The recent Senate squabbling over whether cheaper imports from Canada and elsewhere should be allowed into the US was full of intrigue. Why, for instance, did President Barack Obama flip-flop on his oft-stated campaign remarks that imports should be allowed? Was it the $80 million deal that PhRMA cut on discounts that would help pay for health care reform legislation?
Meanwhile, some questioned the sudden appearance of a letter from FDA commish Margaret Hamburg, who worried aloud that her agency couldn't guarantee the safety of meds coming into the country. Byron Dorgan, the North Dakota Democrat who fought for the importation amendment, tells The Wall Street Journal that he thinks the White House drafted her letter. Ironically, more active pharmaceutical ingredients are coming from China, which is home to scandal after scandal (think Heparin) and where the FDA has only two inspectors (background).
Senators from states where drugmakers are headquartered reiterated Hamburg's argument. For those who are wondering how each senator voted, the contributions they receive from pharma and what that might mean, here is a handy breakdown, courtesy of MapLight.org, which found that, among all Senators, those voting to block imports received an average of $85,812 each from drugmakers, which is 69 percent more than those who voted in favor of imports.
All Democrats (and Independents) Average to Yes votes (allow imports): $41,894 Average to No votes (block imports): $73,729
All Senators Average to Yes votes (allow imports): $50,767 Average to No votes (block imports): $85,812
Campaign Contributions to Senators from Pharmaceutical Manufacturing Interests, January 1, 2003 - August 12, 2009
Senator Party State Amount from pharma interests Vote on allowing imports:
Akaka, Daniel - Dem - HI - $4,000 - No Alexander, Lamar Rep - TN $108,950 - Yes Barrasso, John -Re- WY - $55,500 - No Baucus, Max - Dem MT - $261,020 - No Bayh, Evan - Dem - IN - $144,072 - No Begich, Mark - Dem -AK -$7,500 - Yes Bennet, Michael - Dem - CO - $10,750 - Yes Bennett, Robert -Rep - UT - $124,000 - No Bingaman, Jeff -Dem - NM - $48,500 - Yes Bond, Christopher - Rep - MO - $99,003 - Yes Boxer, Barbara - Dem - CA - $35,900 - Yes Brown, Sherrod - D - OH $17,300 Yes Brownback, Samuel - Rep - KS - $28,250 - No Bunning, Jim - Rep - KY - $64,250 - No Burr, Richard - Rep - NC - $301,898 - No Burris, Roland - Dem - IL - $0 - No Byrd, Robert - Dem - WV - $32,100 - Not voting Cantwell, Maria - Dem - WA - $22,400 - No Cardin, Benjamin - Dem- MD - $40,850 - No Carper, Thomas -Dem - DE - $135,700 - No Casey, Robert - D - PA - $34,750 - No Chambliss, Saxby -Rep - GA - $83,949 - No Coburn, Thomas - R - OK - $44,051 - Yes Cochran, Thad -R - MS - $69,000 - No Collins, Susan -R - ME - $70,500 - Yes Conrad, Kent D - ND - $83,000 - Yes Corker, Bob - R - TN - $65,200 - Yes Cornyn, John -R - TX - $119,700 - Yes Crapo, Michael - R - ID - $64,580 - Yes DeMint, Jim - R - SC - $40,000 - Yes Dodd, Christopher - D - CT - $174,525 - No Dorgan, Byron - D - ND - $12,500 - Yes Durbin, Richard - D - IL - $28,600 - No Ensign, John - R - NV - $89,950 - No Enzi, Michael - R - WY - $146,500 - No Feingold, Russell - D - WI - $6,200 - Yes Feinstein, Dianne - D - CA - $39,500 - Yes Franken, Al - D - MN - $2,500 - Yes Gillibrand, Kirsten - D - NY - $44,400 - No Graham, Lindsey - R - SC - $55,250 - Yes Grassley, Charles - R -IA - $103,700 - Yes Gregg, Judd - R - NH - $122,500 - No Hagan, Kay - D - NC - $4,650 - No Harkin, Thomas - D - IA - $81,800 - Yes Hatch, Orrin - R - UT - $262,950 - No Hutchison, Kay - R - TX - $29,250 - Yes Inhofe, James - R - OK - $20,250 - No Inouye, Daniel - D - HI - $200 - No Isakson, John - R - GA - $126,599 - No Johanns, Mike - R - NE - $43,100 -Yes Johnson, Tim D SD ($1,500) Yes Kaufman, Edward D DE $1,500 No Kerry, John D MA $21,170 No Kirk, Paul D MA $0 No Klobuchar, Amy D MN $2,290 Yes Kohl, Herbert D WI $0 Yes Kyl, Jon R AZ $117,350 No Landrieu, Mary D LA $89,550 No Lautenberg, Frank D NJ $97,550 No Leahy, Patrick D VT $46,600 Yes LeMieux, George R FL $0 Yes Levin, Carl D MI $1,000 No Lieberman, Joseph I CT $199,540 No Lincoln, Blanche D AR $100,750 Yes Lugar, Richard R IN $51,850 No McCain, John R AZ $7,000 Yes McCaskill, Claire D MO $6,050 Yes McConnell, Mitch R KY $225,900 Yes Menéndez, Robert D NJ $196,452 No Merkley, Jeff D OR $18,500 Yes Mikulski, Barbara D MD $70,995 No Murkowski, Lisa R AK $63,050 Yes Murray, Patty D WA $144,400 No Nelson, Ben D NE $138,098 Yes Nelson, Bill D FL $38,600 Yes Pryor, Mark D AR $31,000 Yes Reed, John D RI $34,100 No Reid, Harry D NV $74,800 No Risch, James R ID $22,100 Yes Roberts, Pat R KS $80,650 No Rockefeller, John D WV $44,000 No Sanders, Bernard I VT $420 Yes Schumer, Charles D NY $54,900 No Sessions, Jefferson R AL $45,000 Yes Shaheen, Jeanne D NH $2,250 Yes Shelby, Richard R AL $25,000 Yes Snowe, Olympia - Rep - ME - $4,000 -Yes Specter, Arlen -Dem - PA - $353,550 - Yes Stabenow, Debbie Ann - Dem - MI - $39,134 - Yes Tester, Jon -Dem - MT -$14,000 - No Thune, John - Rep - SD - $45,300 - Yes Udall, Mark -Dem - CO - $102,275 - No Udall, Tom - Dem - NM - $15,300 - Yes Vitter, David - Rep - LA - $17,050 - Yes Voinovich, George -Rep - OH - $63,750 - No Warner, Mark -Dem - VA - $84,950 - No Webb, Jim -Dem - VA - $8,750 - Yes Whitehouse, Sheldon - Dem - RI - $11,800 - No Wicker, Roger - Rep - MS - $67,600 - Yes Wyden, Ron - Dem - OR - $27,800 - Yes
Hat tip to NPR Shots
15 Comments
The graphic is perfect, Ed! We certainly all know who the global puppet master is, don't we. And perfectly shameless, too...the money transfers right before our eyes. The public doesn't seem to mind, though. High drug prices in this country have been "protected"...quid pro quo.
You don't understand, if we don't have your votes for protection of our profits we will not be able to continue to invent new life saving drugs. That is to say people will die. Probably someone you know. You don't want that on your conscience do you?
We are looking for new manufacturing locations right now. By the way how much do you receive in taxes from our current operations and products?
I know our requests are difficult to understand but trust me. You know I was a successful senator once too. You'll never regret this decision, I never did. And look at me now!
Good luck on your coming election campaign. Just give us a call if there’s any thing we can do.
By the way could you get someone to help me out with my suitcase. You wouldn't believe how much money weighs. If I could just find someone agreeable to take some of it...
Sure you don't want to reconsider your position?
I find the item about Hamburg's letter to be the most provocative if true. So far, we have Dorgan's word for it.
As always, aggregate data tells us only so much. Here, in Michigan, Stabenow received 39 times as much pharma money as Levin. She voted _for_ reimportation; he voted against.
The letter was probably drafted by David Axelrod, the guy whose PR firm was paid millions of dollars to run the campaign to sell Obama's deal with Big Pharma to the public.
Granted, Axelrod conveniently sold out his part of the firm when he because Obama's main man in Washington but the company still has to him for his part and Pharm's money will help do that.
Also Axelrod's son still works at the PR firm.
This is how the Illinois Combine works, or I should say the Washington Combine now.
The whole idea of "re-importation" is ludicrous. The drug companies could just paint "Canada" on sides of the warehouse next to the manufacturing plant and sell it from there "as if..."
Adulteration problem solved.
JiM,
You are right, the data only say but so much given that many republicans voted against their previous stances as a means of muddling up the healthcare reform debate. In addition, some democrats may have voted against importation despite their previous stances because of a desire to move the debate forward without adding an additional element of controversy (ie, bucking White House pressure by reneging on the deal with PhRMA.
One additional note...I believe that FDA commissioners or Secretaries of HHS going back to the Clinton administration have all opposed importation on safety grounds. This is not unique to Hamburg.
My opinion is that importation is a false issue. Undoubtedly, there is a safety issue if we open up parallel drug trade. There no way anyone can say that it will be safer than today. Europe has seen a significant jump in diverted and counterfeit drugs. Since pharma companies can easily control the actual amount of medication entering say Canada, it is highly likely that middle men will source drugs from other countries (pick a country) or from counterfeiters.
