Sen. Sanders Shows Fire, but Seeks Modest Goals, in His Debut Drug Hearing as Health Chair

Lambert here: In like a lion, out like a lamb. (The Democrats not only managed to avoid passing single payer during a pandemic, they managed to erase it from the discourse entirely. Impressive.)

By Arthur Allen, KHN Senior Correspondent, who writes about the FDA and the pharmaceutical industry as well as covid-related topics. Originally published at Kaiser Health News.

Sen. Bernie Sanders, who rose to national prominence criticizing big business in general and the pharmaceutical industry in particular, claimed the spotlight Wednesday on what might at first seem a powerful new stage from which to advance his agenda: chairmanship of the Senate health committee.

But the hearing Sanders used to excoriate a billionaire pharmaceutical executive for raising the price of a covid-19 vaccine showed the challenges the Vermont independent faces.

Though its formal name is the Committee on Health, Education, Labor, and Pensions (HELP), the panel Sanders chairs has little if any authority over drug prices. In the Senate, most of that leverage lies with the Finance Committee, which oversees Medicaid, Medicare, and Obamacare.

As far as drug prices go, the platform Sanders commands is essentially a bully pulpit. So Sanders was left to bully his way toward results. And while some committee Republicans sympathized with his complaints, others bristled at his approach.

By the end of the hearing, seeming to acknowledge the limits of his power, the former presidential candidate was pleading with Moderna chief executive Stéphane Bancel for a relatively modest concession on vaccine pricing.

The CEO made no promises. Then again, pulpit proclamations can lead to corporate action, even if delayed and informal; in the weeks following President Joe Biden’s State of the Union call for cheaper insulin, the companies that make it drastically cut their prices.

Sanders began Wednesday’s hearing with his usual fire and brimstone.

“All over this country people are getting sicker, and in some cases dying, because they can’t afford the outrageous cost of prescription drugs, while companies make huge profits and executives become billionaires,” Sanders thundered.

Bancel had won his place in the witness chair with federal assistance. Moderna, which was founded in 2010 and had not brought a drug to market before the pandemic, received billions in government funds for research, guaranteed purchases, and expert advice to help develop and produce its successful covid vaccine. The payoff has been handsome. As of March 8, Bancel held $3 billion in Moderna stock. He also held options to buy millions of additional shares.

Government research and support are foundational to many of the expensive drugs and vaccines in use today. But Bancel made himself the perfect foil for Sanders when he announced in January that Moderna planned to increase the price of its latest covid shot from about $26 to $110 — or as much as $130.

Denouncing greed, Sanders expounded on his dream of a system in which the government fully funds drug development — and in exchange controls drug prices. “Is there another model out there where, when a lifesaving drug is made, it becomes accessible to all those who need it?” he asked. “What am I missing in thinking that it’s cruel to make a medicine that people can’t afford?’”

Sanders’ overt moralizing and harsh attacks on big business make him an outlier in the Senate, even in his own party. Yet distaste for soaring drug prices extends across the aisle. On the HELP Committee, at least, Republican politicians seem about evenly split between populist and pro-business takes on the problem, showing both the possibilities and the pitfalls that Sanders faces.

Sen. Mike Braun (R-Ind.) expressed disgust with the lack of transparency in the health care system and called Moderna’s planned price hike “preposterous.” Sen. Roger Marshall (R-Kan.) called it “outrageous.”

Sen. Rand Paul (R-Ky.), who often bucks mainstream GOP views and has expressed rancor for the biomedical establishment, claimed Bancel was downplaying vaccine injuries to make money. (Paul vastly exaggerated those risks.)

Ranking member Bill Cassidy (R-La.), who has pledged to work with Sanders, responded to the chairman’s opening remarks with both a hedge and a warning. “I’m not defending salaries or profits,” Cassidy said, but he added that he hoped the hearing’s goal wasn’t to “demonize capitalism.”

Only Sen. Mitt Romney (R-Utah), a former private equity executive, came heartily to Bancel’s defense. “If I’m an investor, I have to expect that if a product I’m backing works, I get to make an awful lot of money,” he said. “I’ve heard people say, ‘That’s corporate greed.’ Yeah, that’s how it works.”

Sanders’ idealized vision of the pharmaceutical industry is, in any case, moot. Even the Biden administration, which successfully browbeat insulin makers into drastically lowering prices in March, revealed this week it would not use “march-in” rights to lower the price of a cancer drug, Xtandi, developed with government-licensed patents.

