Happy Summer Fellow Netizens!
Drug prices in the United States are at an all-time high and, depending on whom you ask, there’s plenty of blame to go around for this: corrupt drug companies, government, and Pharmacy Benefit Managers (PBMs). The truth of the matter is that the drug market in the United States is complicated, messy, and unique. No other developed nation has grappled with an issue like this, and it requires solutions that involve multiple sectors of our healthcare system.
And yet, the biggest “thing” that people immediately point to when looking at the cause of high drug prices is “Big Pharma.” This large, looming boogeyman has built a negative reputation for prioritizing profits over people. But is this true?
Let’s find out, shall we…
“Big Pharma”: What is It?
When I first heard the term “Big Pharma”, I wasn’t quite sure what to think of it. To be fair, the term is frankly charged and has a negative connotation from the get-go. This is how Merriam-Webster defines it:
Big Pharma: large pharmaceutical companies considered especially as a politically influential group
Merriam-Webster
The thing that stood out, at least for me, it that it Big Pharma is a “politically influential group”. These words encapsulate the purpose of Big Pharma, linking the interests of pharmaceutical companies with government institutions. One large player dominates this space, spending millions in lobbying dollars for the interests of its members: PhRMA.
That’s Big PhRMA, with no “A”
The Pharmaceutical Research and Manufacturers of America (otherwise known as PhRMA), is the most well-funded lobbyist for the industry at large. From its website, PhRMA’s mission is the following:
“We strive to conduct effective advocacy for public policies that encourage the discovery of important, new medicines for patients by biopharmaceutical research companies.”
PhRMA, 2024
It represents some well-known companies that many of us have probably heard of (or at least know their products). Examples include:
- Bayer (makers of Aspirin, Claritin, Aleve and Alka-Seltzer)
- Bristol Myers Squibb (makers of Plavix, Eliquis and Abilify)
- Eli Lilly (makers of Prozac, Cymbalta, and Humalog [the world’s first bio-engineered human insulin])
- Gilead (makers of various HIV/AIDS medications like Biktarvy, Descovy)
- Novo Nordisk (makers of Ozempic and Victoza)
- And the list continues… (see the full list in their About page)
According to OpenSecrets (a nonpartisan, independent non-profit organization that tracks money in the world of politics), PhRMA has already spent over 9 million dollars in lobbying costs for this year alone as of May 2024. Last year (2023), PhRMA spent a whopping $27 million making it one the top 5 highest spenders in political lobbying (ahead of it was BlueCross/BlueShield at $28 million…).
Annual Lobbying by Pharmaceutical Research & Manufacturers of America
With all that information on PhRMA, one conclusion that can be made is that this lobbying group spends millions every year to promote the advancement of innovation and growth in the pharmaceutical industry. So, where in all this can we connect the dots between PhRMA and the rise in current drug prices?
PhRMA and Drug Prices
Now that we know what “Big Pharma” is, lets clarify why it is associated with the high cost of drugs in the United States. The most obvious association we can make would be that lobbying can impact policies that affect drug prices. One study done in 2020 looked into the relationship between lobbying spending and major political events. Data from the study indicated that lobbying spending by healthcare and pharmaceutical organizations increased during major elections or passages of bills in Congress; an example can be seen with the chart below.
The impacts of lobbying can be predictable; more money means more power in the world of politics. From that same study, there was one concrete example that could provide context on why lobbying works:
“…[A]lthough both [PhRMA and the American Medical Association] supported the Affordable Care Act, they did so only after receiving commitments from the Obama administration and former Senator Max Baucus (D, Montana), then chair of the Senate Finance Committee, that parallel import of lower-cost medicines from Canada would not be permitted, Medicare would not be allowed to negotiate drug prices, and Medicare payments to physicians would not be reduced.”
Olivier J. Wouters, PhD: Lobbying Expenditures and Campaign Contributions by the Pharmaceutical and Health Product Industry in the United States, 1999-2018
Money equals Power…Does it?
So, you’re probably wondering: “Well, it is certainly interesting to learn about PhRMA and its boatloads of lobbying cash, but what should we do about this?”
Well…unfortunately not much, at least on its ability to lobby. Lobbying is a protected act under the First amendment:
Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.
First Amendment of the United States Constitution
This means that anyone (a person or even a large corporation) has the protected right to speak with representatives and plead their case for causes that they believe is important. However, Congress has the power to regulate paid lobbyists. In 1995, Congress passed the Lobbying Disclosure Act which mandates any paid lobbyist to register with the Secretary of the Senate and Clerk of the House. This process requires disclosures for lobbyists, including previous political positions, income reports and prior criminal convictions. However, the Government Accountability Office has reported issues of compliance to the law (which deserves its own article at some point).
You Have a Part to Play
As I continue to repeat in previous articles, the three major items that we as citizens can focus on are: Learn, Educate, and Voice/Vote. In this context, voicing and voting are the key aspects that you have in directly combating the influence of large lobbying groups like PhRMA. Just like how these large companies are able to lobby in Congress, YOU too can bring your case to members of Congress! As someone who currently works in Capitol Hill via a health policy fellowship, I can assure you, dear Netizens, that it is not impossible to simply ask your representative’s office for a quick meeting with one of their legislative aides to voice your concerns about a certain topic.
You may be saying to your screen, “I don’t believe that for a second; why would a Congressperson want to listen to someone like me?” It may be hard to believe, but grassroots advocates can make an impact on legislation as much as large groups like PhRMA. Click here to learn about three instances where small interest groups rose up and actually made an impact in Congress. Needless to say, it requires work and determination to be successful in this endeavor. But it is not impossible!
Stay cool and safe, fellow Netizens!
Featured Image: Photo by Karolina Kaboompics: https://www.pexels.com/photo/image-of-old-building-on-american-banknote-4386157/
Disclaimer: This article reflects the author’s own opinions and statements. They do not reflect the opinions or stances of any organization affiliated with the author
