COVID-19 Has Strengthened Pharma's Negotiating Hand

John L. Marshall, MD


July 22, 2020

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This transcript has been edited for clarity.

I'm John Marshall for Medscape, here in Washington, DC, during one of the craziest times of my entire life.

I wanted to talk about one impact of COVID on our world today that maybe you didn't think about, which has to do with those of us who are involved in new drug development and those of us who are trying to get access to new medicines for our patients.

You may not know this, but here in Washington, we were pretty aware that there was bipartisan support—yes, at times there can be bipartisan support—on Capitol Hill to try and negotiate drug prices.

We all know the problem: Because of health insurance laws within the United States, we're like the only country on the planet that still doesn't have the right, if you will, to negotiate drug prices, hospital prices, and all sorts of costs in the healthcare world.

Because we're removed from it hitting our wallet—it's insurance paying for it—we don't feel it as much, even though it is, of course, our money. However, we also know that because of rising healthcare costs, we, in this country, need to work very hard on this issue.

We were starting to see the battle beginning to build. We would see advertising from the pharmaceutical industry basically saying, "Look, we're in charge of innovation." Indeed they are, and they are investing in new drugs and new therapies with progress not only in cancer, but all sorts of diseases.

The pharmaceutical industry has been saying, "Be careful what you do, because if you negotiate a price, then we may not have the funds to move forward within that research space." That's not a bad argument.

From the other side, we heard that we can't keep borrowing money from China to pay for our healthcare. In addition, why are we the only country that's doing this? Why isn't the rest of the world sharing in this cost and expense [of drug development]? Again, a good counterargument was being built, and you could see it happening in the news and in ads on TV trying to make this case.

It became very contentious, but it's not clear to me, though, whether it actually would have happened before this coming election, because generally Congress doesn't take on items that are that hot before an election. My guess is it was going to get passed to next year, but it was going to get discussed and gain more and more traction on both sides.

Then, COVID happened. Of course, with COVID, we're all immediately hoping that the pharmaceutical industry will help us solve this through the development of vaccines and their capabilities to not only discover them, but also to ramp up manufacturing as well as develop therapies to manage the disease.

We are looking to the pharmaceutical industry to save us in some ways. I was thinking about what that is worth. When you look at the economic hit that something like COVID is having on the planet, maybe the sky's the limit; it's "whatever it takes" to pay for that.

Even though the government is helping to support this and considering other things that go into this complicated formula, we'd pay whatever it takes to get us back to some semblance of normal.

One result of COVID is the fact that we're going to postpone this discussion around pharmaceutical pricing in the United States, at least until we're fairly sure that COVID has quieted down. Even then, I think there will be an even stronger argument for "the sky's the limit" on some of these prices.

We will get back to this value discussion. We will get back to a discussion in the states around negotiating prices, but because of COVID, not for a little while longer.

I'm John Marshall for Medscape.

John L. Marshall, MD, is a leader in the research and development of drugs for colon cancer and other gastrointestinal cancers, and he has been the principal investigator of more than 150 clinical trials. Dr Marshall is the founding director of the Otto J. Ruesch Center for the Cure of Gastrointestinal Cancer, chief of the Division of Hematology-Oncology at Georgetown University, and the clinical director of oncology for Georgetown University Hospital.

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