While campaigning yesterday in Woodland Park, Colorado, GOP contender Rick Santorum told a sick child and his mother that they shouldn’t complain about the exorbitant cost of his medication because some people spend $900 on iPads. He appeared unmoved by the plight of the family, staunchly defending drug companies’ right to charge whatever they want.

The candidate also said that the parent and child unjustly felt entitled to get life-saving care at an affordable rate:

GOP contender Rick Santorum had a heated exchange with a mother and her sick young son Wednesday, arguing that drug companies were entitled to charge whatever the market demanded for life-saving therapies.[...]

“People have no problem paying $900 for an iPad,” Santorum said, “but paying $900 for a drug they have a problem with — it keeps you alive. Why? Because you’ve been conditioned to think health care is something you can get without having to pay for it.”

The mother said the boy was on the drug Abilify, used to treat schizophrenia, and that, on paper, its costs would exceed $1 million each year.

Santorum said drugs take years to develop and cost millions of dollars to produce, and manufacturers need to turn a profit or they would stop developing new drugs.

Santorum proceeded to lecture the mother and suggest she should be grateful to the drug companies for saving her son’s life. “He’s alive today because drug companies provide care,” Santorum said. “And if they didn’t think they could make money providing that drug, that drug wouldn’t be here.” He also claimed it would “freeze innovation” if pharmaceutical companies were required to offer their drugs at a reasonable price.

Although Santorum has been a vocal opponent of health care reform, his callous reaction is somewhat surprising given that he himself is the father of a daughter with a rare genetic disorder. But if the Colorado mother thought Santorum might be sympathetic to families in similar situations who happen to be less wealthy, she was sadly mistaken.

Seniors — the demographic most skeptical about health care reform — are already benefiting from provisions in the Affordable Care Act, the Associate Press’ Ricardo Alonso-Zaldivar reports, as the law gradually closes the doughnut hole in Medicare Part D. The coverage gap is the result of a political compromise in the Medicare Modernization Act of 2003, which created a gap in prescription coverage for seniors who spend more than $2,840 on medications this year. Beneficiaries are responsible for the next $3,600 in drug costs until they reach about $6,440 in spending.

The health law relies on money from the pharmaceutical industry to close the gap in coverage:

The “doughnut hole,’’ an anxiety-inducing catch in an otherwise popular benefit, will shrink about 40 percent for those unlucky enough to land in it, according to new Medicare figures provided in response to a request from The Associated Press. [...]

The average beneficiary who falls into the coverage gap would have spent $1,504 this year on prescriptions. But thanks to discounts and other provisions in President Barack Obama’s health care overhaul law, that cost fell to $901, according to Medicare’s Office of the Actuary, which handles economic estimates.

A 50 percent discount that the law secured from pharmaceutical companies on brand name drugs yielded an average savings of $581. Medicare also picked up more of the cost of generic drugs, saving an additional $22. [...] This year, the law provides a 50 percent discount on brand name drugs and 7 percent break on generics. Next year the discount on generics rises to 14 percent. When the changes are fully phased in, beneficiaries will still be responsible for their annual deductible and 25 percent of the cost of their medications until they reach catastrophic coverage.

The Center for Medicare and Medicaid Services (CMS) estimates that almost 1.8 million seniors have taken advantage of the discounts in the doughnut hole, saving more than $660 million on prescription drugs.

Texas Gov. Rick Perry (R) has come under fire from his fellow GOP candidates for signing a mandate that required teenage girls to get HPV vaccines, despite his staunch public opposition to government interference in health care. The HPV mandate became even more damaging after it was revealed that Merck, the pharmaceutical company that manufactures the vaccine, was a major donor to Perry, and that a lobbyist who represented the company now heads a pro-Perry Super PAC that vowed to raise $55 million to support the governor’s presidential bid.

Now, the Center for Public Integrity reports on another troubling health care mandate Perry signed into law after receiving considerable funds from a pharmaceutical company that stands to benefit from it:

The 2009 measure, the Texas Heart Attack Prevention Bill, requires insurance companies to pay for CT scans and ultrasound tests that can detect heart disease. [...]

It was sponsored by a Democratic lawmaker who suffered from heart disease, and was promoted by a controversial medical group with a history of ties to Pfizer, which makes the cholesterol-lowering drug, Lipitor. Critics say Pfizer, a major Perry contributor, could benefit from the legislation because the mandated test would likely uncover more people with heart problems, who might then be prescribed Lipitor.

Perry received more money from Pfizer than any other political candidate nationwide over the past six years, campaign finance reports show. The company also contributed more than $2 million to the Republican Governors Association between 2006 and 2011, during which time Perry served two terms as the association’s chairman and also as finance chair.

Moreover, the measure was pushed by a group of what one prominent cardiologist called “shameless self-promoters,” several of whom also stood to benefit finally from the mandate.

But perhaps more troubling than the crony capitalism allegation is the fact that the mandate was “a terrible waste of health care dollars,” as one expert put it, at a time when state health budgets are strapped. “There is little evidence that the tests [Perry mandated] can improve people’s health,” experts said. Rather, they drive up health care costs by leading to unnecessary procedures and prescriptions. Many national health experts “sharply criticized” criticized the decision at the time, and have continued to rail against it since.

Perry claims to be against legislative intervention in health care, calling the Affordable Care Act an “unconstitutional and unsustainable government takeover,” but Texas has the most health insurance mandates than all but three other states. Even the conservative Texas Public Policy Foundation, which has advised Perry, has criticized the amount of requirements on health insurance providers in the state.

