We “follow the drug money” and expose California organizations and individuals, including doctors, high officials in state government and patient advocacy groups, who have developed cozy financial ties with the hugely profitable drug industry. Some of these people and groups are the drug industry’s top paid mercenaries, giving a veneer of respectability to what is just a naked attempt by Big Pharma to protect its profiteering and obscene profits.

Ask the organizations opposing Proposition 61, The California Drug Price Relief Act, why they are standing in the way of a long-overdue effort to cap prescription drug prices – and set an example for nation-wide drug industry reforms. Read on and follow the drug money. The trail leads to some surprising places.



 Sadly, too many elected public officials on both sides of the aisle have also entered into shady, backroom deals at the behest of the drug industry. These folks use their public positions and power to do the industry’s bidding, which has included pulling strings to help defeat Prop. 61. Just this year, the heavily Democrat-controlled Legislature has defeated two “transparency” bills, both sponsored by Democrats, to expose the price-gouging of drug companies to public view — Assembly Bill 463 and Senate Bill 1010. That leaves no choice but for the voters to take things into their own hands by passing Prop. 61 .

Below are contributions to California politicians by the drug companies, (ncluding a case study of all the drug dollars that have gone to one Democratic legislator who was the first to oppose Prop. 61), legislative lobbying expenditures by drug companies and total drug company contributions to the No on Prop. 61 campaign — most of it from drug companies that have frequently been fined for violating various federal laws.

Drug Company Campaign Cash to Politicians

Top 20 legislative recipients of campaign contributions in 2013 – 2014 from the pharmaceutical industry, funders of the no on Prop 61 campaign.
(Source: Sacramento Bee)

Sen. Richard Pan*, D-Sacramento – $95,150

Assembly Speaker Toni Atkins, D-San Diego – $90,250

Sen. Ed Hernandez*, D-Azusa – $67,750

Sen. Holly Mitchell, D-Los Angeles – $60,107

Assemblyman Brian Maienschein*, R-San Diego – $59,879

Senate President Pro Tem Kevin de León, D-Los Angeles – $56,648

Sen. Isadore Hall, D-Compton – $52,400

Sen. Jerry Hill, D-San Mateo – $50,209

Assemblyman Henry Perea, D-Fresno – $49,550

Assemblywoman Shirley Weber, D-San Diego – $47,000

Assemblyman Mike Gatto, D-Los Angeles – $46,491

Assemblywoman Susan A. Bonilla*, D-Concord – $45,600

Sen. Andy Vidak, R-Hanford – $42,800

Assemblyman Tom Daly, R-Hanford – $40,300

Assemblyman Kevin Mullin, D-South San Francisco – $38,400

Assemblyman Adam Gray, D-Merced – $37,000

Assemblyman Rob Bonta*, D-Alameda – $36,750

Assemblyman Anthony Rendon, D-Lakewood – $36,200

Assemblyman Jimmy Gomez*, D-Los Angeles – $33,850

Assemblyman Richard Gordon, D-Menlo Park – $33,100

*Member of the Assembly or Senate health committees

Drug Company Lobbying in the News

From the Sac Bee:

“Pharmaceutical companies and their trade groups gave more than $2 million to current members of the Legislature in 2013-2014… records show. Nine of the top 20 recipients are either legislative leaders or serve on either the Assembly or Senate health committees.

In addition, the industry donated more than $500,000 to outside campaign spending groups that helped elect some current members last year.

Leading pharmaceutical companies also spent nearly $3 million more during the 2013-2014 legislative session lobbying the Legislature, the governor, the state pharmacists’ board and other agencies, according to state filings.”

Source : http://www.sacbee.com/news/politics-government/capitol-alert/article24913978.html#storylink=cpy

 Drug Company Spending on Lobbying Jan. 1, 2015 to June 30, 2016

Download full report Here
(Source: Cal Access)

Grand Total

See how much Assemblywoman Susan Eggman, a Prop. 61 opponent, has accepted from Big Pharma Here.

Asm. Susan Talamantes Eggman of Stockton was the first legislator to come out in opposition to Proposition 61 — the first Democrat in either house to do so. Eggman should know better, as she brings the additional perspective of having served as a medic in the U.S. Army, a background which no doubt provided her with what should be a concern about the accessibility of medical care and the out-of-reach prices of so many prescription drugs.

But, as is the case in many instances involving opponents of the drug-pricing measure, Eggman has received more than $100,000 in financial support and campaign contributions from Big Pharma and entities allied with the drug companies and their interests. This includes a campaign contribution directly from the Pharmaceutical Research and Manufacturers Association (PhRMA) itself just two weeks before declaring against the initiative. PhRMA is the main force opposing the measure, and has already raised $68 million from drug companies — most of them from out of state — to fight it.

