During a Senate Judiciary Committee hearing on Tuesday, Sen. Dick Durbin (D-IL) spoke about issues in the prescription drug supply chain.
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00:00Senator Drobank. Thanks, Mr. Chairman. I may be mistaken. I may have missed this
00:05completely as I listen to the witnesses, but I suspect that we have a federal
00:10issue that has been disclosed to us this morning at this hearing. I suspect that
00:15our witnesses have given us a challenge as to whether we're going to do
00:19something about it. I suspect there is a possibility that we may even have to
00:24legislate, pass a bill, make a law, and I think you've spelled out in graphic terms
00:32why this is essential. My challenge to colleagues on my side of the aisle and the
00:37other side of the aisle is let's not walk away from this hearing and say, oh my
00:41God, that's really a mess. Let's do something that we were elected to do and
00:45legislate. The chairman has some legislation. I am co-sponsoring some of it
00:51with him. Each of us has an idea, I'm sure, because we wouldn't have run for
00:55office if we didn't, and we have a challenge that's given to us by this
00:59panel. Dr. Kircher, I tried to imagine you're walking into that patient's room
01:03day after day after day and explaining that the therapy he needed to stop the
01:11cancer in his body was being held up because of a fight, a jurisdictional fight
01:17about how to get the drug to the hospital. How in the world do you possibly
01:22explain that to your patient?
01:25It's interesting because, you know, as an oncologist, we're very well trained to
01:30deliver bad news. You know, I can tell patients that they are, have a cancer, that
01:36it's progressed, that maybe they ultimately need to be transitioned to hospice care
01:40even. But what I've noticed since I started practicing in 2011 is increasing
01:46conversations that I am not prepared for. It's interesting that I can have a
01:51conversation about end of life, but I'm having more and more about affording our
01:56medications and making these difficult decisions that are well beyond the four
02:02walls of our clinic and involved just obtaining their medication. So as far, as
02:09fast as we're hustling in clinic to see patients and get them what they need, we hit this
02:14roadblock that is really difficult to deal with.
02:18So to my colleagues, what if this was a member of your family? What if it was your
02:23spouse or your child that we were talking about? I mean, that really brings it home.
02:28And Dr. McDonough, what you and Dr. Kircher told us about your belief in your
02:34professional responsibility to the patient really rings true to me. You care. And
02:40because you care that patient's going to get better treatment. And the bottom line, Professor
02:45Sood, is you've gone through and analyzed these from an economics viewpoint. I'm really
02:51impressed with what you found. And Mr. Scott, the bottom line is this. You argue that PBMs
02:57give us competition, choice, and flexibility, and the evidence is absolutely to the contrary.
03:03What you've just heard, the illustrations on both sides of you, are proof positive that that is not your goal.
03:09I could go into vertical integration, the opioid crisis, spell out what PBMs have done over and
03:16over again. But how in the hell do you answer this Dr. Kircher's plea to us to give her patient the
03:24medicine he needs to get well and get into a battle over pricing? I mean, you say, well, you go into it
03:31voluntarily. You pick a PBM voluntarily. Clearly, that's not exactly the case. Voluntarily, she had a
03:38pharmacy in her hospital that she wanted to use, but you didn't give her that choice. I don't see how
03:44the PBMs and the examples that we've heard today have done the right thing for the patient. They've done
03:49the right thing for their bottom line. Please.
03:53Ma'am, Mr. Durbin, thank you for the opportunity to comment on some of the issues that have been
03:57raised. I want to start first by just expressing my sympathy for the experience that Dr. Kirchner shared.
04:05My father also suffered from cancer at the end of his life and then Alzheimer's disease and the
04:10coverage that he had through his health care benefits, the way that that system worked in
04:17both instances to make sure that he was getting the drugs he needs. And you know about Alzheimer's
04:21disease, that requires constant changes and dosage adjustments. The way that that worked properly
04:26allowed my mom and I to spend time focusing on him at the end of his life instead of having to
04:31focus on some of those administrative challenges. And that is the way we believe the system should
04:35work for all patients. We want to make sure that is working better. As has been said before, those
04:41those steps can be important in order to make sure that we are getting the right medicine to the right
04:46patient at the right cost. And at the same time, in today, 2025, the way that the system, we should not
04:53be using fax machines, right? We should be at a place where that exchange with the physician can happen
04:58in a more instantaneous place so that we don't have those unnecessary delays, especially in the case of
05:03pharmaceuticals like cancer treatment. Mr. Chairman, to my, to you and to my colleagues, if this isn't a call to
05:10action, I don't know what is. Imagine your own member of a family that you love going through this mess,
05:17because we failed to change the law. I hope we do.