The real issue, of course, is price controls. Congress should have the guts to recognize that and either decide to pursue price controls or not. Obviously, I'm against them, since I truly believe that price controls in the US will stifle innovation. I'm quite sure others are in favor of them. Either way, that is what Congress should be debating, not importation.
Atlex
During the debate over the Medicare Prescription Drug Bill, the Democrats condemned Republicans for not allowing reimportation.
Washington needs to legalize prostitution before those whores in Congress and the Obama administration get arrested.
Fascinating. I suppose there are the democrats who do not want to upset Obama and voted to support him as opposed to pharma.
Baucus, Max - Dem MT - $261,020 - No
he was the guy who got the bill passed through the senate financial committee. he has received more pharma support than the NJ senators. It appears that pharma targeted him because he is the chair of the committee. No pharmaceutical companies in montana, last I heard. he made the deal with pharma with support from the White House perhaps.
The figures above do not represent soft money which is in the millions. It would be interesting to see what tactics pharma employed to pay off these senators on the quiet. McCain receives no support from pharma, would he have been a better choice for the country?
reimportation may not work in reality but it is a creative move to get around an impossible and illegal situation of manipulation of the free market by Merck, GSK and Pfizer.
Allow me show you what power really is. It isn't just about money. (best image ever, Ed)
FDA-Pfizer CRADA: Quality by Design and Process Monitoring of Pharmaceutical Manufacturing at Pilot-Scale
http://www.fda.gov/AboutFDA/CentersOffices/CDER/ucm142591.htm (scroll half way down the page)
"Since pilot-scale manufacturing facilities are not available at the FDA, this collaboration provides the Agency with an opportunity to conduct on-line research related to the implementation and validation of PAT tools. It also provides access to Pfizer’s industry leading expertise in the area of on-line PAT and chemical imaging of pharmaceutical products."
Read the report on that CRADA, really. That didn't go well for so many people. The page has since been updated. The original date was something like September 2007. I'd have to dig up the printed copy to be certain.
Atlex writes: "The real issue, of course, is price controls. Congress should have the guts to recognize that and either decide to pursue price controls or not."
I completely agree. Reimportation serves as a convenient distraction from confronting this core issue.
If, as Evelyn suggests, there are "whores" to be outed, my view would be it is those who don't have the courage to confront this issue (wherever you stand), and play around with easy-headline fantasies about Canada instead.
If we _were_ to confront the price control issue, some of the empirical data to be considered would be:
1. How many truly innovative drugs have arisen, and been developed, in the U.S., in contrast with countries where there _are_ price controls?
2. What does "research and development" actually mean, on the ground, re: what specific endeavors it covers (how much has anything to do with "research" as we usually understand it?)
3. What historical and cross-national evidence is there of a correlation between drug prices and the incicence of significant new drug discovery and development?
If we don't seriously and empirically engage questions such as these, we are, as far as I'm concerned, whistling where the moon don't shine.
"There is a need within the regulatory community and the pharmaceutical industry for case studies that put these principles into action and test these approaches.
Research Approach: This research project has focused on pilot-scale manufacturing of Dilantin capsules as a CRADA with Pfizer." _____________________
This is far worse than eminent domain in my opinion. They can take the health of the people they are supposed to protect, for research, without our consent. There is a fortune committed to it.
I just want to know why me? And because they continue, was it all for nothing? 20 years down the road someone will slap their forehead and say, crap, this was a mistake. Poor bastards.
But hey, the drug companies have invested so much in their new manufacturing & diagnostic processes, how can we not let them do the work?
Take a step back Senators. Look again.
Phrma has made a deal with the devil on this entire healthcare reform. Short term it looks good to them, long term the govt will control it all - but hey the current CEOs will be gone with their millions by then.
the health care bill has the 60 votes? saw Obama on tv, he is exhausted.poor guy liked his theatrics in copenhagen. whatever about his deal with pharma, I do like his choices in Hamburg and Sharfstein, hope that he, or emanuel & axelrod (reminds me of an 80's band) let the FDA do their work without interference from politics. that will be the real test.
Another bought vote.
"Nelson won numerous changes, including tougher restrictions on abortion coverage and an estimated $45 million in federal Medicaid funds, enough to completely cover his state's costs of complying with an expansion of the program mandated by the bill."
How's it feel to know you will be paying for your own state's additional costs. Plus those of the states who's representatives held out? Isn't buying votes illegal? And more, don'tcha wish your senator was a hold out too? You will when the tax bill comes.
http://news.yahoo.com/s/ap/us_health_care_overhaul