Assemblyman Henry Perea, Direct from the Legislature to PhRMA

In addition, a promising Democratic Latino legislator, Assm. Henry Perea of Fresno, actually resigned his seat prematurely last year to become a highly paid lobbyist for the Pharmaceutical Research and Manufacturers Association — after taking big money from the drug companies for his campaigns. The incestuousness just never ends. See Pharma’s contributions to Perea’ here.



The California Democratic Party officially endorsed several November ballot initiatives at its June Executive Board meeting, but took “no position” on Proposition 61. Several Democratic Party officials who are being paid directly by the drug company-funded No on Prop 61 campaign actively lobbied against Party support for the measure.

In the San Francisco Chronicle, columnists Matier and Ross foreshadowed how Pharma money might trump Democratic principles on an issue that should have been a no-brainer for Democrats. Eric Bauman, Vice Chair of the state Party, longtime Chair of the Los Angeles County Democratic Party, and a top advisor (paid by state taxpayers) to the Democratic Assembly Speaker, is being paid by the pharmaceutical industry committee against the Drug Price Relief Act. Jason Kinney, a Party-paid spokesperson for Democratic Senate President Pro-Tem Kevin De León, and an adviser to gubernatorial candidate and Lt. Gov. Gavin Newsom, has also received similar payments from the drug companies to convince Democrats to oppose 61. Even the longtime Democratic activist and Democratic National Committee member who is president of the venerated California NAACP, Alice Huffman, sold out for drug money.

Click below for the news accounts of these revelations and related FPPC reports.

2VICTORYLANDEric Bauman, Vice Chair of the Democratic Party

According to the San Francisco Chronicle: “Even as the state Democratic Party’s executive committee is being asked to endorse a November ballot measure that would cap prescription drug prices in California, a top party member — who is also on the Assembly speaker’s payroll — is pulling down $12,500 a month from the pharmaceutical industry to help defeat it.

Records show that Eric Bauman wears many hats these days, and that he has critics in his own party questioning his role in the $68 million campaign to defeat the California Drug Price Relief Act initiative…”



2KINNEYJason Kinney, Spokesperson for Senate President Pro-Tem Kevin De León

According to the San Francisco Chronicle, “Bauman isn’t the only high-powered Democrat being paid to oppose the measure. Sacramento lobbyist Jason Kinney is working on the ‘no’ campaign while also being paid by the state Democratic Party to act as communications director for Senate Democrats.”

Kinney is a longtime Democratic operative for the drug companies, having also had a role as a paid consultant to Big Pharma during the last drug initiative it opposed, Prop. 79 in 2005. Link here to an analysis of how Pharma used the same lies and tactics — and shills — against that measure.

(Source: SF Chronicle 6/13/16)



2AC PUBLIC AFFAIRSDNC Delegate Alice Huffman, President, California NAACP

California NAACP boss Alice Huffman, whose consulting firm has billed drug companies $12,000 for the campaign against Prop. 61, has now gone all in with “Big Pharma” by also signing the argument against the ballot measure to control drug prices.



CERRELLCerrell and Associates

Supposed Democrat Hal Dash, Chairman and CEO of Cerrell Associates, a Los Angeles-based PR firm that, although founded by the legendary and late Democrat Joe Cerrell, does scads of paid advocacy on behalf of moneyed special interests and corporate clients.

In this case, Dash’s firm is being paid directly by the campaign against the Drug Price Relief Act, which is wholly funded by the drug companies themselves. He is not an objective critic of the measure.



Big Pharma employs two former government officials whose questionable past actions and financial ties to the pharmaceutical industry lends even more evidence to the Pharma’s no on Prop. 61 campaign’s growing credibility problem. Pharma’s campaign reports show it employs Anthony Principi, former Department of Veterans Affairs secretary under President George W. Bush, and Kevin Gorospe, chief of Medi-Cal’s pharmacy policy under Republican Governor Arnold Schwarzenegger.

George W. Bush VA Secretary, Schwarzenegger Medi-Cal Official Campaign Against Prop. 61












Even many of California’s doctors are receiving hefty payments from the drug industry. According to public records, in 2015 alone the industry shelled out a quarter of a billion dollars to pay doctors royalties, speaking, and consulting fees, hire them to do research, and pay for doctors’ perks like business meals and trips.

In addition, the California Medical Assn. (CMA) decided behind closed doors and without explanation to oppose Prop. 61.

Read further to see what we’ve learned about the unseemly marriage between the drug industry and the CMA leadership. To find how much – if any – drug money your doctor is receiving, go to the Centers for Medicare & Medicaid Services

“Open Payments” website.



From time to time we are asked: Why is the California Medical Assn. opposed to the Drug Policy Relief Act?

We don’t pretend to have all the answers to that question. But we do know California doctors are deeply involved financially with the pharmaceutical industry. Could that be clouding their judgment? Might be. It has happened before.

