[Pages S4644-S4645] From the Congressional Record Online through the Government Publishing Office [www.gpo.gov] Prescription Drug Costs Mr. CARDIN. Mr. President, I rise today to highlight a historic moment which will help millions of older Americans and families access affordable prescription drugs. For too long, U.S. families have paid the highest prices compared to other countries, often leading millions of Americans to leave their pharmacy counter emptyhanded. With the passage and implementation of the Inflation Reduction Act under President Biden's leadership, Democrats are answering the call of the American people for affordable, accessible prescription drugs. No one should have to go into debt to buy the prescription drugs they need to live a healthy, productive life. Yet this is a dilemma many families in the United States face. Twenty-nine percent of Americans either cannot afford their prescription drugs or are rationing them, and the United States stands alone in this among our developed-nation peers. The United States spends about $600 billion annually on prescription drugs. In 2019, the latest year in which internationally comparable data from OECD is available, the United States spent over $1,100 per capita on prescription medicines. When you compare that to the other OECD countries, it is twice as much. Getting worse, by 2021 the United States spent over $1,400 per capita on prescription drugs. Americans and Marylanders are struggling to pay for their prescription medications, and it is long past time for Congress to take decisive action to deal with this issue. Prescription drugs have been lifesaving for millions, but if they are unaffordable, then their benefit is lost. High prescription drug prices drive health inequities that we are fighting to eradicate since groups in fair or poor health struggle to afford their medications. U.S. prescription drug prices are set through a complicated process by manufacturers, pharmaceutical benefit [[Page S4645]] managers, and payers. Prices are often disconnected from the health impacts of the products being purchased. Opponents of addressing the high prescription drug prices claim that more affordable prices will come at the expense of innovation. I must tell you, I disagree with that, and research also tells us that is just not true. To ensure access to innovative treatments and prescriptions, the U.S. Government, thanks to the U.S. taxpayer, makes significant investments in biomedical research. No greater example of this investment is the National Institutes of Health, located in my home State of Maryland, which is the world's largest government funder of biomedical research. Almost all drugs rely on NIH-supported basic science in their development, and the returns on these investments are very high. We have doubled down on this in the CHIPS and Science bill, putting more money into basic biomedical research. Researchers from the Massachusetts Institute of Technology have found that each $125 million NIH grant leads to $375 million--that is a 3-to- 1 ratio--more in private market value, 33 more patents, and 1 new drug. Another study estimated that the rate of return on NIH investments is 43 percent and that each dollar of NIH funding leads to an additional $8.40 in private research and development spending. These are great public investments, and it is leading to innovation. It is leading to development of new drugs. Further, the Small Business Innovation Research and Small Business Technology Transfer Programs also support innovation. Known as the SBIR/STTR Programs, they currently are the largest U.S. Federal Government programs supporting small businesses to conduct research and development. This is just another example of government-supported research that is inspiring new innovation and discovery. SBIR began in 1982 and currently requires that each Federal Agency spending more than $100 million annually on external research set aside 3.2 percent of these funds for awards to small businesses. SBIR is very selective, with only about 22 percent of the applicants receiving funding. For many small businesses, the SBIR ``serves as the first place many entrepreneurs involved in technological innovation go to for funding.'' Through the SBIR/STTR Programs, NIH supports drug innovation by setting aside more than 3.2 percent of its overall intramural research and development budget, specifically to support early-stage small businesses throughout our Nation. Many companies leverage this NIH funding to attract the partners and investors needed to take innovation to the market. I have the honor of chairing the Small Business Committee here in the U.S. Senate, and I can tell you the small businesses are the innovators of America. They are the ones coming up with new discoveries. Thanks to this government program and thanks to these government- supported partnerships, our small companies are leading in biomedical developments. And, I must tell you, thanks to small businesses, they are also growth engines for jobs in America. For example, Amgen, which was founded in 1980, received an SBIR investment in 1986 as a small company. Today, it is a multinational biopharmaceutical company with over 20,000 employees. That is creating jobs--good jobs--here for Americans. Despite these significant taxpayer investments, prescription drugs are often priced at levels that limit access to lifesaving drugs, particularly among those who are underinsured or uninsured. Even after accounting for the costs and risks of R&D, evidence shows that the returns on new products exceed the normal rates of return. For years, Congress has been working on commonsense solutions to increase access to affordable prescription medications, reducing costs for patients and taxpayers. Finally, last year, under President Biden's leadership, Congress passed the Inflation Reduction Act. This historic law removed a decades-old restriction on Medicare negotiating directly for the price of prescription drugs, finally empowering Medicare to get older Americans the best prices for their prescription drugs. In the private sector, no plan sponsor or manager would ever accept responsibility without the ability to decide how to negotiate. No private sector company would parcel themselves out in order to negotiate. They would use their full size as their market force. That is exactly what we did in the Inflation Reduction Act to allow Medicare to negotiate using its full market force to bring down the costs of prescription medicines for those under the Medicare system. It should have been done originally. We got it done in the Inflation Reduction Act. Medicare negotiations will ensure that patients with Medicare get the best possible price on high-priced drugs. Three weeks ago, the Biden-Harris administration announced the first 10 drugs that will be part of the first round of negotiation. This historic occasion is the culmination of decades of efforts by Democrats to make prescription drugs more affordable and accessible to Medicare beneficiaries. The 10 drugs chosen for negotiation are taken by 10 million older Americans, representing about $50 billion in annual spending. They are used to treat conditions including blood clots, diabetes, cancer, heart failure, and rheumatoid arthritis. Another policy included in the Inflation Reduction Act is to increase prescription drug affordability by capping Medicare patients' out-of- pocket costs at $3,000 in just a couple months and then lowering to $2,000 beginning in 2025. This policy will save Medicare beneficiaries from paying tens of thousands of dollars to purchase lifesaving drugs prescribed by their doctors. And there is more good news. As of this year, vaccines are free in Medicare, insulin is capped at $35 a month, and drug companies are penalized if they raise prices faster than inflation. All of these policies will make U.S. prescription drugs more affordable for individuals and families who desperately need them. Democrats worked together to pass the Inflation Reduction Act and to make these policies a reality. Today, I celebrate the progress we have made, and I urge all of my Senate colleagues to join in our efforts to continue making progress and leading the world in developing new drugs to improve health outcomes and to make these drugs affordable to our constituents and lower the costs to the taxpayers of this country. I yield the floor. I suggest the absence of a quorum. The PRESIDING OFFICER. The clerk will call the roll. The senior assistant legislative clerk proceeded to call the roll. Mr. MORAN. I ask unanimous consent that the order for the quorum call be rescinded. The PRESIDING OFFICER (Mr. Sanders). Without objection, it is so ordered. The Senator from Kansas.