Last cycle we spent a lot of time learning about southwest Michigan's 6th Congressional District and the would-be feudal lord who represents it, Fred Upton. Judging from his fundraising patterns, Upton has every intention of running for a 16th term next year. His PAC has $339,754 cash on hand and as Boehner's chairman of the House Energy and Commerce Committee he has already stuffed his war chest with tens of thousands of dollars. Last cycle his biggest contributors, by far, were from the industries his committee is charged with overseeing. In terms of sectors, his biggest "contributions" came from "Health Professionals" ($342,251-- almost entirely from the PACs they had set up to bribe powerful lawmakers) and from "Pharmaceuticals/Health Products" ($302,700, again almost entirely from PACs set up specifically to influence the outcome of congressional activities). Upton has proven to be their man-- and, as expected, he's doing it again going into the 2016 election.The 400+ page draft of Upton’s 21st Century Cures Act includes a sneaky provision allowing industry to avoid reporting payments to doctors for attending “continuing medical education” they have funded. It has new reporting requirements for when hospitals switch from brand name to generic medicines.Yes, our democracy doesn’t get sold in the headlines. It gets sold in the fine print.This important act would also provide millions of dollars in new funding for medical research. It helps regulations catch up with dramatic advances in research techniques. What better vehicle for payback to your biggest campaign contributors?In the 2014 election, the average congressional campaign cost just over a million dollars. Upton spent almost 5 million, of which he received a sixth, over $800,000, from health care, pharmaceutical, and health product industries.Should health legislation be written by someone who owes this much to health industries?What would be the effect?Since 1962 the FDA has required evidence from randomized clinical trials that demonstrate clinically meaningful outcomes before approving a drug. Under this legislation, however, manufacturers could get FDA approval for some drugs just by showing they are "reasonably likely to predict clinical benefit."Some of these drugs cost over $10,000 a month.The bill would allow expanded use of approved drugs based on “clinical experience” instead of controlled trials, pushing potentially dangerous drugs into patients’ hands. Ineffective drugs, like the widely advertised Lyrica, need more study, not less. About two-thirds of patients prescribed Lyrica get no benefit from the drug whatsoever. The profit to the manufacturers from Lyrica, on the other hand, is astronomical-- and Upton has no intention of seeing the share contributed to him and his colleagues dry up. Last cycle alone, the pharmaceutical industry gave $21,601,093 to candidates for Congress, overwhelmingly to incumbents and overwhelmingly to Republicans. 217 House Republicans received an average of $38,013 and 189 House Democrats received an average of $29,247. Look at this chart compiled by OpenSecrets.org that shows which Members of Congress took the biggest payoffs from Big Pharma in 2014. Oh dear, look who's taken even bigger payoffs than Speaker Boehner! And keep in mind that since 1990-- Upton was first elected to Congress in 1986-- payoffs from Big Phrama to Upton have totaled $1,145,306. (In this same time frame they've schmeared Boehner to the tune of $1,056,680.)Upton's new legislative proposal extends monopoly rights for pharmaceutical companies, such as by increasing the “market exclusivity” period for specialty drugs from 12 to 15 years. Everything is for the companies' bottom lines; Upton's bill treats patients as victims, not as consumers who need to be protected from greed-obsessed predators. Want to know why the benefits of medical marijuana are being kept from the American people? Ask Fred Upton; it's his bailiwick and he's holding it back until they figure out how to turn it into a profit center for Big Pharma-- the hell with patients who are suffering with unspeakable, unbearable pain that could be directly addressed.Is it fair to accuse Fred Upton of using his position to pay back his biggest contributors? Merrill Goozner directs the overall editorial direction of Modern Healthcare and oversees editorial content for its completely nonpartisan magazine. He states clearly that Upton's proposed legislation "modernizing" the FDA's approach to approving breakthrough drugs and devices would undermine the agency's ability to protect the American public from unproven and possibly unsafe new products.
The so-called 21st Century Cures Act also contains sections that would hamstring healthcare providers and insurers in their efforts to lower the cost of care. Unless the legislation is sharply revised, it should be rejected by Congress or, if need be, vetoed by the president.To gain bipartisan support, the drafters of the bill included more money for the National Institutes of Health and a new role for patient-reported outcomes. Those are laudable goals-- especially the boost for basic science research, which is the foundation of innovation in medicine.But there was no need to simultaneously degrade the scientific basis of new drug and device approvals; allow Congress to impose its own rules for what constitutes acceptable medical evidence; or weaken the standards for protecting human subjects in clinical trials-- all of which is in the bill.For no apparent reason, the legislation also imposes new disclosure requirements on hospitals and insurance companies when they create preferred drug lists or formularies, which enable substitution of lower-priced, comparable products. It also absolves the industry from having to disclose payments to doctors for attending continuing medical education run by a third party they've funded.Those two provisions are not about coming up with new cures. They are designed to give drug and device companies more freedom to market the less effective and more expensive cures they already have....In her final address last month as FDA commissioner, Dr. Margaret Hamburg wisely noted that "innovation doesn't matter if the product doesn't work ... It is foolish-- in fact dangerous-- to believe that reducing regulatory standards will make new treatment interventions appear if the science is not there."
Upton's bill's merits aside, it is clearly designed to increase profits for big campaign contributors, and it clearly increases health risks for patients. And this, my friends, is how our democracy gets sold. Blue America is counting on progressive Paul Clements to run against Upton again in 2016. We are hopeful he will. Below is an ad he ran in 2014 showing how Upton's pay-to-play schemes have worked in other areas besides healthcare. (Don't expect the DCCC to alter its longstanding policy of protecting Upton by undermining and ignoring Democrats who run against him. That's what they do; that's what they are.)