The non-profit investigative journalism group Pro Publica has reported that California doctors received payments of $805 million from pharmaceutical and medical device manufacturers from Aug. 2013 to Dec. 2014. Under the Affordable Care Act, drug and medical device companies have been required since Aug. 2013 to report the payments they make to doctors to the Centers for Medicare & Medicaid Services (CMS)…



Federal records show drug and medical-device manufacturers in 2015 made payments of more than a quarter of a billion dollars that – in one way or another – went directly or indirectly into the pockets of tens of thousands of California doctors, even as the leadership of the California Medical Association decided to oppose Prop. 61, the November ballot measure to cap prescription drug prices.

“The cozy and incestuous financial ties between the drug industry and California doctors raise troubling questions about the California Medical Association’s (CMA) decision to oppose Prop. 61,” said Garry South, chief strategist for the Yes on Prop. 61/Californians for Lower Drug Prices campaign….



If you wonder why doctors are not mobilizing against the opioid epidemic, or the ridiculously high price of prescription drugs, just look at this statistic: drug and medical-device makers made payments of more than a quarter of a billion dollars in 2015 to California doctors.

That’s from federal records. Other research by the ballot initiative campaign to mandate lower price prescription drugs through Prop 61 shows the California Medical Association’s (CMA) president has a medical practice that in Riverside that received more than $1.6 million from drug and medical device makers…



An investigation by the Yes on Prop. 61 campaign found that the drug industry has contributed at least a half million dollars to the California Medical Assn. (CMA) that – directly or indirectly – subsidized the salaries paid to CMA’s executive officers, the same officers who have put their organization on record as opposing Prop. 61, the measure to cap prescription drug prices.

Many of the major pharmaceutical companies voluntarily publish so-called transparency reports disclosing their charitable donations and grants to various non-profit organizations, including patient-advocacy groups and universities…



Using their ill-gotten gains from price-gouging, the drug industry has quietly but perniciously infiltrated the ranks of many trusted non-profit advocacy groups that – on the surface at least – appear to be working to help patients. Shockingly, some of these groups have chosen money over merit, lined up to oppose Prop. 61 and sold out their constituents who would benefit from Prop. 61’s cap on prescription drug prices. It’s outrageous. The CA NAACP, the Ovarian Cancer Coalition, Bonnie J. Addario Lung Cancer Foundation, Latino Diabetes Association, CA Hepatitis C Task Force and the HIV / Hepatitis C group, Project Inform, are a few of the organizations accepting big money from the drug companies.

Read on as we call out these so-called public interest groups and health-advocacy organizations, some of which are just fronts for Pharma.

Lupus Foundation of Southern California – Another “Patient Advocacy” Group on the Take with Big Pharma

Public records reveal the San Diego-based Lupus Foundation of Southern California, a self-described patient advocacy organization that is opposing Proposition 61, is being substantially subsidized by prescription drug companies that have contributed $10.75 million to the anti-Prop. 61 campaign.
“Drug makers have turned patient advocacy groups into pharmaceutical industry advocacy groups,” said Garry South, chief strategist for the Californians for Lower Drug Prices/Yes on Prop. 61 campaign. “This lupus group is just one of many that have been seduced by drug industry subsidies and have become cheerleaders and apologists for the price-gougers and profiteers of Big Pharma.”


Fair Pricing Coalition Has a Web of Ties to Drug-Makers

The leadership of the Fair Pricing Coalition (FPC) – which represents itself as an honest broker that mediates with the pharmaceutical industry to reduce the impact of drug prices on HIV and hepatitis C suffers – is affiliated with so-called patient advocacy groups that have received at least $2,244,500 in funding from at least six drug-makers in recent years, according to a review of currently available public records.

A review of public records shows the 13 members of FPC’s board of directors represent at least 12 different organizations. Of those 12, 10 have received substantial contributions from drug companies.



Public records show that the California Chronic Care Coalition (CCCC) , another so-called “patient advocacy group” that is opposing Proposition 61, has received at least $260,000 in donations in recent years from prescription drug companies, including Pfizer, Abbvie and AstraZeneca – also three of the biggest drug-company funders of the No on Prop. 61 campaign.


ANOTHER “INDEPENDENT” GROUP AGAINST PROP. 61 RIDDLED WITH PHARMA MONEY CA Hepatitis C Task Force Board Members Have Many Financial Ties to Drug Companies

Public records reveal several leaders of the non-profit California Hepatitis C Task Force – a group whose president signed the ballot argument rebuttal against Prop. 61 – have received at least $1.2 million in payments in recent years from drug and medical-device manufacturers, while the Task Force itself has received another $10,000 directly from drug giant Pfizer Inc., one of the biggest financial backers of the drug-company campaign against the measure.

Task Force President and CEO William Remak is one of three persons who recently signed the drug companies’ rebuttal against the ballot argument in favor of Prop. 61 that will be included in voter material sent to millions of Californians.



