Power of the purse
The most important news in healthcare: Friday, October 16th
Today, we’re diving deeper into the impact of pharma on our laws and our politicians, Nancy Drew style. 🔍
Today’s Pulse is 700 words, or a 5 minute read.
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PharmaDeep dive: The impact of pharma on our politics
Source: www.opensecrets.org
The pulse:
An investigational report from StatNews reveals first-of-its kind insight into the extent to which pharmaceutical companies and lobbying groups pour money into state elections. This happens particularly in states with a history of pushing drug pricing policy: in California, Illinois, and Oregon, more than 2/3rds of lawmakers have received checks from the drug industry. Today we break it all down: how is pharma shaping our laws and influencing our policymakers?
At the state level...
A lot of legislators receive small amounts of cash, typically ranging from a few hundred to a few thousand dollars per donor. Legislators in states that are hotbeds of activity are wooed particularly hard – in California, for example, where drug makers are currently battling to keep insurer-negotiated prices private, 85% of politicians get pharma funding. The funding, in California and in other states, is pretty equally split amongst Democrats and Republicans.
In Congress...
90% of members in the House and 97% of the Senate have taken a contribution from a pharmaceutical company. Drugmakers have spent $2.5 billion into lobbying and funding members of Congress over the past decade – more than any other industry in the country.
Is there an election this year?
Pharma usually backs the Republican presidential candidate, and in years past, has put a lot more dollars into funding Republicans running for Congress / the presidency than Democrats (see graph below). This year, however, Joe Biden has received four times the cash as Donald Trump – reflecting, perhaps, a reaction to Trump’s harsh rhetoric against the drug industry and Biden’s general ability to generate more funds.
Pharma funding of Congressional and presidential elections since 1990. Source: opensecrets.org.
The pharma funding fallout.
All things told, though pharma leans Republican, its influence does not necessarily suggest that it will significantly swing the polls towards one party or another. That said, the impact of pharmaceutical lobbying has had massive impacts on the country’s laws, expenditures, and lives over the past few decades. Take a couple examples:
In 2003, the industry successfully slapped a provision onto George Bush’s Medicare Modernization Act: the government could not, under any circumstances, negotiate prices for drugs or medical devices listed on Medicare Part D. The law is immensely unpopular: 93% of Democrats and 74% of Republicans oppose it – but lobbying might in the early 2000s allowed (and still allows) pharma to set prices in the U.S. higher than any other country and prevented the government from doing anything about it.
Industry-funded groups such as the Pain Care Forum spent $740 M lobbying DC in the early 2000s to protect limits against opioid prescribing, triggering a crisis that killed almost half a million Americans over two decades. Amongst politicians who received pharma cash were Senator Orrin Hatch, who took $360,000 and duly pushed against bills that proposed a federal study of proper pain treatment.
Despite the effectiveness of pharma lobbying in the past, it’s fallen a bit flat in recent years. Drug pricing has been one of the few bipartisan issues that both parties can pick on, and Trump’s determination to dampen industry revenues has been slowed only by his recent bout with COVID and his celebration of Moderna, Pfizer, Regeneron, and the other companies making vaccines / drugs. Pharma lobbying has recently been forced to be more defensive than it was a couple decades ago: where the late 90s could be a time to fuel a painkiller epidemic, today is about protecting against indices to overseas drug prices, a single-payer system, and restrictions on price hikes.
Biden is unlikely to be much kinder to the drug industry than Trump. What we can learn from past examples, however, is that the effects of lobbying can take decades to be felt. And the simple fact that 90%+ of Congress members receive pharma funding shows that public opposition to the industry almost never aligns with checkbooks.
Bottom line it for me.
There’s a decent chance that someone you vote for at the state-level this election-cycle has received pharma funding. Think through the implications of their health policy if they have, because the industry isn’t giving this cash away for free.
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