bad times. one of the things that indicate it is a good time is many immigrants are coming in because there are jobs. people react to the new population of immigrants. it is not really a discussion about americans who are suffering, isn't it time to love them more than it is people another country? it is about what we think this country stands for and how we think it is going to grow and flourish. [applause] >> president trump sent his 2019 budget request to congress this morning to be one of the topics secretary sarah sanders discusses during the white house briefing. begin atcheduled to 3:30 p.m. eastern, about 20 minutes away. we will take you there live. discussion about prescription drug costs from today's

washington journal. segment wekend, this take a look at the intersection of your money and federal policy. this week, we are joined by david mitchell, president and founder of patients for affordable drugs to talk about prescription drug prices. what is your group? >> help patients for affordable drugs. we are the only national patient organization focused exclusively on policies to lower drug prices. we don't take money from any organizations that profit from the development of scripture drugs. patients for affordable drugs, you are a patient yourself? i yes, about seven years ago was diagnosed with an incurable blood counter -- cancer. it is treatable, but with very expensive drugs. the drugs i took last year, 400 and $50,000 retail price.

this experience of having a cancer and having to deal with these expensive drugs brought me face to face with challenges people confront. nobody was speaking up on behalf of the patients on direct pricing. decided we arei going to try and start a group to do this. >> how many patients are part of your group and how long have you been around? >> we launched almost one year ago. we have collected 12,000 patient stories and email addresses from almost 30,000 people around the country. >> it's an advocacy organization? what is the tax filing? what are you legally allowed to do? >> 501(c)(3). we also have a 501(c) four that is the political advocacy arm called patients for affordable drugs now.

we are taking patients stories twoamplifying those policymakers, elected officials, and mobilizing patients in our community to speak up for policies that will lower drug prices. last week, one of our patients testified for the oregon legislature on -- on march 1, i will be in colorado testifying before the colorado legislator. called theashington creative act, designed to start -- stop a patent. -- iought agencies from went to a meeting with paul ryan's office and jackie trafton, a retired teacher from his district who pays more than $18,000 a year out-of-pocket for drugs. so we're mobilizing patients online and beginning to mobilize patients directly to be advocates for themselves. host: you mention the c-3 and

advocacy arm. how does your group raise money? guest: we get money from foundations. in order to help leverage that money, my wife and i decided that we would start the group with our own money. we made a commitment to put in $75,000 a year for three years. i work for free. i retired to do this, went to potential funders and said if i work for free and i put in my own money, would you help us? some foundations said yes. we've raised money from friends and family and people online who come to our website patientsforaffordabledrugs.org, they have given us a few bucks. we don't ask for money from patients, but if they want to help, we can use the help. host: david mitchell, founder of patients for affordable drugs. this week's money segment. here is what the president had to say in his state of the union address about prescription drug prices.

pres. trump: one of my greatest priorities is to reduce the price of prescription drugs. [applause] pres. trump: in many other countries, these drugs cost far less than what we pay in the united states. and it's very, very unfair. that is why i've directed my administration to make fixing the injustice of high drug prices one of my top priorities for the year. [applause]

pres. trump: and prices will come down substantially. host: the president from his state of the union address. he releases his budget plan, what do we know how how he will put that into action and bring the prices down? guest: first of all, the president is right, prices in this country are way too high. we pay two to three time what is people pay in other developed countries. there are government-granted monopolies given to pharmaceutical companies and they are allowed to charge whatever they want. we think the president was right a year ago when he said drug companies are getting away with murder. unfortunately, in the proposals we've seen so far. a report released last week by the council of economic advisers in the white house completely excludes pharma from any action, the big drug companies, from any action to lower drug prices. the document says, we'll change

insurance plan design, which could be good, we're going to change design of benefits under medicare and medicaid, which also could be good, but the head waters, the root of the problem is retail prices set by the drug companies and there is nothing in the white house proposals we've seen so far that would address that. now the budget documents are coming today and we'll see more detail. we are very interested to see whether they're going to actually do something that would go after the root cause of the problem, the dug companies. -- the drug companies. host: what is the best way to go at the root cause of the problem? guest: two ways. as the president suggested last year, the federal government should negotiate directly with the drug companies to lower drug prices. every other country in the world does that, we're the only ones that doesn't. we pay more. the other will be to tackle the problem of patent abuse. the drug companies get a period