California NAACP boss Alice Huffman, whose consulting firm has billed drug companies $12,000 for the campaign against Prop. 61, has now gone all in with “Big Pharma” by also signing the argument against the ballot measure to control drug prices. “Once again, it appears Alice Huffman has traded the California NAACP’s endorsement for her own financial gain,” said Gary South, chief strategist for the Yes on 61/Californian for Lower Drug Prices. The NAACP president has a history of financial ties…



Studio City Group and Its National Affiliate Received Almost $300,000 from Drug Companies Sacramento, CA. – The Studio City-based Ovarian Cancer Coalition of Greater California and its partner organization in Washington, D.C. have received nearly $300,000 from a half-dozen prescription drug companies in recent years even as the California group signed up…



As Yes on Prop 61/Californians for Lower Drug Prices continues to expose individuals and organizations that Big Pharma has bought off, the group today released information about one of the organizations the campaign against Prop. 61 lists as an endorser of the “no” side, the Bonnie J. Addario Lung Cancer Foundation. The drug company-funded opposition campaign boasts several supposedly independent “healthcare groups” endorsing its campaign to defeat Prop. 61, the California Drug Price Relief Act, including the Addario foundation. But public records show that this organization…



The Latest Example of Drug Companies “Buying” Support to Defeat Prop. 61 SACRAMENTO, CA – When Big Pharma submitted its ballot argument against Prop. 61 to the Secretary of State’s Office last week, one of the three signers of the argument was a Randy Munoz, vice chair of something called the Latino Diabetes Association (LDA). But research shows that this organization is a little-known Montebello-based non-profit, poorly funded except for significant subsidies by drug maker GlaxoSmithKline (GSK), according to public records obtained by the Yes on 61/Californians for Drug Pricing Relief campaign. GlaxoSmithKline is also a major funder…



Californians for Lower Drugs Prices, proponents of the California Drug Price Relief Act of 2016, today released information that helps explain why some supposed advocates for HIV and hepatitis C patients are shilling for Big Pharma by opposing or criticizing the drug-pricing measure.

Earlier this month, for example a San Francisco-based HIV/hepatitis C group, Project Inform, told the Los Angeles Times it had “deep concerns” about the California Drug Price Relief Act, which among other things, would lower the price of treatments to cure hep C. It turns out that Project Inform receives millions of dollars directly from drug companies, including a total of $4,409,269 from 10 pharmaceutical companies between 2008 and 2014, according to its IRS 990 forms. Its biggest single drug-company donation is $1,214,000 from Gilead Sciences…



Big Pharma Spends Big to Get Veterans to Oppose Proposition 61

Scaring and Misleading Vets Groups Has Been a Standard Tactic of the Drug Lobby

Big Pharma’s campaign against Proposition 61, the California Drug Price Relief Act, has been manipulating veterans organizations into opposing the measure, including paying top dollar to lobbyists who represent veterans in order to help secure their opposition, as well as doling out cash directly to veterans organizations themselves.

“It is really beyond shameless the lies and scare tactics the drug companies are using to bamboozle vets organizations into believing somehow Prop. 61 would be detrimental to their interests,” said Garry South, lead strategist for the Yes on 61 campaign. “Every time there is a debate about reining in exorbitant drug prices, Big Pharma attempts to drag in veterans organizations to protest. The level of manipulation and dishonesty of the industry is just breathtaking.”

According to Big Pharma’s No on 61 campaign finance reports filed with the California Secretary of State’s office, they began paying the lobbying firm of Pete Conaty & Associates in December of 2015. Conaty, a well-known Sacramento lobbyist, represents the California arms of the American GI Forum, the American Legion, AmVets, County Veterans Service Officers, Veterans of Foreign Wars, and the Vietnam Veterans of America, among others.

Three months and $15,000 later, all of Conaty’s clients miraculously came out publicly in opposition to the California Drug Price Relief Act. The very next month, Big Pharma doubled what it was paying Conaty’s firm, from $5,000 per month to $10,000 per month. As of June 2016, the lobbyist who represents most of California’s major veterans groups had collected more than $35,000 from the drug company-financed campaign. In addition, to back up their investment in Conaty, Big Pharma’s campaign has paid more than $8,000 directly to the veterans groups Conaty represents for so-called “meetings and appearances.” 

Conaty’s firm is not the only firm supposedly representing veterans “interests” getting a sweet deal from Big Pharma.

As Californians for Lower Drug Prices exposed previously, Big Pharma’s campaign also hired Anthony Principi, former Department of Veterans Affairs secretary under President George W. Bush, who is now a federal lobbyist. Principi, not coincidentally is also a former top executive of Pfizer, one of the most egregious drug price-gougers, and is a board member of Imprimis Pharmaceuticals.

