Dan Rodricks

Can Big Pharma keep getting away with price gouging? Not if Elijah Cummings has anything to say about it

Know why big pharmaceutical companies in the United States raise the prices of some prescription drugs to outrageous levels? Because they can. There are few obstacles to jacking up prices so the companies that sell brand-name drugs — and spend millions to advertise them ad nauseam — do pretty much what they please, and shamelessly.

In the midst of a real national crisis — unlike the Trump administration’s fake national crisis at the southwestern border — with nearly 50,000 opioid-related overdose deaths in 2017 and likely even more in 2018, the Virginia-based company that manufactures an overdose-reversal drug increased the price of its antidote by 600 percent. The people running that company must have been inoculated against shame.


A survey by The Washington Post shows the following price increases for three versions of life-sustaining insulin: Sanofi’s Lantus brand, once $35 a vial, now lists at $270. A person with diabetes could buy Novo Nordisk’s Novolog for $40 in 2001; by last year it was listed at $289. It took a bit longer, but Eli Lily’s Humalog went from $21 for a 10-milliliter vial in 1996 to its current price of $275.

There’s far more than inflation involved in those trends. I can think of at least three other factors: Greed, greed and greed.


“For years, drug companies have been aggressively increasing prices on existing drugs and setting higher launch prices for new drugs while recording windfall profits,” says Rep. Elijah Cummings, who just became chairman of the House Committee on Oversight and Reform. Wasting little time after the Democrats regained a majority in the House, Cummings on Monday announced a broad investigation that held the possibility of Big Pharma being hauled, like Big Tobacco, before his committee.

That would be a beautiful thing.

“The goals of this investigation are to determine why drug companies are increasing prices so dramatically, how drug companies are using the proceeds, and what steps can be taken to reduce prescription drug prices,” Cummings says. “The ongoing escalation of prices by drug companies is unsustainable.”

Cummings sent letters to 12 drugmakers demanding information about their pricing practices.

I hope he also invites Alex Azar to testify.

Azar is the secretary of Health and Human Services in the Trump Swamp. He served as president of Lily USA for five years, from 2012 to 2017, and during that time the company raised the price of Humalog from $123 per vial to $255 per vial. I’m sure Azar can explain why that happened. I look forward to hearing the reason.

For now, I’m going with greed.

Others with more faith in the free market will say it’s more complicated than that: The drug-supply chain is tangled with thorny corporate, legal and financial issues, many beyond the comprehension or appreciation of consumers who get sticker shock when they see their copay.


No doubt, pharmaceutical companies have come up with wonderful medications. They have a right to patent and advertise their brands. They have obligations to stockholders, and such is life in a capitalist democracy.

But a lot of Americans who built up a tolerance for this system, accepting it as, I suppose, a price of freedom, see the sinister side clearly now. Obamacare opened eyes. It has made a lot of people think about health care and question, if not fully reject, its for-profit nature. Americans who need prescription drugs pay far more to stay alive than people in other countries — the United Kingdom, Japan, Canada, for example — and that raises the costs of health care generally.

Nothing exposes more fully the fallacy of profits reaped from medicine than the cost of prescription drugs.

Even some Republicans recognize that. Donald Trump has made proposals to address the problem, though he’s accomplished little so far. In fact, as if in defiance of Trump, nearly 30 drug manufacturers are expected to raise prices further this year, according to Reuters.

Meanwhile, here in Maryland, legislators, General Assembly leaders, county executives and patient advocates are again trying to get something done.

In 2017, the legislature authorized the attorney general to take action against drug companies that gouge prices on generic drugs. That law has been tied up with a constitutional challenge and, so far, blocked from taking effect. It could end up before the Supreme Court.


This year, there will be a renewed attempt to establish a five-member Prescription Drug Affordability Board charged with protecting Marylanders, and the entire health-delivery system we rely on, from outrageous pharmaceutical costs. The new board would review any brand name drug that launches in Maryland at a cost of $30,000 or more per year, existing drugs that increase in price by $3,000 or more, and generic drugs that increase by $300 or more — generally, any medication that becomes prohibitively expensive. The board could set rates and cap the price of high-cost drugs.

I can think of at least three things to say about all this: Good, good and good.