Merck, Biogen Growth Lobbying to Defy Obamas Drug Comparisons
Already the biggest spender on influencing policy, the drug industry is hiring well-known individuals, some with stories of personal battles against disease. They include Tony Coelho, a former House Democratic leader who has epilepsy; Andrea LaRue, counsel to Tom Daschle when he was Senate Democratic leader; and the firm of Democratic fundraiser Tony Podesta, brother of Obama adviser John Podesta.
The firepower shows the drug industrys resolve to stop Obama from using comparisons of medical treatments to force cuts in health costs. More than half of medical care may be based on insufficient evidence of effectiveness, the Congressional Budget Office said in March. Meantime, the Health and Human Services Department says all medical spending will probably rise this year to $2.5 trillion, or 18 percent of the economy.
“The companies fear that older generic drugs might very well turn out to be better than the newer advertised drugs, which bring in much more of a profit,” said Julian Zelizer, a history and public affairs professor at Princeton University in Princeton, New Jersey. “In difficult economic times, the drug companies dont want to take any risks, so they are bringing out the biggest lobbyists in the business.”
Lobbying vs. Studying
The economic stimulus package includes $1.1 billion for studies showing which medical treatments work best — less than the $1.6 billion the drug industry spent on lobbying from 1998 to 2008, according to the Center for Responsive Politics, a Washington-based research group.
Drug companies “are concerned that there is a potential to come down with pronouncements about what should and shouldnt be covered,” said Jane Horvath, senior director for public policy at Merck, based in Whitehouse Station, New Jersey.
Opponents cite the U.K.s National Institute for Health and Clinical Excellence, or NICE, which looks at the cost and benefit of medical treatments in deciding what should be covered by national health insurance. The agency said March 5 that Tykerb, sold by GlaxoSmithKline Plc of London, is too expensive for routine use in women with advanced breast cancer. Given with chemotherapy, Tykerb costs about $35,000 a year for each patient, the agency said.
Insurers Push Back
Indianapolis-based WellPoint Inc., the second-largest health insurer by revenue, and Philadelphia-based Cigna Corp. are backing Obama with a lobbying push of their own through their Washington-based organization, Americas Health Insurance Plans.
“We need more information about which drugs, treatments and technology are more effective and we need to put that information in the hands of consumers and providers,” said Robert Zirkelbach, a spokesman for the trade group. “That will go a long way to improve the quality of care and bring down health-care costs across the board.”
The drug industry outspent all others in the last decade for lobbying. Health insurers, which back Obama in support of comparative effectiveness, spent $246 million from 1998 to 2008.
Drugmaker Victory
Drugmakers notched an early victory this year against comparative effectiveness. The $787 billion economic stimulus law, signed by Obama in February, dropped cost as a consideration in comparative effectiveness studies.
Merck and Schering-Plough Corp.s cholesterol pill Vytorin may face tougher competition from generic simvastatin if federally funded studies show it no more effective at unclogging arteries. Vytorin prescriptions dropped by a third last year after a study found the pill, a combination of simvastatin and Kenilworth, New Jersey-based Schering-Ploughs Zetia, worked no better than the generic pill alone. Vytorin costs about four times as much as simvastatin.
Obama said during the presidential campaign that studying medical treatments side by side is essential to saving money for expanded health coverage.
The presidents Federal Coordinating Council for Comparative Effectiveness Research, formed last month, includes Ezekiel Emanuel, brother of White House Chief of Staff Rahm Emanuel, to oversee the studies. The councils first report to Obama and Congress, containing recommendations of what treatments should be studied, is due June 30.
Advancing Cost?
“We need to compare whether some of these new ideas are really advances or more costly alternatives to what we know will work,” said Henry Waxman, a California Democrat and chairman of the House Energy and Commerce Committee, in an interview.