for me. I can go on and on about different patient stories, but that's what comes down to and it just needs to be addressed and we need to stop and just do better and be more like other countries as we focus on this approach. Thank you so much, Sarah. And they may just have some questions for you when it comes to patient stories in just a moment. So before we get to questions, I do want to introduce last, but certainly not least, David Mitchell who has joined us today in his role both as president and founder of Patients for Affordable Drugs, which we may all know him speaking from, but also as a patient. And I think that's why David is such an extraordinary champion for affordable drugs. As you probably know, Patients for Affordable Drugs is the only national patient advocacy organization exclusively focused on lowering prescription drug pricing. They have a very clear vision, which is just simply that every person in the United States can get the prescription drugs they need at prices they can afford. Again, he's been an extraordinary champion for affordable drug pricing as an expert with more than 40 years of experience working on healthcare and public health, but also as a patient with an incurable, but treatable form of blood cancer and depending himself on drugs costing hundreds of thousands of dollars a year for his survival. So I'm not sure there's anyone who could speak to this issue more passionately and eloquently than David and we really appreciate you being here today. Well, thank you very much for having me and Sarah. It's a pleasure to hear from you. Senator Walsh, good to see you and always good to hear you lay things out so clearly and so powerfully. And thanks to FamiliesUSA for pulling this together. You know, the drug provisions in the Inflation Reduction Act are historic. Over time, they're gonna save money for millions of Americans by allowing Medicare to negotiate directly on prices by curbing annual price increases by holding the line on premiums. And finally, finally putting in place an annual out-of-pocket cap in Medicare Part D. As the Congressional Budget Office points out, the reforms are going to improve both the financial wellbeing and the health of people, more of whom are going to be able to afford to buy and take the drugs they need. As to negotiation specifically, it's really important to know the history. Back in 2003, when the Medicare prescription drug benefit was enacted into law, Big Pharma bought a sweetheart deal. The chairman of a key committee, Billy Towson, inserted into the bill a prohibition on Medicare negotiating directly with drug companies for lower prices. Now, shortly thereafter, Towson left Congress and went to work for the Powerful Industry Trade Association pharma for a salary of $2 million a year. Now, for almost 20 years after that, pharma fought successfully to keep that sweetheart deal. Drug companies could dictate a price and the American government could not negotiate directly for a better deal. Now, that changed last year with the passage of the Inflation Reduction Act. But of course, the drug corporations and their trade associations are not having it. They filed nine lawsuits. Apparently one was withdrawn today. So maybe there are eight, there could still be nine to block the new law and to thwart the will of the American people, more than 80% of whom support Medicare negotiation. Now, the fact is Medicare sets prices for everything else it pays for in healthcare. Doctors, hospitals, tests, but pharma says no, they won't even negotiate. Pharma says it has to have the power to set prices for the brand name drugs we buy. Now, as a patient with, as was pointed out in curable blood cancer, whose drugs carry a list price of almost $1 million a year, the four cancer drugs I have to take, I can tell you it's wrong. Just one of my cancer drugs, an oral drug under Part D called Pomelus, costs about $1,000 per capsule, but it costs less than a dollar a capsule to make. And I have to pay my out-of-pocket currently based on that $1,000 per capsule price. And that list price means I'm paying more than $17,000 per year out-of-pocket for that one drug. Eloquous, a blood thinner I have to take, that maybe one of the first drugs is going to be one of the first drugs negotiated as a list price of almost $7,000 in the U.S. Because it's maker, Bristol Myers Squibb has blocked competition. In Canada, where there's a generic, the price is less than $1,700. Now, the drug companies also claim, as the senator pointed out, that negotiation leading to lower price going to kill innovation and new drug development. But this is a red herring that just doesn't hold up. In fact, the new drug law is going to spur innovation because drug companies won't be able to generate huge profits by extending monopolies and raising prices at will on old drugs that we're going to negotiate over. They're going to need to innovate. What's more, the negotiating process under law requires that Medicare gives central weight to the clinical value of the drug, whether it represents a therapeutic advancement and the extent to which it meets an unmet need. In other words, drug companies are going to get higher prices for high quality innovative drugs. The law maintains the incentives for innovation that already exist in the U.S. by allowing drug makers to be rewarded for investment and risk by setting their launch prices and maintaining that FDA awarded period of exclusivity, exempting all medications from negotiated prices for a nine to 13 year period. So we can't let the drug companies overcome the will of the American people and restore their sweetheart deal. We're supporting the legal fight against Big Pharma. We've always already signed on to one amicus brief opposing a preliminary injunction in Ohio to stop implementation of the law. And we are going to keep working, doing everything we can to make sure the courts understand how patients are going to be harmed if the law is delayed or overturned. Thank you so much. Thank you to all three of you for your comments today. I'm going to open it up to any questions that folks in the call may have for either the Senator, Sarah or David. We do have a question in the chat. Since Kennedy, Warnock and Collins should be insulin bells don't address the high list prices and only Bush Sanders bill insulin act for all of 2023 addresses the high list prices. Do you think provisions from the Bush Sanders bill should be included in the insulin bill that might be included in a Senate drug price and package since it addresses the root of the problem? Or do you think it will be difficult to include the provisions of the Bush Sanders bill? Sarah, I'm going to say you don't have to answer that question. That's probably not going to kick it straight to you. I don't know Senator Welch if you had a position on the bill from your colleagues or David if patients for affordable drugs has a position on that issue. Sorry, the long question. So we can also