of exclusivity when they bring a drug to market, it allows them to make a lot of money, government-granted monopoly. at the end, we're supposed to allow generics to come to market , that lowers the price over time with free market competition. the drug companies gain the system and do things called pay for delay. they don't give samples of their product to generic manufacturers who need the samples to develop a generic equivalent. we need patent reform there is a bill in congress the president could support, the creates act, it would save taxpayers $3.3 billion and speed cheaper generics to market and he could stand up for that right now. it is bipartisan in both houses and we could do it this week. host: talk more about the creates act. first part of what you were talking about the bloomberg reports about what is being proposed from h.h.s. and what we'll see in documents,

proposals don't include something president trump threatend and one of the drug company's biggest fear, negotiating directly, that is what you think would help most. guest: that is patent reform -- that and patent reform immediately would do the most to drag down drug prices in this country. host: go ahead. want to invite viewers to join the conversation, we split phone lines up regionally, if you live in the eastern or central time zone, the phone number is 202-748-8000. if you live in mountain or pacific region, 202-748-8001. we want to hear your stories and questions for david mitchell with patients for affordable drugs. patientsforaffordabledrugs.org. to check them out on the internet. guest: i want to add one thing, if i can. host: please. guest: there are problems all down the drug distribution chain and there is a fine report that

was issued last november by the national academies of sciences, 17 august people, it was chaired by norm augustine, former c.e.o. of lockheed martin and two cheap recommendations to lower drug prices in this country were medicare should be able to negotiate directly for drug prices and we need patent reform. those things from national academy of sciences, those two things completely missing from the white house proposals. host: barry in island heights, new jersey. good morning. caller: good morning. i wanted to bring attention to the unanimous approval of the 2012 fda safety and innovation act. it gives the fda the right to charge fees for generic drug manufacturers. these fees are unfair, because drugs make 1000 generic

this year and pay $240,000. if you make one generic drug, your fee is $240,000. 65 generic drug manufacturers have gone out of business because of this structure. with: i am not familiar the generic fee structure for fda user fees. competitionxpress to drive down prices under the legal framework we have in this country is we allow generics to come to market after the brand has a time of exclusivity. the first generic reduces the price to 80% of the original brand price, by the time we get four or five, it can come down 20% or 15%. a healthy generic industry in order to be able to effectuate the policy we have learned brands get a big return and research for

that time and then generics drive down prices. i will look at the issue and familiar as myself. host: dean has a question, why can't we model after v.a. system? i use the v.a. pharmacy low cost and order online, they shipped to my house. guest: interestingly, thank you for that. the veterans administration is the only government entity, federal government entity, allowed to bargain over drug prices. they get substantially lower drug prices, that's why we think the experience of the v.a. is something we can build on and allow medicare to use the same negotiating approach on behalf of all of us so that we can get better prices like those in other countries. host: tammy in vienna, virginia. caller: my understanding is many

new drugs and medical protocols actually have their roots in federal funding so federal agencies might support development effort when they are new. it stands to reason that these same companies would be required agreeable to negotiating isis down the road, especially since they benefited from federally funded research. what is your comment on that? guest: i couldn't agree more. of the 50% to 60% of all major new breakthrough drugs that come to market in this country come about as a result of taxpayer investment by the national institutes of health, directly from the nih, or through academic medical centers. there is a drug that just came to market, a wonderful drug i will probably get. it is a cart-t drug, first

approval -- i can explain that if you want. host: please. guest: it genetically reprograms your blood to go after the cancer. cart stands for receptor and regenerates t-cells to find cancer and kill it. the nih invested more than $200 million from 1993 to 2017 to bring this drug to market. the head of the nih said cart-t science conducted by the nih. when it was brought to the market, it was $475,000 just for the drug. then the cost of care associated with administering the drug is about another half million dollars. it is $1 million of treatment. we can't keep pricing drugs this way that we all pay to develop.

we have to have a discussion to how we price drugs to maximize accessibility and affordability while maintaining a rich r&d pipeline and reasonable profit for the companies. host: circle back to the creates act. this from axios reporting noting that the pharmaceutical industry was able to keep the create tax out of the budget agreement last week. the gist is to make it easier for companies that make generic drugs to obtain samples of the branded products they are turned to copy, an integral step to copying them. the problem with the create text is it would be giving away the store to trial lawyers. it would allow generics to sue for axis to product samples. can you respond? est: that senior staffer is confused. trial lawyers can't sue under the create tax, only bona fide

generic companies who have filed the request with the fda to manufacture the drug, and whose safety protocols have been cleared can request the drug. they are the only ones who could sue. a company that can't get the drugs could sue, not trial lawyers. an affirmative defense on behalf of the brand company that refuses to provide samples is to provide the samples and it goes away. wrong, thisious and is just further scare tactics on the part of the pharmaceutical industry, which is not being truthful about this bill. the woman i described to you from congressman ryan's district who came from wisconsin to meet with the staff, she is on a rems drug.