Ironically, the same individual hired by Pharma to convince vets that Prop. 61 would hurt them is the same person whose tenure as VA secretary was marred by accusations that he stopped healthcare enrollments for eligible veterans. In 2008, Principi was forced to repay the VA $3 million after an audit by the VA’s inspector general revealed QTC Management Inc., a company headed by Principi both before and after his service as VA secretary, overbilled the VA $6 million under a long-term contract to conduct physical evaluations on veterans applying for disability benefits. The audit was triggered by a whistleblower’s call to a VA hotline. The Principi Group has collected more than $56,000 from Big Pharma’s No on 61 campaign as of June 30, 2016.

Proposition 61, on the November 8 ballot, would require the state of California to negotiate with drug companies for drug prices that are no more than is paid by the U.S. Department of Veterans Affairs (DVA). The DVA negotiates for drug prices on behalf of the millions of veterans it serves, and pays on average 20-24 percent less for medications than other government agencies, and up to 40 percent less than Medicare Part D. In response to the ballot measure, opponents of Prop. 61, primarily made up of the drug industry itself, have misleadingly argued that implementation of the measure could result in higher drug prices for the DVA. Drug discounts for DVA are actually guaranteed under federal law. Prop. 61 has been endorsed by VoteVets, consisting of 400,000 mostly Iraq and Afghanistan war veterans.  http://www.votevets.org/

Read FPPC Report Here




The drug industry has even captured a segment of the labor movement, which ought to be all for lower drug prices. California State Building & Construction Trades Council unions have established a special relationship with the drug industry and its powerful lobbying arm, the Pharmaceutical Research and Manufacturers of America (PhRMA), apparently based on sweetheart contracts the unions have negotiated to build and maintain industry facilities. In return, the drug industry has gained an influential partner in its efforts to woo Democratic Party officials and unions into their “coalition” against Prop. 61.

Read on below as we uncover an unholy alliance that defies the AFL-CIO’s concerns about the damaging impact of skyrocketing drug prices on its millions of members and the solvency of their union health funds.

The formal alliance between the Building Trades and Pharma is called the “Pharmaceutical Industry Labor Management Association,” and this group’s leader in California, a former Building Trades official, is also earning $8,000 per month from the Pharma-financed committee against Prop. 61 — a committee supported by the California Chamber of Commerce, the Business Roundtable, and the California Republican Party itself. In addition, Bob Balgenorth, longtime President of the California State Building Trades and Construction Council, is also being paid $17,000 per month by Pharma to try to line up unions against Prop. 61.




Drug companies have a problem following the law. Now those same companies are bankrolling the opposition to the Drug Price Relief Act.


Pfizer, Inc. (2004, 2009, 2012, 2013, 2016)**

GlaxoSmithKline (2005, 2010 and 2012)

Johnson & Johnson (2013)

Abbott Laboratories (Abbvie Inc.) (2012)

Eli Lilly and Co. (2009)

AstraZeneca Pharmaceuticals, LP (2003 and 2010)

Amgen Inc. (2012)

EMD Serono, Inc. (2005)

Merck & Co., Inc. (2008)

Purdue Pharma, LP (2007)***

Allergan, PLC (2010)

Bristol-Myers Squibb Co. (2007)

Novartis Pharmaceuticals Corp. (2010)

Bayer Corp. (2001 and 2003)

Sanofi-Aventis U.S., LLC (2009 and 2012)

Boehringer Ingelheim Pharmaceuticals, Inc. (2012)

Daiichi Sankyo, Inc. (2015)

Novo Nordisk, Inc. (2011 and 2011)

Eisai, Inc. (2010)

Astellas Pharma US, Inc. (2014)

Mallinckrodt Pharmaceuticals (2013)

Biogen (2015)



$4.1 Billion

$4 Billion

$2.2 Billion

$1.5 Billion

$1.4 Billion

$875 Million

$762 Million

$704 Million

$650 Million

$634.5 Million

$600 Million

$515 Million

$423 Million

$271 Million

$204.5 Million

$95 Million

$39 Million

$28 Million

$11 Million

$7.3 Million

$3.5 Million

$1.5 Million

$19.02 Billion

























(source: US Department of Justice)




Big Pharma Dumps in Additional $22 Million to Stop Prop 61

According to recent filings with the Secretary of State’s office, the drug companies have dumped an additional $22 million into their attempt to mislead voters into voting against Proposition 61, the California Drug Price Relief Act. The opposition, solely funded by Big Pharma itself, now has accumulated an eye-popping war chest of $109 million, making it the single most expensive ballot side in California history. (The campaign on behalf of Propositions 94-97 in 2008 spent a combined $108.3 million, but that covered four different measures.)

“The drug companies are clearly panicked because their campaign of lies and distortions against Prop. 61 up to this point isn’t working, and they are having trouble moving voters to oppose the measure,” said Garry South, lead strategist for the Yes on Prop. 61 campaign. “Now, their calls with Wall Street investors and stockholders have turned to questions about what happens to stock prices if 61 passes, so they’ve doubled down to try to strangle the measure in order to keep their sky-high profits and stock prices up.”