repeat it if that's helpful. It would be helpful to repeat it. Bailey, you're breaking up a little bit. Apologies, and I can also talk a little slower. Is that better? Yeah. Great. So essentially the Kennedy, Warnock and Collins, Shaheen insulin bills don't directly address high list prices, whereas the Bush Sanders bill insulin for all act of 2023 does address list prices. Do you think that provisions from the Bush Sanders bill that addresses list prices should be included in any insulin bill that could be included in the Senate drug pricing package? But not just capping out of pocket for insulin, but also addressing insulin list price, the crux of the question. We're firm believers that we really should be trying to do both, that you can't really lower out of pocket without lowering price. Otherwise patients just wind up paying in other ways with higher premiums. They get less money in their paycheck if they're getting their healthcare from their employer. So we believe that lowering out of pocket needs to be coupled with lower prices. However, things happen in steps. And we took a huge step last year in winning the drug pricing provisions in the Inflation Reduction Act. And we will begin to negotiate now 10 drugs to begin with then 15 and 15, 20 and 20 in the ensuing years. So we need to always remember that we have to reach for what is the best we can achieve. And if it isn't one bill exactly the way it was written or another bill the exactly exactly the way it's written, that's not nearly as important is making sure we get the best possible result that we can achieve that will help the greatest number of people. Thank you so much, Bailey. Do we have any other questions in the chat? At this time, there are not any questions in the chat. If folks want to feel free to use the Q and A chat or the regular chat to submit questions I can read them aloud. In the interim, I know we did have a question for the Senator, some reflections on the moment we're in. Bailey, do you want to go ahead and ask? Yes, thank you. We did get a question for the Senator which is given this moment, sorry, let me pull it up real quick. All right, given this moment, what does it mean to see the law that you fought to pass in the house go into effect with the announcement of the first 10 drugs? There's two things. One, it's been like a 20 year battle and it's about addressing affordability issues. And we've got those across the economy that really affect working families but there's nothing more poignant than when you can't afford the medication your child needs or your partner needs. So the fact that we've got government standing up for fairness and affordability is really a thrill. Second, not a moment to lose. We've got to keep at it. The fight never stops. The challenges that we face to make healthcare affordable, those are going to continue. So I feel good, but I don't feel, I feel good, but nervous. We've got to keep at it. 100%. As we give just another moment or two for questions in the chat, Sarah, I am coming to you now. You didn't have to answer the wonky legislative question but I am going to come to you for that personal touch that you talked about. I know you've seen a lot of stories in terms of firsthand impacting your patients. Is there anything you'd want to lift up today that you really want people to sort of keep in mind as we move forward in how we're working on this? I guess the thing I want to stress is that in our work and taking care of people, we think about negotiable things like and things that are must haves, right? And so for patients that live on the margin and many and most of my patients in rural Vermont live on the margin, they have a small social security allotment, they have a fixed price rental, they're getting by as best they can. These prices affect everything, right? So if they choose to go forward in the medication that's required and they're paying extensive out-of-pocket, it becomes like the gas they can't buy or the foods they can't afford to eat that drives the diabetes that is uncontrolled or the heart failure admission that we could have prevented, right? There is not like in the lives of many of the people that will be most drastically affected by the reduction in prices out-of-pocket and negotiations, everything's interconnected. It's housing, it's food and the medications are things that if they can't afford them, if they actually make the choice to go forward and they're paying those prices, they're living on the margin with everything else, right? That they're scrimping and saving, they're not doing things that they should be doing in other areas because they're making this the thing that they do and we have to solve all of that for them, right? So solving the price problem is solving like a general wellness problem that shouldn't be there in the first place. Looks like we didn't get any more questions in the chat. Anybody else have last comments they wanted to leave folks on the call with David or Senator Welch, if there's anything else you wanted to leave us with? No, I just want to take a second to thank Senator Welch for his leadership and the fight goes on. And this is not a man who rests on his florals. So we're really glad he's there. Thank you, Senator. Well, you're kind of do that, but it's really, really hard. Sarah, you have patients that come in and you see the anxiety that they have and the shame they have if they can't afford something, there's no way they can afford because they regard it as their obligation to take care of the person they love, no matter what. And it's like you've seen people if they can get a second mortgage, they'll do it. If they can go into the retirement, they'll do it. But do we really want to be a society where we impose that anxiety and uncertainty on people when we really don't have to? So this is a righteous cause for a healthcare system that's affordable and accessible. And we can have it with the innovators and the creative efforts to create new viewers. We can continue to support that and maintain our position of doing that, but it's got to be affordable. I think that was part of the reason. Thank you all so much for joining us. You're extraordinary advocates and really extraordinary humans. And I appreciate both the thoughtfulness and the human compassion and empathy that you approach this work, all three of you. So thank you so much for the time today and to all the reporters who joined. I know this is a story that is going to be ongoing. You're gonna continue to have questions and want to make connections. I know Families USA is available to you at any time. And certainly while these are some very busy folks on the phone, I am sure that they will be available for follow-up questions you may have as you continue to really bring this story to the public and keep reminding folks why it's so important. Thank you all for your time. We'll let you get back to your busy days and keep up the good fight. Take care. Thank you.