expensive,it is so $18,000 out-of-pocket, is because of this abuse by the company that makes the drug. provide samples to companies that want to make a cheaper generic. a entered in agreement with generic and banana doesn't allow it to come to market until 2022, 5 years more of exclusivity. host: who should viewers watch in congress when it comes to the creates act and where it goes from here? guest: that is a good question. the lead sponsor is senator ,eahy, but it has support senator grassley of iowa, the lee of utah, collins of maine, they all rand paul, support it. senator kennedy of louisiana. those are all republicans. it has strong support from the democratic side. watch the house judiciary committee, and watch the budget

be -- the negotiations that are coming up on the funding bill that is due to be acted on in march. we intend to make another big push to get that included into the funding bill. momentum, -- we still have momentum, we were adding cosponsored last week. host: to you think if it gets to the president's desk, he will sign it? guest: i can't speak for the president, it is consistent with what he says he wants. i would say yes. post: to linda. caller: my comment is on the price of prescription drugs. my husband and i live on social security and his retirement. about almost harvard level. aremedication that i take -- a majority of them are the

tier three drugs that have no generic. is without my insurance, it is almost more than half of what i received in social security. my problem is we are going to be in the doughnut hole in four or five months and having to choose between medicine, food, and bills. we don't qualify for food stamps, we don't qualify for medicare extra help, we don't qualify for anything else. host: thank you for sharing your story. david mitchell. guest: this is the kind of story that is the reason we're are doing this. it makes me so mad. she is just expressing what

millions of people are experiencing around the country. the out of pocket for the 12 most expensive drugs or people who have medicare part d coverage runs from 4400 dollars a year to about $12,000 a year. median. not the highest, but the median cost for those 12 drugs. this is for people making a median income of about $26,000 a year. it is just wrong. medicare should be negotiating over the price of these drugs. there are proposals to cap out of pocket medicare part d. we have to see what those look like, because there is a way you can cap the prices and it is like a balloon. you squish it here and it comes out there. if it is going to raise prices -- if it is going to raise amy adams direct -- dramatically, it may not be the best solution. that would be a help, that could

be in the budget today. we will take a look and see. the problem isof we are not negotiating over the price of these drugs with the drug companies. host: david mitchell with patients for a board -- a four of drugs. you have heard some of the stories on this topic read patience for affordable drugs have a map of the various patients that you work with across the country and their stories. i imagine you can click on them individually to hear the story and see them from the patients that work with them. patientsforaffordabledrugs.org, if you want to check it out online. david mitchell with us until about 9:40. taylor is in iowa, good morning. caller: i want to talk about affordable drugs. of people around here, especially this area, where they can't afford what they need.

thething i have noticed is cannabis industry is going to take down the pharmaceutical industry. i hope that happens, we don't want these people to get their pockets full. i saw this video on facebook the other day. that is all. host: mr. mitchell. guest: i am not sure what that comment was, i am not familiar with the cannabis industry. i have to say i wish you well. host: lynette is waiting in clear lake, california. caller: i think the biggest problem we have with our prescription drugs is that the senators and our congressmen are selling their votes to big pharma. they have to vote for that. they don't represent us, they take the money and go big pharma's way. it is just so irritating. i live on $12,000 a year. i got a bill from my silver , they medicare drug plan

want $57 from me. that is taking food out of my mouth. host: mr. mitchell. guest: that comment, thank you of that, it is emblematic what we hear from so many. patients tell us all the time they have to choose between buying food, between paying rent, and bind drugs i need. inients cut their pills half, skip doses, people who are type one diabetics who have to have insulin to manage their disease, who try not to use it until their blood sugar spikes, which is dangerous for a diabetic. it can put them into insulin shock to they can't afford the drugs they need. a patient told us two weeks ago multipleas cancer and sclerosis. he can't afford both drugs, so he let his multiple sclerosis progress because he has to treat his cancer or he will die.