“Big Pharma’s ridiculous boilerplate arguments against 61 are that ‘it won’t work,’ and that it may actually lead to higher drug prices,” South said. “But if there was ever any question as to how much the drug industry really fears this measure and its impact, their massive contributions to try beat it are the best testimony. They are terrified because they know the public supports Prop 61, hates the drug companies and a reckoning is near.”

Prop. 61 is the only vehicle available in this election year for Californians to address the high cost of life-saving drugs, and is the only drug-pricing measure on the ballot in any of the 50 states. As such, it is garnering significant national attention, especially after Sen. Bernie Sanders’ visit to California last week to campaign for 61.

Proposition 61 would require the state of California to negotiate with drug companies for drug prices that are no more than is paid for the same drugs by the U.S. Department of Veterans Affairs (DVA).  Unlike Medicare, the DVA negotiates for drug prices on behalf of the millions of veterans it serves, and pays on average 20-24 percent less for medications than other government agencies, and up to 40 percent less than Medicare Part D.  Prop. 61 empowers the state, as the healthcare buyer for millions of Californians, to negotiate the same or an even better deal for taxpayers, saving the state billions.


Patients groups are the focus of a new report that asks questions about ties to corporate pharmaceutical companies.

Patients groups have credibility and influence precisely because they ostensibly represent the ordinary people whose fate is in the hands of the health care system, from brain injury survivors to people living with cancer to individuals facing mental health problems.

Now a troubling new report from the corporate watchdog group Public Citizen reveals that some patients groups are accepting donations from the pharmaceutical industry and then siding with it in backing policies that may contribute to higher drug costs for the very patients whose interests they claim to represent.

At issue is the pharmaceutical industry’s efforts to undermine a reform proposed by the Centers for Medicare and Medicaid Services (CMS) that would encourage doctors to prescribe cheaper medications that are equally effective as high-cost drugs. Known as the Medicare Part B demonstration project, the proposal would modify the reimbursement structure for prescription drugs “that are administered in a physician’s office or hospital outpatient department, such as cancer medications, injectables like antibiotics, or eye care treatments,” according to CMS.

“Today, Medicare Part B generally pays physicians and hospital outpatient departments the average sales price of a drug, plus a 6 percent add-on,” CMS explains. “The proposed model would test whether changing the add-on payment to 2.5 percent plus a flat fee payment of $16.80 per drug per day changes prescribing incentives and leads to improved quality and value.”

Public Citizen argues that the proposed reform is a step in the right direction because it “aims to remove incentives for needlessly prescribing high-priced medicines when equally effective and affordable alternatives are available.”

“Today, we pay doctors more when they prescribe higher-priced medicines—and so they do, even when there are affordable equivalents,” said Peter Maybarduk, director of Public Citizen’s Access to Medicines program, in a press statement. “As a result, Americans pay more for health care. We struggle to pay medical bills and resort to dangerous pill-splitting, or even forego our treatments.”

Unsurprisingly, the pharmaceutical industry has come out swinging against the proposal, unleashing a large-scale lobbying offensive at the beginning of the summer.

This is where the patients groups come in. In addition to lobbying efforts from pharmaceutical and physicians groups, 147 patients organizations signed two different letters addressing U.S. Congress and CMS opposing the proposed reform, organized by the Partnership to Improve Patient Care and the Community Oncology Alliance.

“We believe that this type of initiative, implemented without sufficient stakeholder input, will adversely affect the care and treatment of Medicare patients with complex conditions, such as cancer, macular degeneration, hypertension, rheumatoid arthritis, Crohn’s disease and ulcerative colitis, and primary immunodeficiency diseases,” states the COA letter.

According to the Public Citizen report, of the 147 groups that opposed the reform, at least 110—or three-fourths—receive funding from the pharmaceutical industry.

“Unfortunately, patients’ groups are not required to disclose these conflicts of interest, so this finding is based on voluntary disclosures that patients’ groups and drug companies provide on their websites,” explains Rick Claypool, research director for Public Citizens’ president’s office and author of the report. “As such, they likely under-represent the degree to which patients’ groups receive pharmaceutical industry sponsorship, and how much the group receives from the industry is unknown.”

separate Public Citizen report released July 11 found that members of the U.S. House of Representatives who oppose the reform received “82 percent more in campaign contributions for the 2016 election cycle than members who did not side with the industry.”

Claypool argues that such donations, at the least, raise questions about the independence of those who accept the funds.

“It is certainly not the case that every patient group that takes money from Big Pharma is at the beck and call of the industry; and of course there is a wide variance in groups’ dependence on pharmaceutical funding,” he writes. “However, it is the case that industry funding tends to make groups more sympathetic to industry positions, and more likely to respond to industry requests to weigh in on policy issues, including matters about which they may have limited expertise.


