Joe Biden

Remarks on Prescription Drug Costs and an Exchange With Reporters

December 06, 2021

The President. Iesha, thank you very much. Your story is important, and—for everyone to hear. And thank God you're with us today.

Today I'd like to talk about how we're going to help millions of Americans protect and preserve their health and live with the dignity of knowing that they can care for themselves and their loved ones, all by making the cost of prescription drugs much more reasonable.

At the outset, I want to be clear: We acknowledge the groundbreaking, lifesaving work that many pharmaceutical companies are doing. Look no further than the vaccines and the treatments they're manufacturing and delivering that are helping fight this pandemic. Our miraculous therapies have, in some cases, turned diseases that were once considered death sentences into treatable conditions.

But we can make a distinction between developing those breakthroughs and jacking up prices on a range of medicines, which have been on the market for years without making a substantial and a substantive change in the medication itself—the medicine itself.

Here in America, it will not surprise you to know that we pay the highest prescription drug prices of any developed nation in the world. Let me say that again: We pay the highest—highest—prescription drug prices of any developed nation in the world. That may surprise you—what may surprise you is, we pay about two to three times what other countries pay for the same drug.

An example: One anticancer drug costs $14,000 in the United States. That same exact drug by the same manufacturer costs $6,000 in France. Today, one in four Americans who take prescription drugs struggle to afford them. Nearly 30 percent—nearly 30 percent—of these patients have skipped doses of essential drugs they have to take.

Others have simply not fulfilled—filled a prescription, tried to use over-the-counter drug, and cut pills in half, or—because they can't afford the cost of their prescription.

You know, even if you think this doesn't affect you, it does. Everyone has less money in their pockets because high drug costs make health insurance more expensive for everyone.

There aren't a lot of things that almost every American agree—can agree on. But I think it's safe to say that all of us—all of us—whatever our background, our age, where we live—we can agree that prescription drugs are outrageously expensive in this country.

It doesn't need to be that way. Under my Build Back Better bill, there will be—which has passed the House of Representatives—it won't be the same way.

One of the most egregious examples of what's happening with drug prices is regarding the treatment of diabetes and the cost of insulin—a drug that people with type 1 diabetes need to take throughout their lives to control their diabetes and stay alive.

It was almost exactly 100 years ago that a 14-year-old boy in Canada dying of diabetes became the first person to receive an injection of insulin. Today, one bottle of this lifesaving liquid costs less than $10 to manufacture. But the—but in certain types of insulin, prices increased by 15 percent or more each year for the past decade.

Depending on the nature of someone's type 1 diabetes, the average sticker price for a month's supply of insulin is about $375. But some people, it can be as high as $1,000 a month because they need to take more.

I just met with the two lovely women we see in front of me today here. And Sa'Ra Skipper, who was diagnosed with Type 1 diabetes at age 5; she has a sister Shelby, who was diagnosed at age 8. She told me that affording insulin has been the challenge of her and her family's entire life. Sometimes, she and her sister rationed doses.

In 2018, Sa'Ra was no longer covered by her parent's policy. Although she was working two jobs, she hadn't met her health care plan's deductible. And insulin was about $1,000 a month's supply for her, so she started sharing her sister's insulin from the same vial.

At one point, because Shelby thought Sa'Ra had taken her dose, that Shelby cut a dose in half because the bottle was sitting there, and it would look like it was half empty. Is that correct?

Center Township, IN, resident Sa'Ra Skipper. Yes.

The President. And at that time, she thought, "Well, I"—guess what?—"I guess I"—she hadn't taken it yet. Shelby had to be hospitalized, as a consequence, for 4 days. Working two jobs, sharing insulin from the same vial—in America? Shame on us as a nation if we can't do better than this.

Sa'Ra is about to start a new job and doesn't yet know what the insulin will cost. Sa'Ra has said, "I wish I could"—and this is a quote—"I wish I could make a decision that didn't include diabetes." She shouldn't have to ask such a question.

You know, I think about what just happened with Iesha, who was diagnosed with diabetes 3 days before her 21st birthday, having to choose between rent and groceries and medication. Quote, "Relentlessly, without relief, every day," was your quote to me. Having to ration her supply and feeling herself, as she says, "slowly dying," she ended up in a coma.

Think about that: The difference between nearly dying and thriving is the cost of one drug. Sa'Ra and Iesha are far, far from being alone. It's estimated that 34 million Americans—10 percent of the population—have diabetes, including more than 1.5 million who have type 1 diabetes, requiring daily doses of insulin in varying quantities.

Remember all of this stress, hardship, suffering, and sacrifice is due to a drug that costs just a few bucks to make. One study found that Americans pay 10 times as much as other countries for insulin. These price increases are about companies looking to maximize profits and nobody standing up for the patients, nobody with the power to do something about it.

It's enough. Enough. Nobody has held the manufacturing—the manufacturers accountable, until now. My Build Back Better bill takes three key steps to lower the costs for families dealing with diabetes.