this is happening all over america right now. right, thelutely pharmaceutical industry is one of -- if not the most powerful industry in this country. they have spent billions of dollars over the past 40 years building up a regulatory framework, a government regulatory framework that enables them to charge monopoly prices. we all pay for it. host: how do you feel about alex cesar? think he is very experienced, he worked at the department of health and human services. i think he understands the drug industry quite well as a result of the time he spent as the head ey, a drug company. he was the head of the u.s. operation of lilly. heremains to be seen whether will use his knowledge and

experience to actually lower drug prices in ways that are meaningful. if he is willing to do what the national academy of sciences suggests, we need a balanced approach from the production of the drugs, to the pharmacy counter. we have reforms we need to make, but you can't leave the drug companies out of it. it appears to me he is in fact leaving the drug companies out. host: jim, good morning. inler: way back when i was is military, the military there to blow things up and kill people, that was the thing. my son is a combat marine, he said it was there for the hearts and minds, shoot them in the head and shoot them in the heart. not delivering the pizza. after 9/11, we needed to do something. we should have landed there with a much bigger footprint and showed the bad guys were this stuff was able to be good

together, we don't want to be the target of any attack like 9/11. host: bring us to drug prices. prescription drug prices. when the social programs spending is much bigger than what the military is spending, there is a problem with both parties. definitely the democratic socialists are in there, and the americans who don't wise up realize they can vote themselves and we are bleeding -- the world is leading towards socialism. host: we are going to stick to the conversation of drug prices. presidenthell, the and founder of patients for affordable drugs with us for 10 minutes or so. tony, baltimore, good morning. caller: good morning. i am in my 70's and about 30 years ago, i'm listening to a talk show, they are interviewing the ceo of a pharmaceutical company. he is explaining why

pharmaceuticals have gotten so expensive. he is going through these reasons, it is a call in show. igentleman calls in, he says lived on a farm all my life. 30 years ago, we raise a lot of sheep, there was a certain pill that we gave that sheep. cost six centsll . recently they found it could also help in the treatment of cancer. now that pill is six dollars. he said to the ceo, why? they had say research, to recoup the investment, the pill is 30 years old. the guy said because it will save your life. he caught himself and realized what he did. that is basically why pharmaceuticals are so high. guest: thank you, tony.

i have an incurable disease. it is incurable because my cancer mutates. it will find its way around the drugs i am on. if i want to live as long as i kid, to watch my youngest graduate from college, maybe have a grand time -- grandchild, they need to develop new drugs. we need to invest in new drugs and innovation. but the fact is there is no direct correlation between the price of drugs and the investment and research for new drugs. my kid is me, if aligned on the gurney and you ask what are you willing to pay to save their life? i would say whatever it takes. sell my house, empty my bank account, that is the wrong question. we have to start asking this question, what is the price for drugs, especially new drugs that maximizes accessibility and affordability while maintaining

a robust r&d pipeline for the new drugs we all want and need? and a reasonable return for the drug companies that commercialize those drugs. now, the drug companies care about one thing, maximizing profits. accessibility and affordability is not what they are focused on. we need to re-weight the discussion back to asking people to get the drugs they need. host: what is reasonable profit to you? guest: a reasonable profit depends. taken, theat was drug i described earlier in the program, the brand-new drug brought to market for the price taxpayers5,000 that actually paid to invent. we took a look at that drug and modeled it with experts at --ard and a former farm

phama ceo. if the drug company got its profit and 19% for continuing $160,000.could charge instead, they are charging $475,000 and will make a profit of 65% on the drug we all depend on. we think we should look more at what is a fair return. we think 27%, in the case of them, the historic return on their portfolio is more than that. host: shreveport, louisiana. caller: thank you for taking my call. i am a veteran, i go to the v.a. would you believe i have blue cross and blue shield on top of that, and i still have to pay $12, $14, for my medicine at the

drugstore. -- it isaper because cheaper to go to the drugstore. it doesn't seem fair. schoolteacher, she had to pay $350 just to be on my insurance. it is insane. usedrked all of our lives, .o be better if it wasn't for my son, i'm catching hell. guest: thank you, thank you for your call. i understand. i would urge you to come to patients for affordable drugs .org. leave us your story, email address, and zip code and join our community. are already mobilizing tens of thousands of patients across the country. you can be part of that to address what we -- the problems you're having right now.

