June 12, 2012—White House and pharmaceutical industry communications released by House Energy and Commerce Committee Republicans late last week shed light on the negotiations over closing the Part D “donut hole” and expanding the 340B drug discount program in the days leading up to final passage of the Affordable Care Act (ACA) in early 2010.
According to a Feb. 21, 2010 email exchange between two Pharmaceutical Research and Manufacturers (PhRMA) officials, Jeffrey Kindler, who was then Pfizer’s chief executive officer, called a senior White House staff member that day and “got promised [a] 340B fix and a good outcome on” the separate agreement under which the industry agreed to provide deep discounts to Medicare Part D beneficiaries in that program’s coverage gap.[ms-protect-content id=”2799″]
The email exchange suggests that in return for the Obama administration’s promises on Part D and 340B, PhRMA would “be doing ads again soon” promoting ACA’s passage.
The version of health care reform approved by the Senate in late December 2009 included 340B’s extension to inpatient drugs. On Feb. 22, 2010—the day after Kindler’s telephone call—the White House issued a blueprint for health care reform that, at the time, was reported to contain the same 340B reform provisions included in the Senate-passed bill.
The House actually passed the Senate bill on March 21 and President Obama signed it into law on March 23. But simultaneous with its passage of ACA, the House on March 21 passed a companion budget reconciliation bill that removed the 340B inpatient extension and added language denying rural and cancer hospitals added to the program access 340B pricing on orphan drugs. The Senate passed the reconciliation bill on March 25 and the President signed it on March 30.
“The emails … confirm that PhRMA’s decision to fund advertisements in support of the law was linked to policy agreements backed by the administration,” the Energy and Commerce Committee’s GOP majority said in news release. In an accompanying memo, it added: “The Obama administration led a closed-door process that used numerous tools at the disposal of the White House … to secure a narrow, partisan victory on a piece of legislation that the public is rejecting in greater numbers every day.”
“There is nothing new here,” the committee’s Democratic minority replied in its own news release. “What President Obama did is no different than what presidents from Lyndon B. Johnson to George W. Bush have done to pass their key legislative initiatives. Nobody should be surprised that supporters of the health care reform law advertised in support of its passage. Opponents of health care reform spent hundreds of millions of dollars in advertising and other efforts to kill the law.”[/ms-protect-content]