March-in rights were established in the 1980 Bayh-Dole Act, which enabled companies to license federally funded research and use it to develop drugs. But federal courts and administrations have consistently said the government can seize a product only if the license holder has failed to make it available — not because the price is too high. The administration did, however, announce a review of whether price might be considered in future march-in decisions.

Sanders said before the hearing that he was “extremely disappointed” with the Xtandi decision. But he was ultimately realist enough to aim his bully pulpit at a lower target. Late in Wednesday’s hearing, Sanders pushed for a minimal gimme from Moderna. “Will you reconsider your decision to quadruple the price of your vaccine to the U.S. government and its agents?” he asked politely.

Bancel dodged, saying pricing was more complex now that Moderna faced an uncertain market, had to fill separate syringes with its vaccine, and needed to sell and distribute the vaccine to thousands of pharmacies, where previously the government did all that work. Later, he left open the possibility that negotiations could drive down the price paid by some government agencies or private insurers.

For all the theatrics of such hearings and the mix of opinions among the senators, interrogations of figures like Bancel may help inspire a shift in how the National Institutes of Health “does business in giving away its science to the private sector,” said Tahir Amin, co-executive director of I-MAK, a nonprofit that advocates for equitable access to medicines.

“You have to prosecute it so you at least get these public comments on record,” Amin said. Eventually, he said, this type of hearing could lead to a recognition that, ‘Hey, we need to do this.’”

Despite the HELP Committee’s lack of direct jurisdiction over drug prices, said John McDonough, a Harvard professor who was senior adviser for health reform on the HELP Committee from 2008 to 2010, Sanders “uses his position of authority and influence to draw attention to this in a way that has been helpful.”

KHN correspondent Rachana Pradhan contributed to this report.

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.


  1. The Rev Kev

    Good luck with Sanders getting much done with his good friend Biden as President. It was only several weeks ago that Biden said-

    ‘Well, folks, look, make no mistake about it: If I — they try to raise the cost of prescription drugs or abolish the Affordable Care Act, I will veto it.’ (Applause.)

    Guaranteed that Biden will always stand with Big Pharma as shown during this pandemic and won’t support whatever Sanders comes up with.

    1. TimH

      Bernie’s value is to give a group of people someone to root for in the expectation that he’ll Do Something.

      Unfortunately, all he’s actually achieved of any value beyond talk-talk-talk is to piss off Mrs Clinton.

    2. flora

      I know. Disappointing. The Dem estab clipped his wings (or cheated in the primaries, depending on your point of view) in 2016. On the other hand…. Maybe his greatest legacy, even if inadvertent, maybe his most important legacy from 2016 was showing all of us just how many of us there are who agree with his economic statements. (You’d never know it from the MSM which specializes in gaslighting their audiences, imo.) / ;)

    3. some guy

      Many people wanted a Savior. Sanders wasn’t the Savior they wanted, but nobody else could be such a Savior either. Saviorism itself is a problem. Mass bunches of people are going to have to be the Savior they want to see in the world.

      Younger longer-future-lifespanned officeseeker wannabes can run on the things which Sanders has said in public and gotten into the public mind.

  2. Camelotkidd

    Only Sen. Mitt Romney (R-Utah), a former private equity executive, came heartily to Bancel’s defense. “If I’m an investor, I have to expect that if a product I’m backing works, I get to make an awful lot of money,” he said. “I’ve heard people say, ‘That’s corporate greed.’ Yeah, that’s how it works.”
    That’s my representative–the Senator from Bain Capital. Romney is lionized here in the Beehive State for his starch opposition to Trump but he and his buddies at Bain engaged in an orgy of looting that helped create the conditions for Trump’s presidency.

  3. Carolinian

    Is there another model out there where, when a lifesaving drug is made, it becomes accessible to all those who need it?

    Is the vaccine a life saving drug? Or is Bernie shocked, shocked that it may have all been about money in the first place? Why does anybody find this price increase surprising?

    Of course socialist Sanders may well favor nationalizing pharma but he’s not going to say it. A revolutionary he isn’t.

