A bipartisan push to reform prescription drug pricing has been delayed after the top Republican sponsor, Bill Cassidy (LA), accused Democrat-aligned "independent" Bernie Sanders (VT) of sabotaging the effort.
The Senate Committee on Health, Education, Labor and Pensions (HELP) is weighing bills that supporters say will increase market competition and force pharmaceutical benefit managers (PBM) to be more transparent.
Cassidy, ranking member of the committee, said the bills would bring transparency to an "opaque" system and bring costs down for consumers "without overhauling the entire healthcare system."
But he chastised Sanders, the committee's chair, for including amendments that the parties had agreed would not be brought forward. Sanders' team did not share the Congressional Budget Office (CBO) scores estimating the budgetary impact of those amendments, Cassidy said.
"The overall package was negotiated in good faith on our side, with concessions made with the understanding and commitment from the chair and his staff that these policies would not be included."
The tone of Tuesday's markup hearing was largely amicable, with senators expressing broad support for the proposed reforms.
One of the amendments, from Maggie Hassan (D-NH), would expedite approval of generic drugs by preventing "gamesmanship" from the Food and Drug Administration (FDA), Republican backer Rand Paul (R-KY) said.
"This is simply Big Pharma wanting to stop generics to come forward," Paul said.
Paul voiced some concerns about potential "unintended consequences" of the overall reform package, which he said could interfere with a complex system and result in fewer, more expensive drug options.
For the most part, there was little disagreement on the substance of the legislation. Cassidy said he backs the "essence" of the amendments but not the "process."
He wasn't alone. There was also criticism from Republican Mitt Romney (UT) and Democrat Tim Kaine (VA) for scheduling the bill markup before a hearing next week with PBMs and major pharmaceutical companies.
“It would seem to me the goal would be to get this bill out of committee with as much momentum as possible so that it has the greatest likelihood on the floor,” Kaine said.
Kaine expressed confusion over the "unusual" situation, which left senators reluctant to vote for amendments they already support. Sanders defended himself by saying it wasn't easy to coordinate a hearing with top pharma executives on a single day.
He ended up calling a recess until May 11, a day after the committee's hearing with Big Pharma bigwigs. Cassidy later told Bloomberg that the postponement was for the best.
“It took a lot of effort, and drama, but now the process is actually kind of what the process should have been all along. We will have a hearing first, and then we will have a markup,” he said.