As a plumber, 2nd District Congressman Markwayne Mullin’s expertise might not seem to be pharmaceuticals.
But as a U.S. representative, he knows the impact of escalating prescription drug prices on his constituents because he and his staff hear about it almost every day.
Adjusted for inflation, Americans’ per capita spending on prescription drugs has increased tenfold since 1960, according to an analysis by the Kaiser Family Foundation.
As a business owner, Mullin knows about the impact of such costs on employers and the people who work for them.
So Mullin has spent the past several years digging into the issue, mostly through his membership on the influential House Energy and Commerce subcommittee on Health.
“We’re not getting any answers,” Mullin told representatives of the pharmaceutical and prescription benefit management sectors during a committee hearing in May.
“We’re going to do this. ... You can choose to be part of the solution or we’re going to consider you part of the problem, and that’s not what we’re trying to do,” Mullin told the panelists.
But if Mullin has been less than impressed with industry response to the situation, he is also lukewarm about some of the ideas bouncing around Washington.
Less regulation, not more, is the key to unlocking lower prescription drug prices, Mullin said last week.
“Right now I don’t think entrepreneurs have access to the markets,” he said.
Some observers see a priority on profits, share prices and dividends as the underlying force driving higher prices. In this argument, pricing and research decisions are driven more by what the market will bear than a reasonable return on investment, even if those decisions mean pricing some Americans out of life-saving treatments.
In Mullin’s view, more competition is the antidote. And the reason there isn’t more competition is pharmaceutical operating costs encourage consolidation, which reduces the number of drugmakers.
Operating costs, he said, are so high largely because of regulations, especially to get new drugs to market.
“Why does it take twice as long (to get approval) than in some European countries?” he said.
In the United States, new drugs are authorized through one agency, the Food and Drug Administration.
Most European countries belong to a consortium, called the European Medicines Agency, which sets testing standards that all members must follow. Test results from one member country are accepted in all the others.
Mullin said cooperation with the European agency could shorten trial times and reduce costs. He thinks that would encourage pharmaceutical startups and increase competition.
So would a less complicated method of determining who pays what for prescription drugs.
Mullin is not a fan of Congressional proposals to require more financial disclosure by medical and pharmaceutical companies, or to simply cap prices, but he is also frustrated by industry doublespeak.
At the May hearing he kept pressing — without much success — for an explanation of why something listed as a “discount” was actually a fee charged to consumers.
Last week Mullin said he still has questions about prescription benefit managers, the supposed third-party administrators who negotiate with drug companies on behalf of insurers.
“We stood up a $1 billion industry,” he said, referring to PBMs. “I want to know who’s paying for it. To me, it’s the consumer.”