Senator Amy Klobuchar didn’t ever expect Donald Trump to be our next president. But the Minnesota Democrat is hopeful she can make the most of the new politics in Washington by leading a serious effort to bring down prescription drug costs.
In a Q&A with STAT, Klobuchar expressed optimism that Congress will act in the coming year. She pointed to the upcoming reauthorization of the Prescription Drug User Fee Act as one of multiple opportunities for lawmakers to exert some leverage over pharma companies and find a way to lower prices.
Klobuchar, who recently penned an op-ed urging her fellow Democrats to work with Trump on the issue, has practiced the bipartisanship she preaches, having co-sponsored legislation with Republican Senators John McCain and Chuck Grassley.
This transcript of STAT’s conversation with Klobuchar has been edited for clarity and length.
STAT: Do you think President-elect Trump could ultimately side with Democrats on this issue over legislators from own party, which is often uncomfortable with Democratic proposals on drug prices?
Klobuchar: I hope that my time has come now, because of two colliding forces, both of which are good. One is that the President-elect has said he wants to see negotiation under Medicare Part D, a bill I’ve been leading for almost a decade, and he wants to bring down drug prices.
And two, we have these escalating drug prices that have have seen such huge increases. Four of the top 10 drugs have increased in price more than 100 percent since 2011. EpiPen is the proverbial canary in the coal mine. You have to look at alternatives.
STAT: You’ve called for a national investigation into the pervasiveness of behavior along the lines of what Mylan did with EpiPen — misclassifying the drug so the company could save money on government rebates. Would this look like, and who would conduct it?
Klobuchar: The idea is that the Department of Health and Human Services would do an investigation on whether this misclassification that we’ve seen is common practice, because if you look at the money Mylan offered in the settlement and then you duplicate that among other drugs, it’s massive.
STAT: That’s to say that the settlement is indicative of how much money Mylan made as a result of that misclassification, and there’s potential for that to have happened elsewhere?
STAT: Where are you and Senator Grassley on the fight to outlaw ‘pay-for-delay,’ which allows pharmaceutical companies to pay to delay competitors from introducing generic competitor drugs?
Klobuchar: He’s not giving that thing up. He just talked with me about it last week.
STAT: If the Affordable Care Act is repealed and Republicans are serious about working to create a replacement plan, what do you think the prospects are for a pharmaceutical pricing provision being included?
Klobuchar: I think the realistic bill this could get on is the Prescription Drug User Fee Act reauthorization, which will speed up approvals for pharmaceuticals.
I would have loved to see an ACA reform package, as opposed to a repeal, that would have included pharma provisions. So I’m just being realistic about where it’s most likely to get done. If something moves that’s reform, we’d be open to that too.
STAT: You and Senator McCain have worked together to increase competition in the drug market by allowing some drugs to be imported from other countries, namely Canada. How do you balance the desire to keep pharmaceutical profits and jobs in the United States with your desire to reduce prices by allowing for some level of international competition?
Klobuchar: At some point, the jobs are important, but if the company knows what it’s doing and is strong, it should be able to have some drugs coming in from Canada, which has similar labor and safety laws in place. That’s why Senator McCain and I focused on Canada. It seems to me that you just need some competition. When you just have one generic option on the market, the whole thing is crazy.
There’s got to be a way to allow some limited competition, as long as it’s on an even playing field. American workers should be allowed to compete in a fair way.
STAT: Where do you think dealing with drug prices rank in terms of legislative priorities in Congress, and when might we see action?
Klobuchar: I think, for a number of us, that this is going to be one of the top priorities of the year. There are really two trigger points. One would be as we debate the Affordable Care Act, the second is the reauthorization of the PDUFA for approval, which is something the pharmaceutical industry cares a lot about. The reauthorization will give us an opportunity to get this included.