Democrats reject Bernie Sanders’ drug-price pressure tactics in advancing NIH nominee

Sen. Bernie Sanders tried to rally Democrats and President Joe Biden to do more to lower drug prices just a year after they ordered Medicare to negotiate with pharma. None showed up.

The Vermont independent's campaign took a blow on Wednesday as Democrats joined forces with Republicans to advance Biden’s pick to lead the National Institutes of Health over Sanders' objections.

The Senate Health, Education, Labor and Pensions Committee that Sanders chairs voted 15-6 to confirm Dr. Monica Bertagnolli, with five Republicans, including the panel’s ranking member Bill Cassidy of Louisiana, joining all 10 Democrats.

Democrats rejected Sanders’ case, that Bertagnolli had not demonstrated she would “take on the greed and power of the drug companies and health care industry and fight for the transformative changes the NIH needs at this critical moment.”

“I have been impressed with Dr. Bertagnolli’s thoughtful approach to addressing the range of public health challenges facing our country," Sen. Maggie Hassan (D-N.H.) said in a statement. "I look forward to her leadership of NIH.”

Meanwhile, the GOP votes for Bertagnolli, though not unanimous, show that at least some in the party want to restore bipartisan support for the NIH, which evaporated during the pandemic.

Many Republicans believe the coronavirus leaked from a Chinese lab that benefited from NIH funding. Others have accused former NIH Director Francis Collins and his top deputy at the agency, Dr. Anthony Fauci, of covering up the possibility of a lab leak.

But on Wednesday, Cassidy said he hoped to put the past behind.

"We need the next NIH director to engage with all parties and demonstrate clear leadership if we have hope to rebuild the trust that NIH has lost with the American public and Congress," Cassidy said. "I plan to work with her and hold her to that challenge."

The five Republicans’ support, along with that of other GOP senators who are not on the committee, means Bertagnolli’s confirmation is likely assured, once Majority Leader Chuck Schumer brings it up for a floor vote.

"She's eminently qualified," said the Senate’s third-ranking Republican, John Barrasso, who introduced Bertagnolli, a fellow Wyomingite, at her confirmation hearing last week.

Barrasso dismissed Sanders’ opposition as irrelevant to her qualifications: "It has to do with his fight with the administration on an unrelated topic."

It now looks as though Sanders lost that fight.

Sanders held up Bertagnolli’s confirmation hearing for five months after he announced this spring that he’d block Biden’s health care nominees until the president released a “comprehensive” plan to lower drug prices.

But Democrats have proved more interested this year in highlighting for voters the Medicare drug price negotiations they achieved in last year’s Inflation Reduction Act — which aim to reduce the prices on 10 high-cost drugs starting in 2026, and more in later years — than the shortcomings Sanders sees in Biden’s efforts to lower drug prices.

When asked about Sanders’ opposition, a White House official pointed POLITICO to efforts the administration has taken to tamp down drug costs.

“The President shares the Senator’s concerns on drug pricing. That’s why he signed into law the Inflation Reduction Act, the most consequential law addressing the high cost of prescription drugs,” the official wrote in an email.

Biden, who regularly touts the Medicare negotiations as a crowning achievement of his presidency, never gave Sanders a comprehensive plan. Democratic senators eager to run in 2024 on the law declined to back Sanders’ pressure campaign.

And Sanders relented, announcing last month he’d allow his committee to consider Bertagnolli after the administration struck a deal with drug company Regeneron to limit the price of a Covid therapy it’s developing with NIH backing.

A former Food and Drug Administration commissioner, Scott Gottlieb, told POLITICO it’s unlikely that deal will ever take effect.

"Pointing to a single case that was a particularly imbalanced situation and suggesting that there's been a policy reversal, I think would be misguided," added Richard Frank, director of the Brookings Schaeffer Initiative on Health Policy, expressing doubt about the significance of the Regeneron deal.

Still, drug pricing advocates, such as Public Citizen’s Peter Maybarduk, said Sanders' push sets an important precedent. "There's a very long way to go, but that for us is not a symptom of a wrong cause," he said. "The senator achieved material progress in an industry in a political context that has been very difficult to move."

When Sanders asked Bertagnolli at her confirmation hearing last week if she’d pursue tougher contract language with drugmakers that rely on NIH help, she demurred.

Then, earlier this week, Sanders called on the inspector general of the Department of Health and Human Services to investigate a potentially lucrative patent license the NIH proposed granting to a little-known company with ties to a former NIH researcher.

In the end, Sanders allowed his panel to vote on Bertagnolli and said he would not lobby Democrats to oppose her.

"This should be a vote of conscience," Sanders said Tuesday.

Although Cassidy pressed Bertagnolli about whether she'd refrain from getting involved in drug pricing at her confirmation hearing — she similarly demurred — Democrats did not join Sanders in questioning her on the topic and said they looked forward to working with her on key health issues, such as Alzheimer's disease and the opioid crisis.

Democrats remain committed to doing more to lower drug prices but are waiting for the right time, said Larry Levitt, executive vice president at KFF, the health policy research group, pointing to the Inflation Reduction Act as a likely centerpiece of Democrats' 2024 election campaigns.

"Democrats are all-in on efforts to lower drug prices," he said. "But it's a little messy to pair a debate about drug prices with the nomination of an NIH director."

David Lim and Ben Leonard contributed to this report.