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Floor Speech

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Mr. DURBIN. Mr. President, as in legislation session, I ask unanimous consent that the Committee on Finance be discharged and the Senate proceed to the immediate consideration of S. 1250; that the Durbin amendment, which is at the desk, be considered and agreed to; that the bill, as amended, be considered read a third time and passed; and that the motion to reconsider be considered made and laid upon the table with no intervening action or debate.

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Mr. DURBIN. I think I would like to----

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Mr. DURBIN. I thought that they told me the script was for some other reason.

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Mr. DURBIN. Thank you. I am new here. I am sorry I made that mistake.

Mr. President, for years, one of the greatest challenges facing American families has been the rising cost of prescription drugs. A recent AARP survey found that the price for the top 25 medications used by seniors has tripled, on average, since those drugs came to market. Those drugs include: Xarelto, Trulicity, Januvia, Jardiance, Humira, and Eliquis.

Now, I imagine most Americans already recognize the names I have read. They sound familiar because they are among the most heavily advertised products and medications on television. You may even have seen one of these ads during the Thanksgiving parade you and your family watched or while you watched a football game this weekend.

Every year, Big Pharma spends more than $6 billion each year on ads. That is the size of the entire budget of the Food and Drug Administration. In fact, we know that most pharma companies spend more on advertising than on drug research and development of new drugs.

It turns out, the United States is one of only two countries in the world that allows people to run ads on television for prescription drugs. Anybody want to guess the name of the other one? New Zealand. That is the only other country that allows this to occur.

You want to know why pharmaceutical companies spend so much money promoting their drugs? Because it increases their profits dramatically. The average American sees an average of nine ads per day, nine. Pharma thinks if they pummel you with enough ads that you will finally learn how to pronounce and spell Xarelto. You will insist to your doctor that this is the one blood thinner you really need. Sometimes it is easier in a 10-minute meeting for a doctor to just write the prescription than to take the time to explain why the drug may not be needed or a generic version might be just as good for a lot less money.

With billions in targeted spending, patients are bombarded with information but kept in the dark about one fact. Of all the things they mumble and chatter about at the end of these ads, the one thing they never want you to know is how much these drugs cost, the price.

This name is probably familiar to you if you watch television at all, Rinvoq. With billions in targeted spending, patients are bombarded with information like the name of this drug. Take Rinvoq--which is manufactured by an Illinois-based company, AbbVie, for eczema and arthritis--it is now the most advertised drug on TV.

AbbVie spent $315 million last year on TV ads for Rinvoq alone, but nowhere in the ad did they tell you how much it would cost. Want to guess what it costs for Rinvoq each and every month? The figure is $6,100. Think about that for a moment.

Well, Senator Grassley and I think it is time for Big Pharma to end the secrecy about the real cost of these drugs. If they are advertising a drug, they should disclose the price upfront. It is a basic transparency measure for patients.

We have introduced bipartisan legislation to require price disclosure in direct-to-consumer drug ads. Our plan is very simple. It has actually passed the Senate once before in 2018. In a minute, we are going to ask consent to pass it again.

Here is why we think this transparency is so important. Earlier this year, a study found that more than two-thirds of drugs advertised on TV were considered ``low value.'' Those pricey wonder drugs with ads showing people golfing and having fun, they are often no better than the other, more affordable versions of the drugs. So don't you think it is worth knowing right away that Rinvoq is going to cost you $6,100 per month rather than waiting for that moment of truth at the pharmacy counter?

One in five Americans do not take their medications as prescribed because they cannot afford it. They cut their pills in half or skip doses because they can't afford to take the medications as prescribed. Don't take my word for it. These advertisements often urge you to ``ask your doctor if it is right for you.'' So we did.

The American Medical Association said:

Direct-to-consumer advertising . . . inflates demand for new and . . . expensive drugs, even when these drugs may not be appropriate.

Think about that--inflating demand for new and expensive drugs, even when they are not the best drug that the person should take.

In 2018, Senator Grassley and I asked the GAO to look at the impact of these ads on television on Medicare's budget. The GAO found that between 2016 and 2018, these drugs accounted for 58 percent of Medicare spending on drugs. The drugs on television are more than half of the budget of Medicare's spending on drugs. These ads ballooned Medicare spending to $320 billion over 3 years. Humira topped the list with $500 million in advertising in 2018, which contributed to 2.4 billion in Medicare costs.

Let me show you this Humira chart so you get an idea of what we are talking about. I used this chart in 2017 when I first introduced this legislation and when the monthly cost of Humira was a mere $3,743 a month. Guess what has happened. The cost of Humira has now risen to $6,900 per month. Shouldn't AbbVie, the pharmaceutical company that makes Humira, disclose that real cost of the drug to you so you can use the information in making treatment decisions?

