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Floor Speech

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Mr. GRASSLEY. Madam President, as a leading advocate for lower drug prices in the Senate, No. 1, I have hauled Big Pharma and pharmacy benefit managers' executives before my committee of Congress; second, I led a 2-year bipartisan investigation into insulin price-gouging; and three, introduced bipartisan reforms to lower the cost of insulin and many other prescription drugs. In the past few years, legislation I have championed into law has saved the taxpayers $9.6 billion.

Right now, the Senate is not acting on bipartisan legislation to lower drug costs. I support a bipartisan plan by Senators Collins and Shaheen that establishes a $35 out-of-pocket cap on insulin for patients with private insurance while also reforming PBMs, the powerful middlemen who are behind rising drug prices. If you don't address PBM reform, a cap on out-of-pocket costs will only result in shifting patient costs somewhere else.

In my 2-year bipartisan insulin investigation, we found that a drug's list price is tied to rebates and other fees that drug companies have to pay the PBMs. The scheme encourages drugmakers to spike the list price of the drug to offer a greater rebate. And then do you know what happens in turn? Secure priority placement on a health plan's list of covered medications. We have to hold PBMs accountable, then, if you really want to lower prescription drug costs.

In 2018, I called on the Federal Trade Commission to assess consolidation in the pharmaceutical supply chain and its impact on drug prices, but I didn't wait for the FTC to act. I introduced the Prescription Pricing for the People Act with Senator Cantwell, and it was approved out of the Judiciary Committee unanimously last year.

A few months ago, the FTC agreed to conduct a study of PBM business practices. This is very welcomed news, but the FTC needs to complete this study and do it in a timely way. Last week, I asked FTC Chair Kahn about when the PBM study would be completed. Chair Kahn didn't commit to a date.

While we need more sunshine on the PBMs, we don't need to wait to take some action. Senator Cantwell and I have introduced the PBM Transparency Act, and it has been approved by the Commerce Committee on a 19-to-9 vote. The bill prohibits PBMs from engaging in spread pricing and clawbacks. Both spread pricing and clawbacks are actions that game the system and hurt consumers.

When the majority party pursued a partisan, reckless spending-and-tax package that they called the Inflation Reduction Act, I filed the Grassley-Wyden Prescription Drug Pricing Reduction Act as an amendment that had 10 Republican cosponsors. I did that in order to show that the majority party could have chosen to pass drug pricing reform on a bipartisan basis if the majority wanted to do that. The bill establishes PBM accountability and transparency, something missing from the Inflation Reduction Act.

So, Madam President, we have bipartisan prescription drug legislation awaiting action. We don't have to wait until 2026 for what happened in August in the Inflation Reduction Act to get anything done because that doesn't take effect until 2026. This includes the bipartisan plan to lower insulin prices and my two bills to hold PBMs accountable. That is what we need bipartisan action on in the U.S. Senate.

I have also led out of the Judiciary Committee three bipartisan bills to establish more competition to lower prescription drug prices. They save taxpayers a combined $1.9 billion.

So the Senate must act on six bipartisan bills. Collectively, they lower insulin costs, secondly hold PBMs accountable, and lastly establish more competition to lower prescription drug prices.

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