Twopart hearing with drug company leaders. It is three hours 35 minutes. Welcome to todays hybrid hearing pursuant to House Speaker rules some members will appear in person and others will appearer remotely. Some members are appearing in person, let me first remind everyone that pursuant to the latest guidance of the house attending physician, all individuals attending this hearing and person must wear a face mask, unless you are speaking. Members whono are not wearing a face mask will not be recognize recognized. Let me also make a few reminders for these members appearing in person. You will only see members and witnesses appearing remotely on the monitor in front of you. When they are speaking and what is known as web act as active speaker view. A timer is visible in theib room directly in front of you. For members appearing know youre all familiar with web ex by now, but let me remind you of a few points. Whether they are in person or remote song as they have their web ex set to active speaker view. If you have any questions about this, please Contact Committee staff. The timer that should be visible on your screen on your active speaker with thumbnail view. The house rules require we see you so please have your cameras turned on at all times. For members appearing remotely should remain muted to minimize background noise and feedback. Since i will recognize members verbally, let members retain the right to seek verbally. Regular order members be recognized in seniority order for questions. Lastly, if you want to be recognized outside of regular order, you may identify that in several ways. New music chat function resent a request for you may send the email to majority staff or unmute your mike to seek recognition. Obviously we do not want people talking over each other. So my preference is that members use the chat function or email to facilitate formal verbal recognition later. Committee staff will ensure that i amns made aware of the request and i will recognize you. Will begin the hearing in just a moment. Enwhen they tell me they are ready to begin the live stream. The committee will come to order. Without objection, the chair is authorized to declare recess of the committee at any time. I now recognize myself for an Opening Statement. Good morning and welcome to day two of our landmark series of hearings yesterday we heard from ceos from three Drug Companies bristolmyers squibb, and tivo. And what we learned was shockin shocking. Drug companies are hiking Prices Higher and higher placing an even greater burden on the very patients who rely on these drugs to survive. We learn the skyrocketing prices are unsustainable. Both for Government Programs and American Families. We also learned that claims by Drug Companies that their price increases are necessary for research and development are completely bogus. The internal Company Documents we obtained, show that Drug Companies hike prices almost entirely for selfish reasons. They do it beat Internal Revenue targets or to increase their own bonuses in some cases. Drug companies certainly spend some funds on research and development. But nowhere near the windfall profits they are bringing in as a result of their massive price increases. Finally, in the cases we examined yesterday, we learned that Drug Companies target our country for their biggest prices. And for their biggest price increases, charging the American People more than the entire rest of the world combined. They do it, simply because they can. Because federal law currently bars our government from negotiating directly with Drug Companies to lower prices for medicare. According to the nonpartisan ceo allowing federal government to negotiate directly with Drug Companies, couldlo lower spending on brand name drugsru by about 456 billion. So let that number sink in, it is nearly half a trillion dollars. Today is day two and we will hear from three more executives. Will hear from the ceo of antigen which completely raise the price of two drugs used to treat rheumatoid i try to send other inflammatory diseases. He as you said treat the effects of kidney failure in thyroid cancer. Will hear from the top u. S. Executive from novartis, about the companys massive price increases for ath drug that treats Myeloid Leukemia. A rare cancer of the blood and bone marrow. We will hear from the ceo of mala crop, about the pricing of its drug called hp. [inaudible] paid which is used to treat a rare caesar disorder and little babies. Freund hubert Opening Statement shorts because we want too hear from the testimony from our guests. But i would now like to turn to our Ranking Member for his Opening Statement. Smacked thank you madame chairwoman for holding this hearing. I like to reiterate a few points brought up at uyesterdays hearing. First, republicans have introduced legislation, hr 19, full of bipartisan provisions that the house could pass today and could be signed into law by the end of the week to decrease the cost of Prescription Drugs for all americans. Second, pharmaceutical innovation is vital to enabling americans to live longer and healthier lives. But we must ensure those Innovative Products are accessible and affordable for all americans. L third, will brand pharmaceutical manufacturers play significant role, we must look at the entirety of the pharmaceutical marketplace including pbms, health insurers, generic manufacturers and wholesalers to truly solve this problem permanently. At this time, met insurers like to yield the balance of my time to representative massie. Thank you Ranking Member and thank you madame chairwoman. I anticipate todays discussion and testimony will involve the u. S. Patent system. And sontem in this Opening Statement, id want to read the patent and copyright because that is in the