host: linda in ohio. caller: good morning. i wish you the best. last year, i was diagnosed with psoriasis. co-centex, acalled self injecting pen. i am paying virtually nothing for it right now because my husband's health care is paying for it. they also pick up the drug company picks up part of the premium that i would normally pay. the program is only good for two years. my question for you is what is going to happen when the two years is up? right now, i take two of those iss a month, each one

$7,500. is $15,000, half of my annual income. what do they do? how does that work? guest: it is a further reflection of the fact that the drug companies control the drug prices. they set the drugs really high and give you a discount for your copayment. everybody else, you, me, we are still paying for the premiums through our employer or taxes. by doing this, they keep you in their control and keep the price high. that's why we are focused on taking steps to lower the retail price so that you do not have to rely on those programs from the are companies, which really a way for the drug companies to sell more products. there was a report by city

financial analytics organization that found that for every million dollars a drug company invests in the program like what they are using for you, they make $21 million back. they give you a little bit of health, but keep the price big and we all pay the balance of the price through our premiums. either as employees, employers, or taxpayers. host: jeffrey wants me to ask you about the programs that drug companies have helping people that can't afford medications. how easy is it to get that help? on a number ofds factors. the drug companies spend billions on those programs, but they are not always there. they are not all year long. are not really programs to help you, they are programs to market. they do it to sell more drugs at a higher price.

host: how so? guest: let's say you have a drug and raise the price to $1000 from $200. and the co-pay is going to be $100. you cover the co-pay for $100, but they still have the increased from $200 to $1000 less 100, they made $700 on that deal and put that in their pocket. donation,hat, the "donation" they made to a foundation to give you that co-pay coupon is tax-deductible. so they get that back. these are marketing programs. --t's why the drug prices the way to fix drug prices starts with lowering the retail price of the drug. we have other issues on the part of pharmacy benefit managers, who control 80% of the market. they are the people who run the

drug insurance programs. there are other issues. if we don't get to the drug pricing, we don't get at the problem. host: another jeffrey in frederick, maryland, good morning. byler: i want to start off thanking david mitchell and c-span for doing this program. i have two questions. is there going to be a difference between life-saving durings like carboni this epidemic we are having, this hiv epidemic, is there a difference between maintenance drugs and life-saving drugs, can there be made a difference? with the opiate epidemic being that it is, they are not talking about carfentanil, the synthetics being brought into this country. i am a chronic pain patient, i am suffering more today getting my medication and being able to

live my life because there is an epidemic of disproportion, which i understand. it has affected my family and my town, as well. in the process, all of these people that have cancer and ms, chronic pain, they are committing suicide because they can't get proper help. i am going to talk about pepsi drug. c drug. hep there are millions of people in this country who can't get access to the drugs. they are just too expensive. they cure hepatitis c. we can wipe it out. but the drug companies who own those drugs, gilead, has priced it out of reach for public programs. we have folks but could be

cured, but aren't because the price is too high. host: what about the access to pain medication and the impact that the efforts to cut down on opioids has had on patients who use it correctly and need it? i am not an expert on opioid addiction. believe that we need better steps to track the distribution of these drugs, how they are getting into people's hands, prescribing patterns by doctors, dispensing patterns by pharmacies, so we can get a better handle on it. people who have addiction need appropriate treatment area that could be treatment -- people who have addiction need appropriate treatment. we can take them off of different drugs. we need to make sure they are cracking down on the supplies, but also supporting people who are trying to fight their addiction. host: the group is patients for

affordable drugs. patients444 drugs.org. thank you for your time. guest: thank you for having me. request to budget congress, one of the topics we may hear about during today's white house briefing in the briefing room. we will have that live as soon as it begins with press secretary sarah sanders. until then, a look at washington journal and a week ahead. monday roundtable, we're joined by the white house reporter for reuters and paul singer. hill, the stage being set for somewhat unique debates on immigration. explain how and when this is going to go down. >> this is one of those things that is rare to see in washington. a bill coming to the floor where we have no idea what is going to happen. the senate is supposed to tee up

a conversation about immigration all week long. we have been told by mitch mcconnell that he has no parameters for this bill. he is not bringing a specific set of requirements to the floor. he is going to open the door to a series of bills being voted on and see if it even gets 60 votes in past. this will be the immigration debate. >> the bill he is bringing up tonight had nothing to do with immigration. it is just a vehicle. >> a shell. it can be about anything. he can put up a bill about french bread pastry. the whole idea is the senate does not know what there is a majority to support. leader has said let's bring up all of your immigration proposals, we will see the one close to the president asked for one week ago, border wall. >> supreme couus