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<a href="http://www.nytimes.com/"><img src="http://graphics8.nytimes.com/images/misc/nytlogo153x23.gif" alt="The New York Times" align="left" border="0" hspace="0" vspace="0"></a>
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<div class="">January 22, 2013</div>
<h1>Amgen Gets a Gift From Congress</h1>
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<p>
For a disheartening example of how intense lobbying and financial
contributions can distort the legislative process in Washington,
consider what happened to the “fiscal cliff” bill approved three weeks
ago by Congress. </p>
<p>
Senators who play a major role in federal health care financing were
happy to help Amgen, the world’s largest biotechnology company, evade
Medicare cost-cutting controls by delaying price restraints on a class
of drugs used by kidney dialysis patients, including Sensipar, a drug
made by Amgen. That provision was inserted into the final fiscal bill by
Senate aides. Many members of Congress did not know it was in the bill
until just hours before it was approved. </p>
<p>
Although other companies will benefit financially from that delay,
Amgen, which has 74 lobbyists in Washington, was the only company to
lobby aggressively for the provision. The delay will cost the Medicare
program up to $500 million over a two-year period. </p>
<p>
The disturbing details were revealed in a report by <a title="NYTimes article" href="http://www.nytimes.com/2013/01/20/us/medicare-pricing-delay-is-political-win-for-amgen-drug-maker.html?pagewanted=all">Eric Lipton and Kevin Sack</a>
of The Times on Sunday. The maneuvering to exempt these drugs undercuts
a five-year effort to change the incentives used to pay for kidney
dialysis care. Previously, Medicare had paid providers separately for
the drugs and for administering dialysis treatment, a system that often
encouraged overprescribing. </p>
<p>
But, in 2008, Congress reversed the incentives by requiring Medicare to
pay a single, bundled rate for a patient’s dialysis treatment and
related medications, starting in 2011. But certain oral drugs, including
Sensipar, were given a two-year reprieve, to expire in 2014, from being
included in that more cost-effective bundled system. The fiscal bill
has now extended that exclusion for an additional two years. </p>
<p>
Supporters of the delay — notably, Senator Max Baucus, a Democrat of
Montana, who leads the Senate Finance Committee, and Orrin Hatch, of
Utah, the ranking Republican on that committee — say it is needed to
give the Medicare system and dialysis providers time to absorb other
complicated changes in federal reimbursements for kidney care. But there
is good reason to suspect other factors were involved as well. Both
senators have political and financial ties to Amgen, as does Mitch
McConnell, the Senate minority leader, who exerted great influence over
the fiscal negotiations and praised the Medicare provisions. </p>
<p>
A top aide to Mr. Hatch, who was involved in negotiating the dialysis
delay, previously worked as a health policy analyst for Amgen. The
current lobbyists for Amgen include former chiefs of staff for both Mr.
Baucus and Mr. McConnell. And the three senators have received
substantial contributions from Amgen’s employees and its political
action committee since 2007 — almost $68,000 to Senator Baucus, $59,000
to Senator Hatch, and $73,000 to Senator McConnell. </p>
<p>
Amgen’s strong influence prevailed even though it had pleaded guilty
just weeks ago to marketing an anti-anemia drug illegally and agreed to
pay criminal and civil penalties of $762 million, a record settlement
for a biotechnology company. </p>
<p>
This dreadful episode is a classic example of the power of special
interests to shape legislation and shows how hard it may be to carry out
the reforms needed to cut health care costs. </p>
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<br>-- <br>Art Deco (Wayne A. Fox)<br><a href="mailto:art.deco.studios@gmail.com" target="_blank">art.deco.studios@gmail.com</a><br><br><img src="http://users.moscow.com/waf/WP%20Fox%2001.jpg"><br>
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