NCL offers support for Increasing Access to Biosimilars Act (S. 1427)

December 16, 2021

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org or (412) 945-3242

Washington, DC—The National Consumers League (NCL) is pleased to support the Increasing Access to Biosimilars Act (S. 1427), as introduced by Senators Michael Bennet (D-CO) and John Cornyn (R-TX). This Act directs the U.S. Department of Health and Human Services (HHS) to launch a pilot program that increases Medicare payments for providers who use biosimilars. Representative Tony Cárdenas (D-CA) introduced a similar bill (H.R. 2869) in the House of Representatives.

Since 2014, the growth in pharmaceutical spending has been primarily driven by increased spending on biologic drugs. Biosimilars demonstrate no clinically meaningful differences in terms of safety, purity, and potency against their FDA-approved biologic counterpart, and are generally 15 percent to 35 percent lower in price. Therefore, biosimilars pose great potential to reduce health care costs.

The Increasing Access to Biosimilars Act would create a new pilot program administered by the Center for Medicare & Medicaid Innovation (CMMI) that aims to encourage physicians to prescribe less expensive biosimilars through shared savings. Shared savings is a payment strategy that offers providers a percentage of any net savings generated in order to reduce health care spending overall.

The following statement can be attributed to NCL’s Health Policy Director Jeanette Contreras:

“This legislation would not only broaden access to cost-saving biosimilars and reduce unnecessary spending on costly biologics, but it could also foster greater competition. In addition, it signals to future participants the viability of the biosimilars market, which is a win for consumers.

NCL believes that well-aligned payment incentives can steer providers toward cost-saving behavior with the overall objective of reducing Medicare expenditures. We strongly urge Congress to pass the Increasing Access to Biosimilars Act as the FDA continues to approve new biosimilars to market at increasing rates.”

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Abortion: The continuous fight for reproductive freedoms

By NCL Health Policy Intern Grace Mills

Grace Mills is a DC native, completing her undergraduate education at American University in Washington, DC. Her major is Public Health, with a minor in Spanish language. She will graduate in May 2022.

Women in the United States have been fighting for reproductive rights for decades. Activists like Margaret Sanger and Mary Ware Dennett argued during the early part of the 20th Century that women must be in control of their reproductive choices; the book “The Birth of the Pill” documents their crusade. Officials tried to prevent these two and many others from speaking and publishing about human sexuality, reproduction, and contraception. In the succeeding decades, activists pioneered the right to contraception, the right to abortion, and the right to bear a child.

Several landmark cases are worthy of mention. In Griswold v. Connecticut (1965), the Supreme Court ruled that a state’s ban on the use of contraceptives violated the right to marital privacy. In 1971, in the case of United States v. Vuitch, the Court rejected the claim that a statute permitting abortion only to preserve a woman’s life or health was unconstitutionally vague. It concluded that “health” should be understood to include considerations of psychological as well as physical well-being. The following year, in Eisenstadt v. Baird, the Supreme Court struck down a Massachusetts law limiting the distribution of contraceptives to married couples whose physicians had prescribed them. This decision established the right of unmarried individuals to obtain contraceptives.

In 1973, Roe v. Wade was a challenge to a Texas law prohibiting all but lifesaving abortions. The Supreme Court invalidated the law on the ground that the constitutional right to privacy encompasses a woman’s decision whether or not to terminate her pregnancy. Characterizing this right as “fundamental” to a woman’s “life and future,” the Court held that the state could not interfere with the abortion decision unless it had a compelling reason for regulation. NCL strongly supports the landmark protections in this case, including a woman’s right to control her own reproductive destiny.

Sadly, Roe v. Wade has been under attack from the right since 1973. After the Trump Administration’s Supreme Court appointments, there is a 6-member majority that appears to favor overturning Roe vs. Wade. States will have the right to pass far more restrictive laws than what Roe allowed for constitutionally. There will always be states that protect women’s right to choose and access to abortion, however, the issues lies in women living in states with restrictive laws or lack of money and/or resources to get to an abortion clinic.

This flies in the face of what the public wants. Indeed, a recent Gallup poll show Americans’ support for abortion in all or most cases at 80 percent in May, only slightly higher than in 1975 (76 percent), and the Pew Research Center finds 59 percent of adults believe abortion should be legal, compared to 60 percent in 1995. The share of Americans in Gallup’s poll who say abortion is morally acceptable reached a record high of 47 percent in May, up from a low of 36 percent in 2009, and a Quinnipiac poll found support for abortion being legal in all or most cases reached a near-record high in September with 63 percent support.

Many red states have recently passed some of the most restrictive and punitive abortion laws. In March of 2018, former governor of Mississippi Phil Bryant, signed into law the strictest abortion ban in the country up until that point. The law bans abortion at 15 weeks (about 3 and a half months), even in cases of rape or incest. But a federal district court judge shut the law down, and the U.S. Court of Appeals for the Fifth Circuit backed the court’s decision. This law is what was challenged in the Supreme Court last week.

