Drug Costs

An Unbalanced Debate

July 18, 2019 10:56 am

On July 24-25, the National Academies of Science, Engineering and Medicine (NASEM) will convene a two-day workshop to discuss “the role of NIH in drug development innovation and its impact on patient access.” But don’t expect a balanced event.


The seminar has one sponsor—the John and Laura Arnold Foundation—and they have hand-selected several panelists who share their perspective. In fact, sixth session is stacked almost entirely with individuals who receive funding from the Arnolds.


This event shows how industry critics have used seemingly neutral third parties to promote potentially damaging public policy – and how they face a much lower standard for disclosure than industry advocates like us. (The Alliance to Protect Medical Innovation is funded entirely by the biopharmaceutical industry, for those of you who don’t already know.) This is important because policymakers and the public rarely know who is funding these biased studies and events.


The announcement for the workshop says it “will feature invited presentations.” While NASEM acknowledges the conference itself is supported by the Arnolds, its announcement does not mention any of the following connections between the Arnolds and the speakers. So we’ll break it down for you.


Session 6

Representatives from Patients for Affordable Drugs and the Initiative for Medicines, Access and Knowledge (I-MAK) both have a prominent place on the final panel of the event. According to a public grants database, these groups have received a combined $7 million in grants from the Arnolds. I-MAK has worked to undermine the U.S. patent system, which protects intellectual property rights, and Patients for Affordable Drugs has worked to convince taxpayers that they are “footing the bill” for drug innovation. (The NASEM workshop clearly is in line with that argument. More on this argument below.)


David Mitchell from Patients for Affordable Drugs, which has received nearly $3 million in grants from the Arnolds, will discuss how to “ensure affordable access to innovative drugs that have benefited from federal investments.” The political arm of that organization, Patients for Affordable Drugs Action, raised another nearly $10 million from the Action Now Initiative, the Arnolds’ political arm.


Also joining that panel is Tahir Amin from I-MAK, which has received almost $4.2 million from the Arnolds.


The Mitchell/Amin panel also will feature former Center for Medicare and Medicaid Services (CMS) Director Dr. Mark McClellan and Dr. Aaron Kesselheim from Brigham and Women’s Hospital in Boston.


Dr. McClellan is one of the featured experts at the Alliance for Health Policy, which also has received almost $250,000 from the Arnolds over the last two years. Approximately 80 percent of that funding went to efforts to “convene health policy experts, key stakeholders, and policymakers to discuss policy solutions to address rising health care costs.”


According to the Arnold grants database, Brigham and Women’s Hospital, where Dr. Kesselheim works, will receive nearly $9 million from the Arnolds between 2016 and 2020, including $100,000 over three years to “develop and publish 20 evidence-based commentaries on health care topics.”


Dr. Kesselheim is the director of the hospital’s Program on Regulation, Therapeutics and Law (PORTAL), which has received more than $6 million.


Another representative from Brigham and Women’s, Dr. Ameet Sarpatwari, will close out the first day of the NASEM summit. He is the assistant director of the PORTAL project. According to his biography, Dr. Sarpatwari also is “a co-investigator on grants from the Laura and John Arnold Foundation.”


Session 4

Dr. David Dilts also will be a featured speaker on the first day of the conference. He will address “infrastructure in drug development administration.”


Dr. Dilts is a management scientist at Oregon Health and Science University, which has received almost $10 million from the Arnolds, including nearly $1.6 million to “support efforts to improve the Medicaid drug purchasing process through research and design of value-based payment models.” Dr. Dilts also is a consultant who is managing partner of Dilts+Partners, LLC.


The Arnolds’ Misguided Talking Points on Federal Funding of Innovation

As noted above, the premise of the Arnold-funded NASEM conference is that the federal government is primary driver of drug innovation. We have dismantled that argument here.


While the federal government, led by the National Institutes of Health, is an important partner in the drive to find new treatments and cures, private sector companies provide the bulk of research and development funding. And the private sector is almost entirely responsible for delivering these breakthrough medicines to patients.


You won’t hear the Arnold-funded panelists acknowledge this fact, but, according to the Congressional Budget Office, “The pharmaceutical industry is one of the most research-intensive industries in the United States.” In fact, “Pharmaceutical firms invest as much as five times more in research and development, relative to their sales, than the average U.S. manufacturing firm.”


Double Standard

If any pharmaceutical company or industry group attempted to fund a conference this stacked with people sharing the same perspective, we’d be—rightly—accused of buying influence or slanting the debate. And yet, a billionaire couple who made their money by betting on energy prices is given a free pass.


Why the double standard?