Big Pharma Can Be Beaten: This Union Proved It

by Fran Quigley, Truthout | Report –

When Nevada Governor Brian Sandoval sat down at the Culinary Health Center in east Las Vegas on June 15 to sign the nation’s toughest-ever drug pricing law, Bonnie Sedich was thinking of her daughter Mary. Mary had Type 1 diabetes, and she had struggled to afford insulin as its cost rose by over 300 percent in recent years. Sedich thought about the still-unpaid bills for the credit cards that she and her husband maxed out trying to help Mary buy medicine. And she thought about Mary’s last grim months of life, partially paralyzed by a stroke and tortured by other diabetes complications, before dying in November at age 51.

Bonnie Sedich’s grief was still raw when she talked to Nevada legislators earlier this year about the need to rein in the price of insulin, a 95-year-old drug likely manufactured at a cost of a few dollars per vial but sold for as much as $400. For many diabetics, including all Type 1 diabetics like Mary, insulin is necessary for survival. “But what good does it do if you can’t afford it?” Sedich asked the lawmakers.

On the day of the bill signing, Sedich watched the governor talk with health care providers and working people with diabetes. The ceremony’s setting at the health center operated by the Culinary Workers Union of UNITE HERE was no coincidence. Sedich is a former union member, and the union was the driving force behind Nevada’s new law.

As the governor put pen to paper, several of those gathered around him were in tears, including Sedich. “It just seemed that Mary’s suffering had taken on some meaning,” she said later. “I felt encouraged.”

Others are feeling encouraged, too. The Nevada legislation is the most significant victory to date for the movement to hold pharmaceutical corporations accountable for their record-setting profits gathered from the skyrocketing prices on essential medicines. More than two dozen states are reviewing proposed legislation to address the drug pricing crisis. Multiple bills have been filed in Congress, ranging from allowing importation of low-cost medicines from Canada to bypassing the patents on overpriced drugs discovered with taxpayer dollars.

There is enormous public support for drug pricing reform, with national polls showing that 77 percent of Americans consider drug prices to be unreasonable. Strong majorities, including a majority of Republicans, support reform measures. But the populist anger — remember that even Donald Trump said the drug companies are “getting away with murder” — has not yet translated into widespread changes. Nearly all of the legislative efforts to advance drug pricing reform have been blocked or delayed.

However, the Nevada legislation is a sign that the tide may be turning. The new law requires transparency from the players in the secretive world of medicines pricing. If manufacturers raise Nevada prices on insulin and diabetes-treating biguanides, they are required to report their costs of manufacturing and marketing. Pharmacy benefit managers, the middle men in the medicines process, are forced to disclose the rebates they receive from the manufacturers. And pharmaceutical sales representatives, notorious for wooing physicians with gifts and misleading claims about their products, will be compelled to report the details of their interactions with those doctors. Even health care nonprofits that receive pharma industry donations will be required to make that information public.

No one in Nevada or elsewhere is claiming that these measures will alone fix the drug pricing crisis. But they are a historic first step toward doing so, especially since many observers believed that the powerful pharmaceutical lobby would easily block all reform efforts. Last April, the Wall Street brokerage and research firm Bernstein issued a report concluding that state-level drug pricing proposals are “a very modest risk to pharma, if at all.” The industry “is very much on the ball” in opposing reform, Bernstein concluded.

That prediction was partly on target, as the industry was definitely on the ball in Nevada. It hired dozens of lobbyists in the state, launched an aggressive social media campaign and threatened lawsuits to challenge any legislation. Yet the industry was beaten, and advocates across the world have taken note.

How was this victory won, and what lessons can be learned by other patients, activists and lawmakers wanting to build on the Nevada success? Here are the highlights.

Grassroots Organizing Works

No clever slogan, ad campaign, or social media plea will singlehandedly beat Big Pharma, says Bethany Khan, communications director of the Culinary Union. “You have to organize, and you have to organize every day,” she says.

Fortunately, Khan and her colleagues were no strangers to that challenge. With 57,000 members, the Culinary Union is the largest local of UNITE HERE, and has a reputation for being unafraid of a fight. In the 1980s and 1990s, the union led multiple fiercely contested strikes at Las Vegas casinos, including a battle with the Frontier Hotel and Casino that lasted six-plus years, the longest successful hotel strike in history. The union that stands toe-to-toe every day with some of the richest casinos in the country was not fazed by Wall Street analysts concluding that the pharma industry was unbeatable. “If money could buy everything in Nevada, this would not be a blue state,” says Khan.

As the legislative session began, union workers and allies flooded each legislator’s district with door-to-door campaigning and thousands of phone calls supporting the insulin pricing bill. For those who think of labor struggles as focusing only on wages and collective bargaining, it may be surprising that the Culinary Union put its full strength behind a piece of drug pricing legislation. But the union’s Culinary Health Fund provides health insurance for over 140,000 Nevadans who are union members or their dependents. Diabetes care is the fund’s fastest-growing cost, rising over 20 percent in 2016 alone.

So, it was not hard to find Nevadans like Bonnie Sedich who had stories to tell legislators and media about the struggle to afford insulin. The Nevada capital of Carson City is a seven-hour drive from Las Vegas, but that did not stop diabetes patients, family members and advocates from packing a legislature hearing room in April to testify about the bill. Afterwards, they fanned out across the Nevada Legislative Building to buttonhole legislators and talk to the media. Some of the patients who travelled to Carson City had lost legs to diabetes; some had lost homes when they had to choose between paying their mortgage and paying for medicine.



Reprinted with permission from Truthout