constitution. N. This clause was so uncontroversial, that it was accepted by all of those who are drafting and voting on the constitution unanimously without debate. It says the United StatesCongress Shall have power to promote the progress, the science and useful arts by securing for limited times, to authors and inventors the exclusive right to their respective writings and discovery. To some people, who have not studied this issue too much, think that perhaps patents are the reasons drug prices are high. But the reality is, on a lot of the drugs, the patents have expired. There is no restriction from the Patent Office to keep somebody from making the generic version of the drug. But there are other impediments not involving patents to stop these genetics from coming to market. I hope we find out what those are about. And i also want to say that our Founding Fathers were really smart here. They knew that if the owner had a limited period to recoup their investment, the inventor and the owner, than they would be able to find the capital the backers to develop these ideas and discovery. So even if you have scientists who would come up with new drugs for free and they just gave thehe idea away, these new drugs require hundreds of millions in some cases of development in order to bring them to market. Without a patent which is equivalent to a deed, i could do to peace of property, no one would develop a peace of property they could not get secure title to a property. Patents work the same way they allow investors to get clear title to the idea so that they can then invest the money thats required to bring that to market, to tested and make sure it is safe for all human beings. So i look forward to a robust discussion on that. Without a yield back. I want to thank my w colleagues and with your indulgence, because of my cough i would just like to leadth up to the video we want to play before we go intoay it. But i did want to respond to my good friend and colleague mr. Comer. I agree which work on this issue it should be bipartisan. But since you mentioned yours im going to mention my hr3 which would nearly allow our country to negotiate for a lower drug prices for medicare thas we do with the veterans association. Its past the house is now the senate. I would really like to do right now is to honor and ijremember our former chairman Elijah Cummings who launched this investigation 18 months ago. His number one priority then in our number one priority now, is to help the wellbeing of the American People who are being harmed by a daily basis by these astronomical price increases. So i would like to conclude my statement by playing a clip of three individuals patients and doctors who are being directly and negatively affected by the actions of these three Drug Companies. And if we could now play that video. And move quickly q forward. Statement my name is heidi i am a proud mom from missoula, montana. Three years ago after an abnormal blood test, my doctor told me i had leukemia. One day i was healthy, the next day hadi cancer. Om it was a complete shock. He told me i am lucky though, my cancer is treatable with a drug. But i would have to take it every day for the rest of my life. Then i got a second shock, on top of my awful diagnosis, he told me the drug cost 10000 every month. I am so grateful for gleevec, keeps me live. But the price tag constantly hangs over my head. Instead of just focusing on my family and myy health, i also have to carry around the burden of what would happen if i cannot pay for. I have no choice, but you all have a choice. You can take action to lower drug prices. T because drugs dont work if people cant afford them. Civic hello my name is carteret im a pediatric neurologist, i take care of babies suffering from c a rare disease. The best to help is a gel part without this medication children are likely to face lifelong uncontrolled epilepsy have Developmental Disabilities including mental retardation. Families affected by this condition, this is the best chance for their child to live a more normal f life. It is not a new drug, in fact it was first founded 1952 prepared decades it was priced at 50 a bow. But since an drug Company Seeking more profit have madets a series of unwanted price increases. Today almost that same file from his 40000 in 1000 increase. The price of that drug. Is impacted my practice and my patients devastating ways. I must know families can afford 150,000 for a treatment course. For my patients the cost delays their care, prolonged hospitalization, increases seizure in harms intellectual developmentt. If it can mainly hide price because they have it captive Patient Population and doctors do not have a good alternative. The prices lot rely on the desperation of families with their children suffering. It should not be able to profiteer in the tragedy of these babies. Thank you for listening and i appreciate you addressing this issue. Stomach high, my namee is kip burgess and im from chicago, illinois payment of 30 is diagnosed with incurable condition called psoriatic arthritis. To treat theon constant pain for my disease, i think a weekly injection of a drug called emerald. When im on embryo, i do no have symptoms, can ride my bike or scoop up my 1yearold daughter, totally painfree, almost forget i am sick. But i also have to carry the fear of knowing all of this can be ripped away. Because embryo is priced at nearly 6000 every single month my ability to cover that cost goes away ill go back to waking up on top of that because the way this drug works, missing even one dose committed drug stops working for me. These risk crippling anxiety and top of the burden of the disease itself. In order to avoid these interruptions in my dosing, ive been forced to dip into my savings and