Americans Need to Hold the U.S. Congress Accountable for the World’s Highest Drug Prices.

Posted at 3:58 PM on Aug 4, 2020


While the coronavirus pandemic is the most pernicious public health crisis of our time, for decades now the crisis of high drug prices is a ubiquitous feature of the American healthcare landscape. Young adults dying because they can’t afford insulin; people burdened with battling cancer facing bankruptcy due to the price of cancer drugs; patients going to the emergency rooms because they did not take heart medications due to cost; parents faced with the decision of whether or not they can afford a new Epipen, as their old one faces expiration, and the list goes on and on. We are outraged by the greed of the pharmaceutical industry, but we cannot vote in and out of office their CEOs and other executives. But we can do just that when it comes to Congress. To help, Prescription Justice has created the Drug Prices Congressional Report Card in which we have graded all members of the U.S. Congress, House and Senate, on their action or inaction on drug prices.

See the Drug Prices Congressional Report Card.

Drug Prices are Not Partisan

The public policy issue of high drug prices in America is unique in that Americans across the political spectrum, Republicans, Democrats, and Independents, agree that it’s wrong and about the solutions needed. Whether it’s guns, abortion, taxes, foreign policy, education, Obamacare, etc., Americans are too divided. In contrast, drug prices are a unifying issue! Let’s come together on it.

For example, a 2019 survey by the Kaiser Family Foundation showed that 92% of Democrats, 85% of Republicans, and 90% of Independents, want Medicare to be able to negotiate drug prices with pharmaceutical manufacturers. Is there any other issue with such intense unanimity? Despite what the voters want, the ban on Medicare negotiating drug prices remains part of federal law. Drug companies can’t change that. Even the president can’t change that. It’s up to Congress, which means it’s up to us to vote for politicians who will end this egregious ban.

How We Grade

The Drug Prices Congressional Report Card (the “Prescription Justice Grade”) is different than most other Congressional scorecards. You may be familiar with the congressional scorecards of organizations such as Planned Parenthood, the American Civil Liberties Union, or, on the other side of the political fence, the National Rifle Association and Club for Growth. Traditionally, congressional scorecards tally the votes of members of Congress on a given issue or subject area defined by an organization focused on a specific category of public policy (abortion, freedom of speech, guns, and taxes). Members are scored on their yea or nay votes.

With the huge expenditures it spends on lobbying, the  pharmaceutical industry is often able to stop votes on bills from coming to the floor that, if passed, would lower drug prices. By huge, we’re talking about hundreds of millions of dollars a year, about $3 billion lobbying over the past 20 years. Without votes how do you grade?

The Prescription Justice Grade uses four factors to score a member of Congress: 1) votes; 2) sponsorship and co-sponsorship of bills on drug prices; 3) campaign donations from pharmaceutical manufacturers; and 4) soft data, specifically drug price positions articulated on members’ websites. 

Using this multi-factor approach we have created a methodology to grade Congress on drug prices. The methodologies are very similar for each chamber but have needed differences to reflect differing terms and election cycles among other variables. To understand the details, read the House methodology and the Senate methodology.

The Point Breakdown

Votes – 30 points.

In the methodology, congressional voting is assigned the greatest number of points because, in the final analysis, it is lawmaking that will actually stop the price gouging and endless price increases from the drug companies.

Drug price bill sponsorship and co-sponsorship – 25 points

Members of Congress should be rewarded for taking the initiative to sponsor and co-sponsor bills that will end the crisis of high drug prices. They received points for sponsoring or co-sponsoring such bills and there were many (of course most didn’t come to a vote). Some members sponsored or co-sponsored almost all bills that would lower drug prices, others none.

Pharma campaign contributions (25 points)

As noted above, one of the biggest obstacles to bringing about serious legislative and regulatory reforms to lower drug prices is money in politics: the more money a candidate receives from the pharmaceutical industry, the more likely their vote will favor the industry. Our methodology rewards members of Congress for not taking money from drug companies and vice versa.

To bring more rigor to this factor than just total dollar numbers, members were scored on campaign contributions from pharmaceutical companies based on 1) amounts received proportionate to contributions from other sources and 2) relative to each other members.

Soft Data

Sometimes members don’t get around to co-sponsoring bills that they like. Others might not even vote for bills that contain some policies they strongly support. Why? Because the bill might enact other policies that they do not support. Or certain bills may not go far enough in support of a certain policy and a member places a protest vote against it. 

In considering the above and enriching our drug price report card, we wanted to find other ways to reward members for going on the record. Going on the record helps build momentum in favor of a policy. Many members list the legislative and policy issues of greatest importance to them on their websites. We reviewed them all for policy positions related to lowering drug prices.

The Prescription Justice Pledge

Our mission at Prescription Justice is not just one of reporting about how Congress is doing on drug prices but of advocacy to get them moving. To motivate members and get them on the record, we created a questionnaire, which we call the Prescription Justice Pledge.

The pledge is based on the policy priorities of Prescription Justice, which advocates for drug price negotiations, ending patent games, reforming importation laws to allow parallel imports, and expressly allowing individuals to import for personal medication as a lifeline if they need it.

Members of Congress can improve their grades by filling out the Prescription Justice Questionnaire. For each “Yes” answer, members will increase their raw scores by two points. Those members who fill out every question with a Yes answer will move up a full grade and are considered Prescription Justice Pledgers.

How to use the grades?

The grade can be used to name and shame, laud and applaud Members of Congress. Those with high grades will have bragging rights and can use the grades to communicate with their voters or in campaign ads. Campaigns can also highlight the poor grades earned by competitors.

Advocacy groups focused on lowering drug prices can use the card to highlight good and bad grades. If you are part of an advocacy network or community organization committed to lowering drug prices, please share it far and wide.

The grades are easily shared using social media: Twitter, Facebook and LinkedIn – and of course by email.

For those readers working to re-elect a member of Congress who received a high grade then share it. If your chosen candidate is a challenger to an incumbent, then encourage them to fill out the Prescription Justice Policy Questionnaire so they can go on the record in favor of lower drug prices.

Congress needs to be held accountable for the astronomical costs of prescription drugs in America. The Prescription Justice Drug Price Report can help!

To learn all about the Prescription Justice Congressional Drug Price Report Card, watch the presentation

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