Our bill is supported by AARP, which speaks for seniors across America; the American Medical Association, which speaks for doctors across America; the American Hospital Association and 88 percent of Americans support the concept of this bill. How can anyone object to it?

Hold on tight. You will find out.

In fact, President Trump supported it. After our bill passed the Senate but was stopped by a single House Republican, President Trump issued rules to require these pricetags. Famous for his tweets, here is one that I want to advertise. Look what he said:

Big announcement today. Drug companies have to come clean about their prices in TV ads.

This is from former President Trump.

Historic transparency for American patients is here. If drug companies are ashamed of those prices--lower them.

I didn't always agree with President Trump, but he was sure right on in that statement. In fact, he supported our bill.

Unsurprisingly, Big Pharma went to the courts to stop this legislation. They hate the idea of being open, honest, and transparent with the American people about the price of their drugs because they are afraid it is going to cut into their profits.

Senator Grassley has been a great partner, and I want to ask him why he believes it is important to bring a dose of sunshine to these airways.

Senator Grassley.

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Mr. DURBIN. I want to thank Senator Grassley. He is a proud Republican conservative. I am on the other side of the spectrum. I am a Democrat, proud of my progressive background.

The two of us agree on this because it is common sense. If the drug companies are going to spend a fortune, billions of dollars--more than they spend on research for new drugs--advertising these drugs, we have a right to ask: What does it cost? Is that such a tough question to answer? Not if you are proud of your product. Not if you are proud of the price you are charging.

But if you don't want the American public to know, you conceal the price and you send Senators to the floor to object.

Now, both political parties spend an awful lot of money on political opinion surveys: What are Americans thinking? Do you know what shows up as a No. 1 concern year after year after year? The high cost of prescription drugs. That isn't getting any better.

If you ask insurance companies: Why does the cost of health insurance keep going up? The No. 1 driver: the high cost of prescription drugs.

If you ask: What are we going to do about Medicare's runaway costs? You have to do something about the high cost of prescription drugs.

We are addressing that issue directly, but there are only four U.S. Senators on the floor of this Senate for this occasion, because we are not going to go to the measure and actually debate and consider it. It is going to be pushed aside for a procedural reason, and it will go back to an empty floor and an empty Chamber waiting for the next rollcall on a nomination.

The American people have lost faith in this institution because we are afraid to tackle the real issues they care about. This is one of those issues. It is a bipartisan matter, even approved by former President Trump, and I am sitting here talking about it. It is an indication to me that this an idea whose time has come.

1250; that the Durbin amendment, which is at the desk, be considered and agreed to; that the bill, as amended, be considered read a third time and passed; and the motion to reconsider be considered made and laid upon the table, with no intervening action or debate.

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Mr. DURBIN. The Senator from Idaho is my friend. We have worked together and served together, and I count him as my friend.

I would just say that arguing that the list price is deceptive suggests that there is some third party, some Agency--perhaps in Government--that is creating this list price which we are asking to be on the ads that the pharmaceutical companies put on television.

Do you know who creates the list price, Mr. President? The pharmaceutical companies themselves. We go directly to them. Give us the list price. You saw what happens over the span of a few years: The list price can double.

Who is creating that doubling in the price? The pharmaceutical companies themselves. And, now, to argue that the price that they agree on, that they advertise, is one that is somehow deceptive to consumers just doesn't square.

Have you ever heard of AARP, the American Association of Retired Persons? Most of us respect them because we have worked with them over the years. They speak for seniors. They have endorsed this bill. They don't think it is confusing or deceiving to tell consumers how much these drugs actually cost.

Let's get down to reality. Whether it is from healthcare providers or pharmaceutical companies, many times the starting price is not the end price. But you never know where that is going to end up. It depends on the insurance company, for example, as to how much they are going to reimburse or whether there are any copays involved in it. So the one price we can stick with is the price created by the pharmaceutical companies themselves.

Is it so confusing to consumers that you can't state a number? They get it. They know what the cost is. What they don't get and what they may not understand is all of that mumbling that goes on at the end of the ads: Don't take this drug if you are allergic to this drug. Incidentally, this drug may kill you.

You listen to all that stuff, and you say: How in the world can they jam in all of that information in just a few seconds?

Listing the price of a drug on TV is very simple, very straight, and very honest and transparent. Pharmaceutical companies should want to join in that effort.

I thank Senator Grassley for coming to the floor to join in this effort today.
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