Ranking Member Cassidy Delivers Remarks During Hearing to Address Cost of Insulin in America

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Thank you, Chair Sanders.

In a sense, this is the culmination of a portion of my life. I went to medical school in New Orleans, did my residency in Los Angeles, and then treated patients in Baton Rouge, each time in a hospital for the poorly insured or for the uninsured. And diabetes was a constant, but also the ability to afford the drug was a constant as well.

And it's been interesting for me because I've seen the work that you've done, the technology that you, the drug companies, have put together that have made these medicines more convenient to take and have made it easier for the diabetic to manage his or her diabetes.

But on the other hand, the ability to afford the insulin is equally important as to the innovation that may have occurred. If you cannot afford the innovation, it is as if the innovation has never occurred.

Now, 100 years ago, diabetes was a death sentence. In 1983, when I graduated from medical school it was a lot more difficult to control than now. Not only have we had the medical breakthrough, but you have come up with products that have made it easier for the diabetic to manage. I thank you for that.

In that time period, we've had a remarkable increase in the quality of life.

But you've got to be able to afford the innovation. Now we have to look at this issue. Is it the pharmaceutical manufacturers? Is the pharmacy benefit managers?

That's the kind of discussion here. And that's why I'm glad you are all here.

When I go to church and people are pulling on my jacket, they want to know about drug prices. And if they're diabetic, they want to know about the price of prescription drugs. And if it's a parent of a diabetic, they're really pulling me on my jacket.

So the PBMs, vertically integrated with the largest insurance companies in the world, manage about 80% of prescription drug claims. What I'm told is that in recent years, the net price of insulin has actually decreased, even as the list price has increased. The money is going someplace, but the patient is paying this price. And somehow the money is going from their pocket to folks who are far richer.

Now, I appreciate the roles that pharmacy benefit managers play. We had some Zoom hearings with academics come in and the academics all will state that at their best, PBMs drive down the net price for patients.

But it's clear that the savings are not always reaching the patient and that at times, particularly when choosing are deductible, the patient really pays a lot. And that's when we hear the horror stories of folks that cannot afford the treatment.

So to have the manufacturers, to have the PBMs here is just really wonderful. The goal of today's hearing is to find answers and to find solutions. Not to point fingers, but to figure out what is going on and to address why are prescription drug costs so high, particularly for the issue of insulin, and what is the respective role of each of the players.

I suspect that if we realign incentives, we can actually find a way to benefit patients. I have learned since graduating from medical school way back in 1983 that oftentimes bad behavior is driven more by bad incentives than by bad actors. So what can we do about those incentives?

Tomorrow, we will continue our markup on bills addressing PBMs and generic drugs.

The goal is to try to make sure that everybody has access to these drugs and that they can afford it. Today is our opportunity to inform our legislation.

I'm committed to working with my colleagues to find common ground on solutions that fulfill our objectives, and that the president will sign into law and that the House of Representatives will pass. This should be our goal.

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