CLSA in STAT News: It’s tiny biotechs — not big drug makers — that fear ‘nuclear winter’ from Pelosi’s drug pricing bill

NOVEMBER 12, 2019

WASHINGTON — No one asked Paul Hastings what he thinks about Speaker Nancy Pelosi’s major new drug pricing legislation, or how it might affect his company, Nkarta Therapeutics. No one asked Bassil Dahiyat, the CEO of Xencor (XNCR), or Dr. Barbara Weber, who helms Tango Therapeutics, either.

But they’re all scared stiff.

They and other leaders of small biotech companies — most of whom stick to science, not politics — are speaking up now because they are uniquely worried that the policies included in Democrats’ marquee bill will dry up the venture capital funding that drives their industry and, in turn, make it impossible for the similarly small startups that turn basic research into new medicines to get off the ground.

“If they don’t educate themselves on what this bill could do to this industry, they are doing their constituents a disservice,” said Hastings, referring to members of Congress. “This bill could have devastating effects on our industry, period. End of discussion.”

“It’s storm clouds on the horizon,” said Dahiyat.

Theirs is an important perspective — and one that, until now, has been virtually erased from the debate over the landmark legislation. That conversation has focused almost entirely on large pharmaceutical companies — enterprises that, at least as many supporters of the legislation argue, would be able to withstand diminished investments or other financial changes. In more than 20 hours of hearings on Pelosi’s bill, small biotech firms have only been mentioned a handful of times.

It’s true that Pelosi’s bill takes aim at prices for existing drugs — and therefore, that its most direct, immediate impact will hit those drug makers who make major medicines like Humira or Harvoni.

But more than a dozen experts, venture capitalists and biotech veterans who spoke with STAT acknowledged that smaller biotechs would ultimately be hit hardest by the bill’s policy changes. None of the small biotech CEOs is peddling pricey drugs — in fact, none of them even has a drug of their own on the market. They’re still laboring in the lab, trying to discover new treatments for cancer, HIV, and Alzheimer’s. It is venture capital funding that keeps their lights on — venture capital funding that could disappear if investors don’t see high profit margins as an achievable outcome.

“We could end up shooting ourselves in the foot,” said Andrew Lo, an economist at Massachusetts Institute of Technology who studies biotech investors’ behavior. “These efforts, while they stem from very reasonable and laudable motivations, they will have an unintended consequence of creating a chill on funding.”

Even the most progressive economists acknowledged the potential impact on the biotech sector.

“Will we have fewer of these biotech startups? My guess is we probably would,” said Dean Baker, an economist at the Center for Economic and Policy Research, who is known for his progressive stances including support for Pelosi’s bill and “Medicare For All.”

Pelosi’s drug pricing bill would drastically cut the price of certain high cost drugs. The bill would allow Medicare to negotiate with drug companies over the price of up to 250 drugs per year, and the maximum the government could pay for drugs is 120% of the price charged in six countries. If drug makers refused to agree to that price, the government could virtually put a drug company out of business via huge taxes.

The plan specifically targets the costliest drugs to the Medicare system that have no competition, drugs like AbbVie’s rheumatoid arthritis drug Humira, which retails for more than $2,000 in the U.S. but costs roughly $500 in other countries, according to a recent report from the House Ways and Means Committee.

The Congressional Budget Office has estimated that the bill would take up to a trillion dollars out of the industry and result in eight to 15 fewer drugs being developed in the next 10 years. But industry estimates are much higher: A recent study from the California Life Sciences Association estimated that 88% fewer drugs would have been developed over the last 10 years by small biotech companies in California if the Democrats’ drug pricing legislation had already been law.

Henry Connelly, a spokesperson for Pelosi, told STAT in a statement that H.R. 3 would “require HHS to reward genuine innovation, while protecting American patients from price gouging.”

“People are dying because they cannot afford the out-of-control prices of their prescription drugs right now. H.R. 3 simply insists on the basic measure of fairness that American seniors and families not be charged more than what drug corporations charge for the same prescriptions overseas,” Connelly added.

CLSA’s analysis is one of the few that has tried to quantify exactly how hard Pelosi’s plan would hit small biotech companies. None of the key congressional committees has brought in any company representatives for testimony, or solicited feedback from them directly. Instead, they have mostly relied on feedback from larger trade groups like PhRMA or BIO.

In conversations with STAT, multiple biotech CEOs expressed frustration that they’ve been virtually erased from the debate about this legislation on Capitol Hill. And they’re even more frustrated when they hear politicians say the plan won’t impact them, as Rep. Anna Eshoo (D-Calif.) implied recently.

“I have more biotechnology in my congressional district than any other place in California, than any other place in the country. … I wouldn’t have my name on the bill if I thought we were going to kill innovation in our country,” said Eshoo, the health subcommittee chair of the Energy and Commerce Committee.

Read the full article at STAT.