Groups push pharma agenda under the guise of patient advocacy

There’s nothing like a new Astroturf group to confusethe public. Astroturfers gather ordinary citizens from the grassroots to advocate for various causes while in reality shilling for the trade associations, PR firms, corporations, and political organizations that set them up. Now along comes a new patient advocacy organization, Patients Rising and its sister group Patients Rising Now, which debuted in late summer shortly after the House of Representatives passed the 21st Century Cures Act. Recall that the Cures Act would weaken already weak standards for FDA approval of medical devices opening the door for potentially harmful products to get on the market.

Like most Astroturf groups, its purpose seems noble enough and its goals lofty. On Facebook Patients Rising describes itself this way:

“Patients Rising was launched to fight for access to vital therapies and services for patients with life-threatening diseases. This patient advocacy organization will educate, advocate and communicate the importance of access to essential treatments and diagnostics.  We will be focused on ensuring that the patients’ voice is heard, access to new therapies is paramount, and the pipeline of progress is not threatened.”

The group, co-founded by Jonathan Wilcox, a corporate communications and public relations consultant and adjunct professor at USC’s Annenberg School of Communications and his wife Terry, a producer of oncology videos, aims to accomplish all that through workshops, webcasts at conferences, social media, and sharing patient stories, a staple of these groups.

Its goals are in sync with the zeitgeist of the medical marketplace—Joe Biden’s Moon Shot, the Cures Act, the FDA’s eagerness to push more drugs into the hands of patients. Astroturf groups, of course, are nothing new in the commerce of medicine, but the emergence of a new patient advocacy group to push against the developing meme of unaffordable drugs couldn’t have come at a better time. The Pharmaceutical Research and Manufacturers of America (PhRMA) announced the other day plans for a several million dollar advertising campaign aimed at federal and state lawmakers, policy analysts, and other political influencers, according to the Wall Street Journal. The aim is to polish up the industry’s image in light of rising drug prices and promote the industry’s role in developing new drugs and advancing medical science. The ads will feature patients who’ve been helped by new medicines, putting the patient story front and center in any discussion of the drug industry and drug costs, said Robert Zirkelbach, senior vice president of communications at PhRMA.

High drug prices have made their way into presidential politics, and some in the industry are speaking out like Dr. Steve Miller, head of the pharmacy benefit manager Express Scripts, who said recently,  “We are now being much more vigilant about identifying these things that we believe (are not driven by) scientific innovation, but financial innovation.”

That sounds like the sort of scrutiny Patients Rising will fight against. In a very brief phone interview Jonathan Wilcox told me the fight for access “is a cause worth fighting for,” especially against what he calls “widespread interference in the doctor patient relationship,” which he said had become “a patient crisis.” He said his group also opposes step therapy, a requirement which insurers impose that makes patients try least expensive drugs before taking ones that cost much more. Wilcox had to catch a plane before we could explore that issue and before I could ask about who funds Patients Rising. He didn’t respond to my requests to finish the conversation. Both Wilcox and his wife had worked with Vital Options International, another patient advocacy group with a special mission of generating global cancer conversations. She is a former executive director. A search of its website showed that drug industry heavy hitters, such as Genentech, Eli Lilly, and Bristol-Myers Squibb, had in the past sponsored some of the group’s major activities, including The Group Room and Advocacy in Action, which offer educational patient-driven content filmed at oncology conferences.

Patients Rising uses Twitter to advance its goals. One tweet : “As a patient I expect to be able to access the health services I need. Retweet if you agree.” Who wouldn’t agree with a statement like that, which builds support and awareness for the group?  It also reposts material from other news outlets like “New medicines can be winning play for patients,” an op-ed from the San Diego Tribune, or a lengthy news release about the newly formed Patients Alliance for Drug Safety Protections, a coalition of advocacy groups with links to the pharmaceutical industry, or Jonathan Wilcox’s column in the Los Angeles Daily News“How Step Therapy Tramples Patients.”

The group makes clear it doesn’t buy the argument drug prices are too high. A commentary on its website from The Tampa Tribune“Price controls on drugs every bit as absurd as a nationwide salary cap for cancer patients,” by Dr. Thomas Stossel, the American Cancer Society Professor of Medicine and a visiting scholar at the American Enterprise Institute, argues that instead of cost controls we need to make sure that financially-needy patients “find their way to assistance programs to help pay for treatment,” a remedy that might help patients but does nothing to put the brakes on the high underlying price.

The group’s pushback against the high drug price argument aims largely at Dr. Peter Bach, the epidemiologist at New York City’s Memorial Sloan Kettering, who has spoken out about the high price of cancer drugs. Patients Rising doesn’t like Bach’s DrugAbacus that lets users evaluate the value of their cancer drugs on dimensions such as cost, side effects, and benefits. A post by Terry Wilcox for Vital Options International last summer notes, “Cancer patients don’t see value in economic terms,” and advises readers: “Beware drug price calculators that give insurance companies and hospitals the ability to quantify a cancer patient’s life.”

