August 17, 2018

Warren, Smith Raise Questions about Accuracy of Secretary Azar's Testimony Blaming PBMs for High Drug Prices

Question Whether Secretary is Coordinating with Pharma to Deflect Responsibility for President Trump's Broken Promise to Reduce Drug Prices

Text of Letter (PDF)

Responses from PBMs and Distributors (PDF)

Washington, DC - United States Senators Elizabeth Warren (D-Mass.) and Tina Smith (D-Minn.) today questioned Health and Human Services (HHS) Secretary Alex Azar about his potentially misleading statements during Senate testimony in which he blamed pharmacy benefit managers (PBMs) and drug distributors for drug manufacturers' ongoing refusal to meaningfully reduce their prices. The senators' letter follows new information obtained from PBMs and drug distributors that directly contradicts the allegations made by Secretary Azar and raises questions about the accuracy of his testimony to Congress. Despite President Trump's promises that drug companies would voluntarily enact "massive" price cuts, there have been no significant drug price drops.

In a June 12, 2018 hearing in front of the Senate Health, Education, Labor and Pensions (HELP) Committee, Senator Warren asked Secretary Azar to explain why drug prices remained high despite President Trump's assurances of massive price reductions.  In response, Secretary Azar indicated that PBMs and drug distributors-not drug manufacturers-were to blame, alleging that drug manufacturers were "finding hurdles" from PBMs and drug distributors that were preventing them from enacting voluntary price cuts. 

To better understand Secretary Azar's allegations, Senators Warren and Smith asked six of the largest PBMs and the three largest drug distributors to respond to a detailed set of questions about whether they had engaged in the activities described by Secretary Azar. In response to the senators' letter, each of these companies explicitly denied Secretary Azar's accusations that they had created hurdles to lower drug prices, and indicated they would be supportive of manufacturer efforts to reduce prices.

"The accuracy of your testimony is a serious matter," the senators wrote. "If your allegations are false, you owe the HELP Committee and the Finance Committee an explanation for why you misled these committees about the reasons for President Trump's failure to meet his promises to reduce drug prices."

The senators also noted reports of the pharmaceutical industry's efforts to get "Americans mad" at PBMs and drug distributors in order to deflect blame for their high prices and refusal to reduce prices. They questioned whether Secretary Azar is coordinating with the drug industry on this attack.

"If you have coordinated with the pharmaceutical industry to concoct a scenario in which the drug company failure to reduce prices is blamed on industry middlemen...it would raise very serious questions about your commitment to enhancing and protecting the health and wellbeing of all Americans as the Secretary of Health and Human Services," wrote the senators.

The senators' eight-page letter asked Secretary Azar twenty questions about his testimony, requested additional information about his claims, and asked him whether he wished to modify his June 2018 testimony. The senators are seeking answers to their questions by no later than August 31, 2018.

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