Sen. Bernie Sanders (I-Vermont) has condemned the Biden administration’s decision this week to reject a request to lower the price of an extremely expensive prostate cancer drug that can help extend the lives of patients for months or years.
Failing what advocates considered a litmus test of the administration’s willingness to act on prescription drug prices on Tuesday, the National Institutes of Health (NIH) announced that it will not use its “march-in” authority to lower the price of the drug, Xtandi, which was developed using taxpayer funds. The administration instead announced that it will be conducting a “review” of march-in authority, which advocates dismissed as a move to shield itself from criticism of the rejection.
Sanders, who has made lowering the price of prescription drugs a focus in recent months, said that he is “extremely disappointed” in an unusually critical and pointed statement against the Biden administration on Tuesday.
“This is a drug that was invented with taxpayer dollars by scientists at [University of California, Los Angeles] and can be purchased in Canada for one-fifth the U.S. price. The Japanese drugmaker Astellas, which made $1 billion in profits in 2021, has raised the price of this drug by more than 75 percent,” Sanders said. “How many prostate cancer patients will die because they cannot afford this unacceptable price?”
Rep. Lloyd Doggett (Texas), the top Democrat on the Ways and Means Health Subcommittee, also issued a statement criticizing the decision.
“Today’s decision is a blow to prostate cancer patients, their families, and taxpayers,” Doggett said. “The Biden Administration has missed yet another opportunity to do something meaningful to lower prescription drug costs and protect taxpayer investments. Its decision protects monopolists over taxpayers and patients, despite clear statutory authority and reasonableness to intervene. This decision effectively rubber stamps continued Big Pharma abuse.”
The price of Xtandi is a major problem for many prostate cancer patients. The average wholesale price for Xtandi is nearly $190,000 a year, with an out-of-pocket price of roughly $10,000 a year for patients on Medicare, making it one of the costliest drugs on Medicare’s list. The price makes the drug out of reach or financially ruinous for many patients — and because it is so expensive, doctors often have to obtain prior approval from private insurers to prescribe it, making it even more inaccessible.
The problem disproportionately affects Black people. Prostate cancer has one of the highest disparities between the rate of white and Black people who contract it, and Black people are two times more likely to die of prostate cancer than their white counterparts.
As with many — if not most — prescription drugs, Xtandi costs far more in the U.S. than it does in other countries. According to Knowledge Ecology International, which filed the request for the administration to use its march-in authority to lower the price of the drug, the drug is three to five times more expensive in the U.S. than it is in other countries.
The administration’s rejection comes despite the fact that patient advocates say that the government has the authority to exercise its march-in rights in this way, as allowed under the 1980 Bayh-Dole Act. Knowledge Ecology International called the decision “appalling,” pointing out that not only did officials reject the request, they also didn’t use the threat of exercising march-in rights to pressure manufacturer Astellas or Pfizer to lower the price themselves — an action officials have taken in the past.