Perhaps the most extreme is S.B. 8, the Texas law that went into effect on September 1, 2021 that prohibits abortion after “cardiac activity is detectable,” which is usually around the 6-week mark (about 1 and a half months). The law has a vigilante justice component, letting Texans sue anyone they believe is violating the law and/or is involved in an abortion in some way. This includes anyone who provides transportation to the abortion (even an Uber driver could be culpable) or a physician that performs the abortion after 6 weeks. This is the most draconian legislation so far, in part because many women do not even know they are pregnant at just 6 weeks.

S.B. 8 specifically does not allow state officials to enforce the law, authorizing only private citizens to do so, by suing an abortion provider for damages of ten thousand dollars for each procedure performed — what several Justices referred to, during oral arguments on November 1st, as a “bounty.” The Supreme Court will likely have the chance to review a challenge to the constitutionality of this law, but that’s a few years away and until then, the law remains in force.

NCL strongly supports women’s access to reproductive, abortion and maternal care. We understand that lack of access is directly related to a wide range of health disparities in the United States. It is no surprise that people of color in the United States have less access to the care they need and have more health complications. This is true for reproductive care and family planning. Black and Hispanic women have much higher abortion rates than white women largely directly related to a higher rate of unintended pregnancy.

These facts raise the question about what more can be done to provide women of color better maternal care and family planning resources. We need to reverse the pattern of inequality. NCL supports funding for sex education, full access to maternal care, and family planning to provide women with services, information and resources necessary to make informed decisions about their reproductive health and prevent any unnecessary health risks.

The tenuous hold we have on the right to abortion in every state, with the Mississippi law likely to get the thumbs up from the anti-choice Supreme Court, puts all women at risk. The Texas law is that much more draconian. We lament these attacks on women’s access to health care — especially poor women — that these restrictive abortion laws represent. Lastly, making abortions a crime won’t stop them from happening, it will only drive abortion back into the back alley and make it once again, a dangerous procedure that puts women’s health and safety at risk.

Jeanette Contreras portrait

Listen up: FDA’s proposed OTC hearing aid rule

By NCL Director of Health Policy Jeanette Contreras

Whether it be listening to your grandchildren share a story or having dinner with a friend, many consumers rely on devices to help them hear and understand speech every day. Hearing loss is something that we need to be mindful of at all ages, and as consumers, we look to our nation’s regulators to make sure these devices are safe to use.

Some people with hearing loss are able to work closely with hearing care professionals to finely adjust their hearing aids at sound levels that enable them to hear speech at comfortable levels without causing any harm. But, as more Americans struggle with their hearing, accessible hearing aids becomes increasingly important. Proposed regulations by the Food and Drug Administration will allow hearing aids to be sold over-the-counter to adults with mild-to-moderate hearing loss, a step forward in making them more affordable and accessible.

While these regulations are positive for access, the FDA’s proposed thresholds for volume or output for over-the-counter hearing devices are more in line with those for earbuds people use to listen to music for short periods than they are for hearing aids that are worn for several hours a day. These draft rules would allow a maximum sound output level of between 115 and 120 dBA, which is the equivalent to the volume of a chain saw. According to the CDC, exposure of sounds at 120 dB could become dangerous in as little as nine seconds. As you can imagine, being exposed to this level of sound for long periods of time is unsafe and could increase hearing loss and significantly damage the ear.

Hence, there is widespread concern among hearing care professionals that allowing an unnecessarily high level of amplification can lead to further hearing loss. Leading hearing care associations recommend a maximum output limit of 110 dBA for OTC hearing aids and establishing a gain limit of 25 dB.

As the leading consumer healthcare organization, we applaud the FDA’s efforts to increase access to hearing aids for those who need them. We do hope that the FDA will adjust its proposal, so it is in line with the recommendations of hearing care professionals before finalizing the regulations. Consumers shouldn’t be concerned that they may find their situation worsened by devices that are intended to help.

To learn more about gain and output and how to protect yourself from hearing loss, check out our new infographic.

Groups offer support for Forbidding Airlines from Imposing Ridiculous (FAIR) Fees Act of 2021

December 9, 2021

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org or (412) 945-3242

Washington, DC—The National Consumers League, Business Travel Coalition, Consumer Federation of America, Consumer Reports, and U.S. PIRG have signed onto a letter to Members of Congress in support of the Forbidding Airlines from Imposing Ridiculous (FAIR) Fees Act of 2021. Their letter appears below:

Dear Chairman DeFazio, Ranking Member Graves, Chairman Larsen, and Ranking Member Graves:

The undersigned consumer advocacy organizations support the Forbidding Airlines from Imposing Ridiculous (FAIR) Fees Act of 2021. This bill would protect consumers from unreasonable fees that airlines have reimposed as consumer demand to fly has rebounded from the pandemic.

