Sen. Estes Kefauver, D-Tenn., (Left) and Sen. Everett Dirksen, R-Ill. (Others from the left) clashed with the reopening of a 1960's Senate drug survey on whether witnesses could be forced to disclose "business secrets" while witnesses.
Bettmann / Bettmann Archive
Bettmann / Bettmann Archive
Sen. Estes Kefauver, D-Tenn., (Left) and Sen. Everett Dirksen, R-Ill. (Others from the left) clashed with the reopening of a 1960's Senate drug survey on whether witnesses could be forced to disclose "business secrets" while he was witnessing.
Bettmann / Bettmann Archive
Kenneth Frazier, chief executive of pharmaceutical giant Merck, is set to meet senators Tuesday saying medical costs are "sky-high" and "out of control".
But Frazier does not need new talk points. 60 years ago another panel of senators grilled another Merck boss about the same problem.
People who are likely to survive Tuesday – high drug prices and profits, limited pricing, aggressive marketing, alleged drug abuse, and mediocre "me-too" drugs are largely identical to the issues the Senates examined decades ago, historical transcripts .
Frazier is scheduled to testify before the Senate Financing Committee, led by Iowa Republican Chuck Grassley, along with the CEOs of AbbVie, AstraZeneca, Bristol-Myers Squibb, Merck, Pfizer, and Sanofi, and a top manager of Johnson & Johnson.
Hearings led by Sen. Estes Kefauver, D-Tenn., In 1959 and 1960, was the first major congressional investigation into rising drug costs and drug company profits. While this rebellion led to new legal standards for drug security and efficiency, cost control measures never took it to the final bill.
Health policy teachers say similar hearings show how much unfinished businesses remain and how well drug companies have protected profits and limited regulation over the years.
"Every decade since the Kefauver hearings have seen at least one set of congressional hearings in the rising prices of prescription drugs," said Dr. Jeremy Greene, a drug profile at Johns Hopkins University.
"Drove prices, especially at the high ends, are only even higher" since the 1960s, said Dr. Scott Podolsky, a healthcare professional at Harvard Medical School. "The question of openness and profitability has certainly been there from Kefauver's first day."
A Tennessee Democrat known to investigate Mafia, Kefauver launched a series of business hearings in the late 1950s. His Senate Antitrust Subcommittee began to testify to high drug prices in late 1959. "While this country has the best drugs in the world, it appears that the large number of letters received by the Subcommittee that many of our citizens are experiencing difficulties "The sessions, which lasted until September 1960, were" among the most sensational "hearings of that congress, wrote a syndicated column at that time. , Pfizer, Schering, Bristol-Myers, Upjohn, SmithKline and American Home Products Senators buried in the prices of antibiotics, corticosteroids and tranquilizers, the wonderful drugs of the time.
John Connor, then Merck's president, said he had "deep sympathy" for people who could not afford medicine, and Schering also did, but he said it was not the industry's fault.
"There is no doubt that someone finds It is difficult to pay for the necessary medication. They will also have trouble meeting their rental and billing bills, "said Francis Brown, Schering's president at the time." It's about insufficient income rather than high prices. "
"We meet different market conditions in different countries," was Connor's response. The Americans became "a fair trade," he said. "Merck's head of defense drug prices" was the front of the headline the next day in The New York Times.
Senators accused businesses of marking the cost of drugs by thousands of percent. So now leaders defended high profits as needed to fund research and development, although they often spent more on advertising and marketing than R&D.
"They were advised that when the senators mentioned high prices, just mention research and how difficult it is, how expensive it is," said Donald Light, a health political professor at Rowan University in New Jersey. "Since 1959, that's the repeated and successful theme of Big Pharma."
"The few successful products have to pay for hundreds of research failures," Alvin Brush, president of American Home Products, told Kefauver's selection.
As patients today, people in 1960 were amazed at what the medicine cost until they got the bill. Such uncertainty led to overpayment.
"The consumer, in this field, cannot exercise his normal, economical prerogative for shopping or pricing before a purchase," said the head of a generic drug producer to the committee. "The usual laws of supply and demand have no application here."
Drug companies engaged in a "pharmaceutical plate chain" by promoting various strengths of established drugs such as new medicine and charging more, Louis Lasagna, a pharmacology professor from Johns Hopkins University, told the committee.
"Now this is like saying that a dime is stronger than two nickel because you can use a coin instead of two," he said.
Businesses often did not work to develop breakthrough medicine, but to take an existing product and "modify the original drug just enough to get a patentable alternative," said Dr. Frederick Meyers, pharmacology professor, at what later became the University of California – San Francisco.
Contrary to the unstopped consumer television commercials today, prescription drug advertisements in 1960 were targeted at doctors and hospitals, which appear in medical journals.
Even they were considered aggressive. A committee staff dumped a large bunch of samples, ads, and flyers that a Minnesota doctor said he had received in just one month.
Perhaps if the companies spent less on ads, soldiers of sellers and "expensive stock options" for managers, Kefauver suggested, "you can also reduce the price of drugs."
Senators propose sweeping solutions.
Kefauver's draft bill would have withheld patents for modified substances, unless the new molecule gave a "significantly larger" therapeutic response than the original. It would have promoted competition by letting someone license and sell a patented substance, as opposed to royalties paid to the patentee, after three years.
An expert urged the government to publish an official list of patented drugs and their generic equivalents along with prices so that everyone could see what they were costing.
None of this happened. The industry fought back. Any legislation seemed doomed to the tragedy of thalidomide, a pill taken for morning sickness that caused deformities in babies, urged lawmakers to act.
However, the 1962 Kefauver-Harris changes, which impose medical trials and lay the foundations for the modern drug approval process, did little to control costs.
It was not necessary to limit drug prices, Austin Smith, president of the Pharmaceutical Manufacturers Association, told the Kefauver committee. Attempts to prove excessive industrial performance were "doomed to failure," he said. Drugs prices rose slowly than consumer prices in general, Smith said.
Smith's counterpart today is Stephen Ubl, who runs what is now known as Pharmaceutical Research and Manufacturers of America, or PhRMA. He takes a similar line, one that is likely to be repeated on Tuesday. "The drug prices are falling rapidly," Ubl tweeted last month.
Kaiser Health News is an ideal news service that covers health issues. It is an editorial independent program by the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.