First, we're going to cap cost-sharing of—for insulin at $35 per month. That means you can't get charged more than 35 bucks at a pharmacy counter for your insulin. That's across the board, whether you get health insurance through your private policy, the Affordable Care Act Marketplace, or through Medicaid. Nobody is going to pay more than $35 each month for insulin.

Second, for people who don't have health insurance, we're helping you get insurance. That way, people with diabetes can get protected with that $35 copay cap. People who are uninsured today can visit to check out the options. In many cases, people can get a full health care plan, including coverage for insulin and other prescription drugs, doctor's visits, and hospitalizations for less than $10 a month if you sign up for the plan.

If you live in a State that has refused to expand Medicaid under the Affordable Care Act, my Build Back Better bill is going to fix that as well. These changes are going to ensure access to affordable coverage for millions more Americans and help more people with diabetes get the coverage they desperately need.

Third, we're going to end the days when drug companies could increase their prices with no oversight and no accountability. Going forward, drug companies that increase their prices faster than inflation are going to face a steep excise tax. In other words, if you're saying to drug—we're saying to drug companies: If you're finally doing it because—to be accountable, when your prices to the American people go up, you're going to be accountable.

This is important not only from a health standpoint, but the standpoint of personal dignity. Imagine if you're a parent of one of the roughly 200,000 young people in this country that suffer from type 1 diabetes. Imagine if you can't afford their insulin. It's not only a risk to your child's life, it deprives you of your dignity.

Just imagine, as a parent having a child with Type 1 diabetes and not a damn thing you can do about making sure they have it. You've sold what you can sold. You don't have the money to get it done. Well, my plan addresses an additional fear patients [parents]* face, which is that when their children are starting their careers and are no longer eligible on their parent's health care plan, they'll be able to get the insulin they need.

Outrageous costs affecting everyone across the board, spanning every kind of condition and disease. I remember what it was like when my mom—for my mom when she got older and moved in with us. Her prescription drugs were thousands of dollars on a monthly basis. Fortunately, I had three other siblings, and we collectively had the means to chip in so she didn't have to exhaust all of her savings and sell whatever she had left to make sure she could get her drug costs covered.

So I'm committed—I'm committed—to using every tool I have to lower prescription drug costs for Americans, consistent with the drug companies getting a fair return on their investment.

To really solve this problem, we need the Senate to follow the House of Representatives' lead and pass my Build Back Better bill. In addition to the specific progress that the Build Back Better bill is going to make for families facing diabetes, it will also take the additional step of lowering drug costs for people on Medicare.

Right now the only thing Medicare are—is not allowed to negotiate—they can negotiate the cost of doctor's visits, hospitalization, and all the rest. But the one thing they can't, as a matter of law, they are not allowed to negotiate the price for prescription drugs. For everything else—doctor's visits, crutches—they can negotiate.

My plan gets rid of that prohibition. What I'm proposing is that we negotiate a fair price—one that reflects the cost of research and development and a need for significant progress—excuse me, need for significant profit, but that is still affordable for consumers. Right now drug companies will set the price at whatever the market will bear.

My plan also caps the amount that seniors on Medicare have to spend on prescription drugs each year to no more than $2,000 per year, with Medicaid [Medicare]* and drug companies picking up the rest of the cost. And, again, our plan says that any drug company can only raise prices based on the rate of inflation and caps insulin cost-sharing at $35 a month.

So let me close with this: I've long said health care should be a right, not a privilege, in this country. And the women I've met with today, and millions like them, are the reason why: people for whom the cost of one drug is the difference between hope and fear, life and death, dignity and dependence.

We're closer than ever to passing my Build Back Better bill and providing people suffering from diabetes and so many other diseases the medicines they need and the dignity they deserve—being able to afford them.

This is not a partisan issue. Diabetes, Alzheimer's, cancer, so many other diseases, they don't care if you're a Democrat or a Republican. This is not whether—it's not about whether or not your loved ones can afford a prescription drug you need. So we need Congress to finish the job, to come together and make a difference in people's lives.

I want to thank both the guests here today for being so straightforward with me. We had a good conversation in the office before coming over here. I admire you both. I admire you both.

And as my grandpop used to say, with the grace of God and the good will of the neighbors, we're going to get this done so you don't have to worry every single day about what you're going to be able to do.

God bless you all, and God protect our troops. Thank you so much.

Q. President Biden——

Q. What is your message to Putin tomorrow?

Build Back Better Act

Q. Do you still expect to pass Build Back Better by Christmas, Mr. President?

The President. As early as we can get it. I want to get it done no matter how long it takes.

NOTE: The President spoke at 2:22 p.m. in the East Room at the White House. In his remarks, he referred to Phoenix, AZ, resident Iesha Meza, who introduced the President; and his brothers Francis W. and James B. Biden and sister Valerie Biden Owens. He also referred to H.R. 5376. A reporter referred to President Vladimir Vladimirovich Putin of Russia.

* White House correction.

Joseph R. Biden, Remarks on Prescription Drug Costs and an Exchange With Reporters Online by Gerhard Peters and John T. Woolley, The American Presidency Project

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