  4. Rolf

    At the risk of being too preachy and simplistic, doesn’t it ultimately come down to this: in what market do we (as in, We The People) allow industry to profit without limit? What kind of society do we want? Where and when is Romney’s implicit “greed is good” (or at least, a given), morally acceptable, or even particularly intelligent? Citizens of a society that allows the most pre-potent of Maslow’s needs to be governed by the vagaries of Mr. Market will be fundamentally insecure and vulnerable. In contrast, citizens of a society whose government minimizes the costs of being fed, healthy, housed, secure, cared for, and educated, will have at least a chance of reaching their full productive potential, able to respond positively to life’s uncertainties. Which society do you want? Long term, which is sustainable?

    1. tegnost

      If we live in a country where the wishes of the bottom 90% of the population can be subverted by the wishes of the top 10%, what would we call that system?

      1. Rolf

        Increasing wealth of a vanishing small fraction of the population begets increasing political power of that fraction, power which is used to undermine support for policies that would protect the remaining fraction. Reinforcing itself in “democracies“, inequality is a positive feedback (see Michael Hudson) that eventually collapses the system. So: unsustainable, I think.

      2. BillC

        Call it what it is: Terminally Malignant Capitalism, aka Terminally Cancerous Capitalism. Capitalism that grows until it destroys the host.

  5. Not Again

    I remember when I used to read posts that had Senator Sanders’ name in them. Now I don’t know what he said and don’t care.

    1. JEHR

      It takes a village to support the leaders who want the best for the villagers. Surely, you don’t expect one person to do all the requesting for you?

      1. Big River Bandido

        I will note that there were supposedly a dozen real Democrats in Congress. I don’t hear a peep out of any of them. And I don’t read or care about what they say anymore either, because they are phony and useless.

      2. Jeff

        It takes a leader with courage to do what is necessary to lead a movement. Bernie had no courage when it’s needed most.

        Orange man bad had it.

  6. Mo

    Romney is something else. I can’t believe there are people who fall for his reasoning anymore. If a product he invests in works, he “gets to make an awful lot of money”. But the real reason his class makes a lot of money is because they start with a lot of money. If I had scraped together a thousand dollars and bet it on Moderna, I’d have 8000 now. BFD.

    When I hear capitalists talk, all I hear them saying is we already have all the money and we’re not gonna let that change.

  7. Jason Boxman

    A real effort would deep dive into nationalization of the drug industry itself as essential from a variety of angles, including national security given China is the source of many precursor chemicals. Not to mention the essential need for end-to-end testing of these inputs, which no one actually tests. A few independent pharmacies that actually test the drugs from major manufacturers have found a disturbing and possibly fatal lack of quality control here. A serious effort would involve Stoller or someone from the anti-monopoly crowd as well.

    Instead we get the usual Sanders song and dance, with no action. Sanders was built for sheep dogging; he seems to emphatically believe what he says, but when it comes down to business, nibbling around the edges with minor amendments is all he actually does. A perfect vehicle to dup whatever the left might be in America. Well played, Democrats, well played!

  8. Questa Nota

    Is there a Senate rule about disclosing any contributions, of whatever nature, to the members and even their families? Would those members ever write rules disqualifying recipients from voting on legislation where their votes would be perceived as being bought, or at least rented? Yeah. I know. :/
    Same could apply to the House. Have those displayed next to voting records.

  9. mcwoot

    “If I’m an investor, I have to expect that if a product I’m backing works, I get to make an awful lot of money,” he said. “I’ve heard people say, ‘That’s corporate greed.’ Yeah, that’s how it works.”

    What return is the USG getting for it’s massive investment in Moderna?

    1. Rolf

      What return is the U̸S̸G̸ Congress getting for its massive investment in Moderna?

      Dark money contributions.

    2. some guy

      Maybe the answer to corporate greed is public greed. The public has a right to be greedy to get and retain the value of things the public paid to develop. That should be ‘how it works’.

  10. orlbucfan

    March 26, 2023 at 6:55 pm

    What return is the U̸S̸G̸ Congress getting for its massive investment in Moderna?

    Dark money contributions.
    How about calling the black $$ money what it actually is: BRIBES! And for all the Bernie criticism on here, how about putting yourselves in his shoes in that beyond-corrupted place?! He’s putting a spotlight on these predatory capitalistic creeps and crooks. Who else is doing it?

  11. timotheus

    Mr Adams doesn’t hide his dislike of Sanders with descriptive language like “fire and brimstone,” “harsh attacks,” “bullies his way” toward results and “excoriates” Pharma. He’ll go far in the specialty media when CEOs take note of his corporate-friendly rhetoric.

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