Millions of consumers are annually charged excessive fees for checking baggage, changing reservations, canceling flights, and other services.[1] These fees are a major profit center for the airlines. For example, U.S. airlines collected $5.8 billion in baggage fees alone in 2019.[2] Compare this to analyst estimates that it costs airlines less than $20 per bag flown to provide the service.[3]  Furthermore, exaggerated change and cancellation fees are especially punitive as consumers cannot plan for unexpected events that force them to adjust their reservations.

The capture of more than 80% of domestic air traffic by just four U.S. airlines is a clear predicate of the rise in ancillary fees.[4] The non-competitive nature of the industry has allowed predatory practices to go unchallenged for too long. To be clear, airlines have the right to charge appropriate fees to cover operational costs and to make a profit. However, the supra-competitive amounts that airlines collect for providing basic services are unjustifiable. Prior to some ancillary fees being waived during the COVID-19 pandemic, such add-on fees were a steadily increasing source of revenue for the industry.[5] Now that the airlines’ moratorium on many of their fees has ended, we are concerned that this trend will resume.

The federal government must act to protect consumers from being forced to pay billions of dollars in bogus charges. The FAIR Fees Act, which has received bipartisan support,[6] would bring much-needed relief to travelers by requiring fees to be reasonable and reflect the actual costs of the services provided.

In addition to this immediate cost-saving benefit to consumers, the FAIR Fees Act would also direct the Department of Transportation to review any other fees charged by airlines and work to reduce airlines’ untaxed revenue. Since the IRS does not consider baggage fees or other ancillary fees to be related to the transport of a person, airlines do not pay excise taxes on the earnings they receive from these charges.[7] As ancillary charges have become a major source of revenue for the industry, this loophole has allowed airlines to avoid (conservatively) hundreds of millions of dollars in federal taxes.[8] Therefore, reining in ancillary fees would help reduce the amount of untaxed income this industry receives.

We applaud Representative Cohen for his continued leadership in protecting consumers from the exorbitant ancillary charges found on too many plane tickets. We urge your respective committees to report the legislation without delay.

Sincerely,

National Consumers League
Business Travel Coalition
Consumer Federation of America
Consumer Reports
U.S. PIRG

 

cc:       Members, House Committee on Transportation & Infrastructure

[1] USA TODAY. Shopping for flights? Change fees and other pre-pandemic penalties are back or returning soon on cheapest tickets. April 2, 2021. Online: https://www.usatoday.com/story/travel/airline-news/2021/04/02/covid-travel-airlines-change-fees-return-cheap-tickets-american-united/4805128001/

[2] CNBC. US airlines charged almost $5 billion in baggage fees last year—here’s how to avoid them. May 16, 2019. Online: https://www.cnbc.com/2019/05/15/us-airlines-brought-in-almost-5-billion-dollars-in-baggage-fees-last-year.html

[3] McCartney, Scott. “What It Costs An Airline to Fly Your Luggage,” Wall Street Journal. (November 25, 2008). Online: https://www.wsj.com/articles/SB122757025502954613 (Note: $15 in November 2008 is equal to $19.11 when adjusted for inflation in September 2021, per the U.S. Bureau of Labor Statistics.)

[4] Openmarketsinstitute.org. Airlines & Monopoly. Online: https://www.openmarketsinstitute.org/learn/airlines-monopoly

[5] Statista.com. Total ancillary revenue in the airline industry from 2011 to 2020. December 4, 2020. Online: https://www.statista.com/statistics/788849/airline-industry-ancillary-revenue/

[6] Office of Senator Edward J. Markey. “FAA Bill a Missed Opportunity to Protect Passengers from Ridiculous Airline Fees, Says Senator Markey.” Press release. (October 3, 2018) Online: https://www.markey.senate.gov/news/press-releases/faa-bill-a-missed-opportunity-to-protect-passengers-from-ridiculous-airline-fees-says-senator-markey

[7] Smarter Travel. If Fees Were Taxed, Would Airlines Ditch Them? July 16, 2020. Online: https://www.smartertravel.com/if-fees-were-taxed-would-airlines-ditch-them/

[8] Testimony of Dr. Gerald Dillingham (Director of Civil Aviation Issues, U.S. Government Accountability Office) before the House Subcommittee on Aviation. (July 14, 2010) (“However, if checked bag fee revenues that airlines reported in fiscal year 2009 had been subject to the excise tax on domestic travel, it would have generated about $186 million, or somewhat less than 2 percent of the Trust Fund revenues for 2009.”) Online: https://www.congress.gov/event/111th-congress/house-event/LC6763/text?s=1&r=9

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

The drug pricing middlemen driving up drug costs

Healthcare continues to be front and center in the national discourse, particularly in the midst of the pandemic. As Congress works on policy solutions to lower healthcare costs for consumers, we face an unfair disadvantage when it comes to what we’re paying at the pharmacy counter.