Nonprofits, Flush With Pharma Donations, Voice Criticisms of Drug Pricing Bill, Report Says

Major drug companies poured hundreds of millions of dollars into nonprofit patient advocacy groups last year, as a fight over federal legislation to curb rising pharmaceutical prices is underway, Bloomberg Government reports.

Six drug companies—AbbVie, Bristol-Myers Squibb, Pfizer, Merck, AstraZeneca, and Johnson & Johnson—gave nonprofits more than $680 million last year, more than double the $321 million donated in 2015, according to tax filings and data provided to the Senate Finance Committee earlier this year. Some of the money also went to educational grants and fellowship programs for physicians, parts of which were run through nonprofits, according to an analysis by Bloomberg.

However, many of those nonprofits are now raising concerns about the bipartisan Prescription Drug Pricing Reduction Act of 2019, which the Senate Finance Committee cleared in July.

Among other things, the bill includes a major restructuring of the Medicare Part D benefit, one that Congress says would help steer utilization of generics and biosimilars. It would eliminate the coverage gap and establish 25% cost sharing between the annual deductible and the catastrophic threshold, which would be set at $3100 in 2022.

It would also make Medicare responsible for 20% of drug spending in the catastrophic phase, and insurers would pay 60%. Drug makers would provide 20% discounts in the catastrophic phase, including for low-income subsidy beneficiaries, instead of the 70% discount in the coverage gap.

The $680 million sent to nonprofits is far beyond what the drug industry’s official lobbying organization, the Pharmaceutical Research and Manufacturers of America, last year: $27.5 million. through the second quarter of 2019, it spent more than $16 million, Bloomberg says.

The report says it’s uncertain how drug maker cash influences patient advocacy groups and what kind of return on investment the companies receive.

However, the opinion of the pharmaceutical industry is at the lowest point it has ever been, according to a recent Gallup poll. Patient advocacy groups, which fund research, medical education, patient education and support, and sometimes co-pay assistance, generally enjoy a greater degree of trust and goodwill. Many often conduct lobbying activities alone or together as a group, sending patients to testify in Congress and in state legislatures.

One group is the coalition MapRx, which was founded by the Lupus Foundation of America in 2005. One of its members, the Patient Access Foundation, received the most amount of funding from the 6 pharmaceutical firms over the past 3 years, Bloomberg says; a spokeswoman said the donations do not influence their activities.

According to a letter sent to the finance committee by MapRx in July, it is in favor of an out-of-pocket cap but is concerned that changes to Part D will restrict beneficiaries’ access to drugs.

Reports about pharma’s influence on the activities of nonprofits are not new. A 2017 report in The New England Journal of Medicine noted that concerns have been raised about industry influence on patient groups, and attempted to quantify the extent of policies related to transparency and conflicts of interest, as well as the breadth of financial support. The authors called for the creation of a “sunshine law” that would cover industry payments to patient organizations.

Reference

McCoy MS, Carniol M, Chockley K, Urwin JW, Emanuel EJ, Schmidt H. Conflicts of interest for patient-advocacy organizations. N Engl J Med 2017; 376:880-885. doi: 10.1056/NEJMsr1610625.