Thank you for being among the 129 of our colleagues, who have cosponsored H.R.

1046, the
Medicare Negotiation and Competitive Licensing Act. While I still believe that competitive
licensing represents the best way to address prescription price gouging, it is certainly not the only
way. From the outset, I have indicated my willingness to join most any legislation that
effectively addresses this troubling problem.

As you know, with the introduction of H.R. 3 last Thursday, Speaker Pelosi has chosen a
different path to seek lower drug prices. After reviewing her plan, I find much to merit support
but some significant limitations that require improvement. At the first and only brief Caucus to
consider this proposal, a schedule was suggested calling for its markup by three committees at
the same time, hours after we return from the upcoming recess.

That means the window for necessary improvements is very narrow. As you talk with
constituents in coming days, no doubt many will want to know if the particular drugs, which they
require, are covered and when they will see any reduction in soaring prices. It’s important not to
overpromise.

Significantly, unlike the John Dingell negotiation bill overwhelmingly approved by the House in
2007, H.R. 3 fails to repeal the existing prohibition against Medicare negotiation of drug
prices. While it creates a major exception to that prohibition, it will remain against federal law to
negotiate the price of a multitude of medications. For example, it will be against federal law to
negotiate lower prices on EpiPen about which so much public concern was voiced only months
ago. This shortcoming cannot be corrected by simply itemizing the most infamous excluded
drugs like EpiPen. We should repeal the prohibition against Medicare negotiation that Big
Pharma so successfully included in the original Republican creation of Medicare Part D.

Even when negotiation is permitted, H.R. 3 envisions dealing with a very small number of drugs
each year—perhaps fewer total drugs than even the number of new drugs the FDA approves for
marketing each year. The mandate of H.R. 3 can be fully satisfied by negotiating prices for a
mere 25 drugs each year. And for these few negotiated drugs, no price savings apply to the
uninsured, leaving this most vulnerable population with no relief.

Moreover, Big Pharma can continue to launch new drugs at whatever sky high price desired with
no fear that H.R. 3 will mandate negotiation until long after it has raked in millions.

Nor is there protection for taxpayers, who fund the research that makes new lifesaving drugs
possible. While we all want new cures, reinvestment of savings from this bill in federal research
grants should be accompanied by assurance that resulting medications are accessible at a fair
price, which reflects the taxpayer investment.

Additionally, H.R. 3’s protection against frequent, outrageous drug price spikes above the
inflation rate fails to include so many pharmaceutical purchasers such as those reliant on
employer group health insurance and the uninsured.

My objective is not to let the perfect get in the way of the good, but to ensure that the good we
seek actually reaches those whom we serve. In short, more work and amendments are needed to
make H.R. 3 effective in achieving our shared objective of lowering drug prices for American
families. I hope you will join me in seeking these improvements. Please contact Afton Cissell
on my staff with any questions or suggestions at Afton.Cissell@mail.house.gov or 5-4865.

Sincerely,

Lloyd Doggett