It’s telling that while Texas highest level of residents lacking heath insurance, Perry focused on this unnecessary mandate that will do little help outcomes but may helps donors.

On Tuesday, Sen. Orrin Hatch (R-UT) told Inside Health Policy’s Sahil Kapur that the Democratically-backed idea of extending Medicaid drug rebates to beneficiaries in Medicare Part D was “a very important area,” and said he “expect[s] it to be under consideration” in the deficit reduction talks. “We’re going to have to try and go through it line by line, every part of that, and see what we can do with it on a bipartisan basis,” Hatch told Kapur.

But the morning after, drug lobbyists — who are the senator’s top campaign contributors — “were frantic,” Kapur’s sources claim, and, “Hatch’s office sent an email to IHP emphasizing the lawmaker’s opposition to Part D rebates and seeking a clarification in the article.” The senator’s staff even released a memo to journalists and lobbyists “saying the reporting of his comments ‘completely mischaracterizes’ the lawmaker’s position on the issue”:

In the meantime, industry sources said, Hatch’s office went into damage control efforts with the drug industry, which loathes the rebate proposal. In one email to the industry’s top lobbying group, the Pharmaceutical Research and Manufacturers of America (PhRMA), obtained by IHP, Hatch’s office insisted the notion that he supports changes to rebates “of course is false.” He promised them he is not asking the super committee to take up the policy and declared that the Part D program is “working so well.” PhRMA excerpted from the email in a note to its members. [...]

In an email exchange with IHP Wednesday (Oct. 12) morning, Hatch spokeswoman Julia Lawless said the lawmaker meant that he would go through the proposal on a line-by-line basis to see how to prevent government price controls. “This can be done on a bipartisan basis, given that some Democrats are against government price controls as well,” is what Hatch intended to say, according to Lawless.

Indeed, extending Medicaid drug rebates to Medicare patients has long been a Democratic priority that is typically opposed by Republicans. Back in 2003, the GOP-backed Medicare Part D legislation moved the 6 million Americans who were eligible for both Medicare and Medicaid into the Medicare Part D program, creating a windfall for the industry. Whereas Medicaid delivered an average discount of about 34 percent from pharmaceutical companies that participated in the Medicaid program, “the average discount obtained by the Part D plans was 14 percent,” according to a report issued by Rep. Henry Waxman (D-CA). As he put it, “The drug companies are making the same drugs. They are being used by the same beneficiaries. Yet because the drugs are being bought through Medicare Part D instead of Medicaid, the prices paid by the taxpayers have ballooned by billions of dollars.” CBO estimates that if drug manufacturers provided the Medicare Part D program with the same prices that Medicaid receives, the government could save $112 billion over 10 years.

According to Open Secrets, pharmaceuticals is Hatch’s top career contributor, funneling some $1,705,597 to the senator since 1989.

Prior to the Affordable Care Act, there existed no expedited pathway for approving generic versions of brand name biologic drugs — a new class of “wonder drugs” that contain living organisms and could one day help treat everything from cancer to Parkinson’s disease. The ACA sought to strike a compromise that could lower costs through generics while giving brand-name manufacturers the patent protection to continue researching and developing new medicines, ultimately granting generics the opportunity to enter the market “after a brand-name biologic enjoys exclusivity for 12 years.” Today’s deficit plan proposed by President Obama changes all that. It modifies the law by accelerating access to generic biologics and shrinks the exclusivity window from 12 to 7 years, yielding savings of 3.5 billion over 10 years, the administration predicts:

The Administration’s proposal accelerates access to affordable generic biologics by modifying the length of exclusivity on brand name biologics to encourage faster development of generic biologics while retaining appropriate incentives for research and development for the innovation of breakthrough products. Beginning in 2012, this proposal would award brand biologic manufacturers seven years of exclusivity rather than 12 years under current law and prohibit additional periods of exclusivity for brand biologics due minor changes in product formulations, a practice often referred to as “evergreening.”

Reducing the exclusivity period increases the availability of generic biologics to encourage faster development of generic biologics while retaining appropriate incentives for research and development for the innovation of breakthrough products. The Administration’s proposal strikes a balance between promoting affordable access to medications and encouraging innovation to develop needed therapies. The proposal will result in $3.5 billion in savings over 10 years to Federal health programs including Medicare and Medicaid.

During House Energy and Commerce Committee’s mark-up of the health care bill, Rep. Henry Waxman (D-CA) “had pushed to shield biologics for no more than five years — the same amount of time that traditional pharmaceuticals” receive, and Obama himself had originally suggested a 7-year exclusivity provision as a possible compromise. Lobbyists for the pharmaceutical industry ultimately prevailed, however, and a 12-year period was included in the final law. The industry even began lobbying the Food and Drug Administration (FDA) for “an additional 12 years of exclusivity if manufacturers alter an existing product to improve safety or potency.”

All along, the government argued that the 12-year period was too long and the additional time unnecessary. A Federal Trade Commission report released last year, for instance, found that “the 12- to 14-year regulatory exclusivity period is too long to promote innovation by these firms, particularly since they likely will retain substantial market share after FOB [generic drugs'] entry” and recommended against establishing an exclusivity period. Brand name drugs are “expected to respond and offer competitive discounts to maintain market share and are likely to retain 70 to 90 percent of their market share and will continue to reap substantial profits, even after FOB entry,” the report concluded.