Other targets are the insurance companies and regulatory barriers “standing in the way of the vital treatments they (patients) need every day.” The group passes along unfavorable stories from other news outlets about insurers. When Cigna dropped coverage of 3D mammograms, Patients Rising took note. It also passed along a story in The Fiscal Times“The Most Hated Health Insurance Company of 2015.” It was Cigna. Insurers have begun their own campaign to bring attention to the high cost of medicines. Its Drug of the Week feature spotlights high-cost pharmaceuticals.

It’s pretty clear after dissecting the activities of this new patient advocacy group that it’s advocating for more drugs no matter what the price, no matter how effective or ineffective they happen to be. Is the group’s agenda the same as that of patients? I asked Dr. Vinay Prasad, an oncologist and researcher at Oregon Health Sciences University, who just published a paper last week in JAMA Internal Medicine. Prasad and a colleague found that of the public speakers at 28 meetings of the FDA’s Oncologic Drugs Advisory Committee, one third had financial connections to drug companies or the organizations they represented received support from those companies seeking marketing approval.

There’s a flawed narrative, Prasad said, that patients want more drugs faster and are willing to tolerate major uncertainty about the risks. “There’s a big disconnect in my experience about what you hear in the news and what patients want,” he told me. In his practice, they are asking about risks and benefits, but that story never gets told. “Have you read a story about patients asking for more information about risks?  A vocal minority is speaking on behalf of a largely silent majority.” But it’s a vocal minority that’s very well funded.


Furor Over Drug Prices Puts Patient Advocacy Groups in Bind

By KATIE THOMAS September 27, 2016
The New York Times

Public anger over the cost of drugs has burned hot for a year, coursing through social media, popping up on the presidential campaign, and erupting in a series of congressional hearings, including one last week over the rising price of the allergy treatment EpiPen.

But one set of voices has been oddly muted — the nation’s biggest patient advocacy groups. The groups wield multimillion-dollar budgets and influence on Capitol Hill, but they have been largely absent in the public debate over pricing.

To those who have closely followed the drug world, the reason is simple: Many of the groups receive millions of dollars a year in donations from companies behind the drugs used by their members. When they prod drug companies, it is generally for better — not less expensive — treatments.

But critics say that by avoiding the debate over cost, they are failing in their patient-advocacy duties.

“It is a conflict of interest, because the interests of the pharmaceutical industry, from whom they are getting support, may be different from the interests of the patients,” said Dr. Michael Carome, the director of the Health Research Group at Public Citizen, a consumer advocacy group.

Over the last year, pharmaceutical companies have set high prices on medications as varied as breakthrough hepatitis C drugs and little-known generics that have been around for decades. The higher prices have hit American pocketbooks harder than usual, as insurers have increasingly shifted costs to patients.

And for patient groups, loudly addressing the issue can be perilous, as Cyndi Zagieboylo, the chief executive of the National Multiple Sclerosis Society, recently discovered.

She said members of her group, one of the most influential patient charities, had identified cost as a priority. The average annual cost for multiple sclerosis medications is $78,000 today, nearly 400 percent higher than the $16,000 average in 2004, the group says.

But as soon as Ms. Zagieboylo started discussing a plan — a modest proposal that involved bringing together drug makers, insurers and others to find solutions — she said she encountered resistance. Other patient groups would not join her, and she said she was told by members of Congress, as well as some of the pharmaceutical companies that donate to her group, to tread carefully.

“We were warned, you know, in a number of ways, just sort of to be careful about this,” Ms. Zagieboylo said. “A couple of pharmaceutical companies mentioned, ‘Boy, we support you, why are you doing this to us?’”

The group went ahead with the new campaign anyway, announcing it last week at an event attended by the National Health Council, an umbrella group for patient advocacy groups.

But Ms. Zagieboylo said the pushback gave her pause. She said she and the group’s board members decided they had to be ready to lose donors over the issue, including drug companies. The pharmaceutical industry donated about $10 million to the group in 2015, according to its website, accounting for about 4 percent of its annual budget.

“They are taking a lot of heat,” she said of the companies, who she said were not solely to blame for higher drug prices. “And they don’t want us to pile onto that, because they know we have influence.”

That influence is what makes patient groups so attractive to the drug industry. Some of the largest groups can call on millions of dedicated and highly motivated members and help drug companies by signing up participants for clinical trials, running financial assistance programs and even lobbying government officials for drug approvals or favorable legislation.

“It’s much more compelling when a parent reaches out to their congressman and says, ‘Please contact the F.D.A., because my child is dying,’” said Diana Zuckerman, the president of the National Center for Health Research, a nonprofit that does not accept money from industry.