They lined the wall of the hearing room in Augusta on Wednesday in their various shades of gray business suits, each waiting his turn to tell lawmakers what a fool’s errand they were on. At issue were cheaper, more accessible prescription drugs from Canada – and this platoon of paid pharmaceutical lobbyists wanted no part of it.
Christina Raymond didn’t care. She’d never been to a legislative hearing before, let alone spoken at one. But on this day, 250 miles from her home in far northern Maine, she would be heard.
“The thing is, I have breast cancer,” Raymond told members of the Health Coverage, Insurance and Financial Services Committee. “And I have an auto-immune disease called lupus. So, I have been 20 years being sick and thousands and thousands of dollars in medication and health care. However, surviving my cancer is not all I’ve had to deal with. The high costs of medication have led me to go into debt and I had to file bankruptcy.”
High costs? Try crime in progress.
Raymond, 39, has lived all her life in Aroostook County. She grew up in Madawaska, then moved to Caribou and now lives with her husband, Jeffrey, in Limestone.
She smiles a lot, even when she’s nervous. And make no mistake, as she rose to the podium in this roomful of people she’d never met, Raymond was palpably nervous.
But she’s also angry. The longer she struggles to stay alive, the deeper into debt she sinks. Taking her many and varied prescription medications, medical miracles every one, is the easy part. Paying for them isn’t.
“I have had 18 rounds of chemotherapy to treat my breast cancer. Before each round, I had to take a drug called Neulesta, which helps my body fight infections after treatment. And the Neulesta costs $6,000 a shot, which costs $12,000 a month. And I had to take it for two months. Twenty-four thousand dollars out of pocket,” she testified.
“I also need a cancer medication called Lupron, and the Lupron is for five years, which will cost myself $1,500 a month out of pocket. Five years of treatment costs $99,000,” she continued. “Because this medication is not approved for breast cancer treatments, that $99,000 is out of my pocket, which I had to go into debt on credit cards.”
Medicare, which Raymond receives through Social Security disability insurance, pays for a small portion of her meds. Her never-ending search for discounts and grants to help beat back the bills also helps some – although there are no guarantees from one year to the next that this or that sliver of assistance will be renewed.
Nevertheless, it’s never enough. The last time she checked, Raymond owed $36,000 on credit cards she uses not just at the pharmacy, but for food, gas and other daily necessities.
Hence the bankruptcy, now in progress.
“It’s quite difficult,” Raymond told the committee in a moment of painfully obvious understatement.
Last week’s proceedings focused on five bills, all spearheaded by Senate President Troy Jackson, D-Allagash.
The measures would allow the state to import wholesale lower-priced drugs from Canada; establish a Prescription Drug Affordability Board to oversee and set limits on excessively expensive drugs; codify federal drug policy into state law so Mainers can individually fill their prescriptions across the border (where, according to Jackson’s office, the price averages 30 percent cheaper); force insurers and pharmacy benefit managers to pass along any and all drug manufacturer rebates to the consumer; and require fuller disclosure of the costs of drug production, research and development, marketing, advertising and the actual price paid for a drug by the patient.
The guys in the suits, all paid to testify via one or another tentacle of Big Pharma, told lawmakers – and, by extension, the people of Maine – that this was all a terribly misguided crusade.
Speaking of the importation of low-price Canadian drugs, they warned that all of Canada hates the idea, that there are only so many drugs up there and our neighbors to the north will run out, that sooner or later organized crime will get involved. Plus, they said, it’s all in conflict with federal law anyway, so why even try?
It was enough to make Jackson laugh. “All of a sudden, we’re going to run out of drugs. The whole country,” he said, parodying his opponents “I mean, come on.”
Sitting in the quiet of his office, Jackson said he’s pushing this reform package at the state level, as have other states as politically diverse as Vermont, Utah, Colorado, Missouri and West Virginia, for one simple reason.
“I say we have to do it because if we don’t, no one else is going to,” he said. “What else are you going to do? We’re not going to make that result in D.C. There’s no other way to make it happen.”
Health care and prescription costs are, by far, the No. 1 concern Jackson says he hears from his constituents. And he’s beyond weary of listening to their stories – food or medication? mortgage payment or co-pay? – only to shake his head and say, “I feel for you, but there’s nothing I can do for you.”
He’s also had it up to here with the lobbyists who “are all taking money off the backs of consumers in this state. Their greed is just so rampant, it’s unbelievable.”
Christina Raymond would second that. Her in-laws recently paid for her passport as a Christmas present – she’d long held off because she couldn’t afford the $145 fee – after she learned that the Lupron she pays $1,500 per dose for here costs less than a third of that right across the border.
She knew, as she took a deep breath Wednesday, who all those guys by the far wall were and why they were there. She also knows there’s a vast chasm between their world, which took in $457 billion in prescription drug sales from Americans in 2015, and her world, which teeters on a precarious pile of maxed-out credit cards.
“I’m just thinking, ‘These guys are making good money. They don’t know what it’s like to be the little guy.’” Raymond said in an interview after her testimony. “And I’m like, ‘I’ve got a story to share and I’m going to do my best to share that. Maybe they’re not going to listen, but I have to say what I have to say.’”
And so, share she did. And as the crowded room listened in rapt attention, Raymond’s story rang truer than all the over-the-top warnings, all the single-space typed statements and supporting documentation, all the expressions of sympathy rendered hollow by the fact that the men in suits, first and foremost, are paid large sums of money to preserve the status quo.
As Jackson so succinctly put it, “I don’t even know how they can show up in a building like this and continue to spout their (expletive).”
But they do. And they will. And should one or more of Jackson’s bills pass, the pharmaceutical lobbyists will make way for the pharmaceutical lawyers, who will flock to the courts the next morning to argue that Maine has no idea what it’s doing.
“Screw ‘em,” Jackson said. “Sue us, then.”
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