jeopardize my financial help to preserve my physicalin health. But i have no choice. I consider myself one of the lucky ones. I urge you on behalf of patients to it acts solution to lower drug prices. Thank you. Thank you very mention of them introduce our witnesses. And we are grateful for their attendance today and for their testimony. Our firsthe witness today is mr. Robin bradley is a chairman and ceo of amgen. Amgen sells the antiinflammatory drug and a Chronic Kidney Disease drug, it will go to mr. Mark trudeau, who is the president and ceo of mellon cross pharmaceuticals. It sells the anti immune diseasean drug hp. [inaudible] finally will heal for mr. Thomas kendras whose u. S. Country president of novartis sells the cancer drug gleevec, the witnesses will be un muted so we can swear them in, please raise your right hand you swear or affirm that the testimony you are about to give us the truth, the whole truth and nothing but the truth so help you god . I do. I do pray thank you let the record show the witnesses answered in the affirmative without objection or written statements of any part of the record, that comment mr. Broadway you are now recognized for your testimony. Spinning if you could un you chore mike. Civic thank you, good morning chairwoman, Ranking Member gomer and other members of this community. Hn a leading biological Company Based in thousand oaks, california. Before begin my formal remarks i went to acknowledge the work of Elijah Cummings on drug pricing issues as chairman of this committee. He is sorely missed dedicated to improving access and affordability forab patients. We are serving patients ripped her innovative medicines and highua quality to treat the world series and costly illnesses. Were also engaged in the fight to understand, treat and prevent c covid19. We employ nearly 14000 people here in the u. S. , or we conduct the vast majority ofh our Cutting Edge Research and eco friendly manufacturing. Amgen is deeply committed to meeting the needs at every patient every time. Therefore its of great concern to us when those who might benefit from our medicines cant get them. Were committed to responsible pricing. A few examples in 2008 to be launched a new migraine prevention treatment at a price that was between 20 and 65 below market expectations. We also made a medicine proven to reduce heart attacks and strokes in patients with stubbornly high cholesterol levels available at a 60 reduced price. This helped lower outofpocket costs for ketients, especially seniors on medicare. Over the last two years, we have launched similar to the topselling medicines in the country and plan to bring more to market over time. In patients with more Affordable Treatment options. Overall, the average net price for amgen medicines across the entire portfolio the u. S. Declined in 2018 and 2019. And we are on track for further decline this year. Embryo is in amgen medicine that treats patients with autoimmune disorders, such as moderate to severe remote tort arthritis. Enbrel highlights the tension between ensuring patients access to critical innovative medicines and the outofpocket costs they are often required to pay. Physicians tell stories of how heeir waiting rooms were cluttered with canes, crutchesth and wheelchairs. But thanks to enbrel, capless patients have been giving a new release on their life. Since enbrels approval, weve invested hundreds of millions of dollars in studies for additional uses and to make it more patient friendly. As an example, we recently introduced an easy to use self injection device designed for emerald patients whose disease has sapped the strength inen their hands. But innovations like this cost money. Ththat is partially why we have increased the list price of enbrel in the past. D but what has driven up the list price for that any other factor is the pressure we face to match the price increases of the market leader. I know this sounds strange. Something virtually every other industry by offering the lowest price. Unfortunately current rebate system and the u. S. , created with good intent, now often leads to a situation in whichto not getting checked off matching a competitor hires price for these higher prices increase the already significant rebates made to the middlemen who largely dictate which medicines patients can access, regardless of which medicines their prescription agenda physician prescribes. Or still, these rebates paid on all of our medicines do not translate into lower costs for patients. And that is because they dont get passed on to patients at the pharmacy counter. There is no question that the present rebate system is dysfunctional and does little to serve the very patient it was designed to benefit. As we wrestle with the worst Public Health and Economic Crises of her lifetime, the time is now and the place is here to craft the changes that are needed. Innovative, biopharmaceuticals or part of the solution diverted serious decisionsim impose on patients and sick inside while society. It improves affordability for patients however a single manufacturer cannot make that happen alone. We stand ready to work with members of both parties, the administration and other stakeholders to develop policy solutions to help improve access and affordability for patients without stifling innovation. There are so many diseases to confront and patients to help. If we all stay focused on what is best for patients i am confident we can that been a better place. Thank you for the opportunity to speak to youen this morning. Mr. Trudeau you are now recognized respect chairwoman maloney, Ranking Member, and members of the committee thank you for the opportunity to be ofhere today. I started the pharmaceutical industry as a research and develop an engineer nearly 40 years