Senator Bernie Sanders is getting ready to grill the CEOs of three main pharmaceutical firms. 

On Thursday, Joaquin Duato of Johnson & Johnson, Robert Davis of Merck, and Chris Boerner of Bristol Myers Squibb will testify earlier than the Senate Health, Education, Labor, and Pensions (HELP) committee over why the U.S. pays the very best costs on the earth for pharmaceuticals. 

“Whether you’re Democrat, Republican, independent, conservative, progressive, you know that the pharmaceutical industry is ripping us off,” Sanders, an impartial from Vermont, says. 

The HELP majority workers launched a report on Tuesday that exposed that the median launch value of revolutionary pharmaceuticals offered by Johnson & Johnson, Bristol Myers Squibb, and Merck have elevated by greater than $220,000 from $14,000 within the years 2004-2008 to $238,000 previously 5 years. The report additionally discovered that Johnson & Johnson and Bristol Myers Squibb spent extra money on inventory buybacks, dividends, and govt compensation than they did on analysis and growth within the 12 months 2022.

Pharmaceutical Research and Manufacturers of America (PhRMA) spokesperson Sarah Ryan says Sanders is participating in a “shaming exercise.”

“A small number of senators are focused on a political shaming exercise instead of what will help lower what Americans pay for medicines at the pharmacy. The United States is the only country that allows middlemen to profiteer on medicines, leading to higher costs for patients,” Ryan stated in an announcement.

TIME spoke to Sanders on Feb. 7 forward of the listening to about what Congress can do to decrease drug costs, what Americans don’t perceive about Big Pharma’s enterprise mannequin, and why the Biden Administration needs to be doing extra.

The following interview has been evenly edited and condensed.

TIME: The HELP Committee simply launched a report on Big Pharma’s enterprise mannequin. And one of many key findings was that for a few of the hottest medication, pharma makes extra money off of Americans than the remainder of the world mixed. Why is that?

Sanders: The cause is that the pharmaceutical trade is an especially grasping trade. Their aim is solely to make as a lot cash as they presumably can. Every different main industrialized nation has—in a single type or one other—nationwide healthcare packages, which, amongst different issues, ensures healthcare to all of their folks, but in addition places them able to negotiate the costs of medicine with the businesses.

In the United States, up till very not too long ago, the drug firms might cost any value they need for any cause. The results of that’s that in some instances, we’re seeing the identical actual pharmaceuticals offered in America for greater than 10 occasions what they’re offered in Canada, or Europe, or Asia.

Pharmaceutical firms often make the argument that they want to cost these excessive costs so as to fund the analysis and growth of recent medication. What would you say to pharmaceutical executives who argue that decreasing drug costs will damage innovation? 

We need innovation, we wish analysis and growth to tackle most of the horrible sicknesses that are afflicting the American folks as we speak, whether or not it’s most cancers or Alzheimer’s or coronary heart illness. But in occasion after occasion, what you discover is that regardless of what they are saying, these firms put extra money in inventory buybacks and dividends to their shareholders than they do into analysis and growth. 

Even once you discuss what we refer to as “research and development,” the typical particular person may assume that they are working on Alzheimer’s or most cancers. Sometimes they’re, however typically they’re not. They are additionally working on what we name “me-too” medication, that are modest modifications of current medication to allow them to get a brand new patent to prolong their monopoly. So it isn’t all that it appears to be.

The backside line is, within the final 12 months, 10 main pharmaceutical firms earned over $110 billion {dollars} in revenue. Year after 12 months these are a few of the most worthwhile firms in America. So I do not settle for the argument that they desperately want these excessive costs only for analysis and growth.

What can Congress realistically do right here? 

Congress can do what each different main nation on Earth does. And that’s, amongst different issues, negotiate prescription drug costs with the trade and never allow them to cost us something they need. 

Now, now we have made a modest step ahead with the Inflation Reduction Act. And by the way in which, all these firms are suing the Biden Administration for having finished this.

There are many different issues that we are able to do. The United States authorities spends tens of billions of {dollars} in serving to to develop new pharmaceuticals by the NIH. What now we have finished previously is solely give the drug firms the cash, and after a superb drug is developed, passes FDA approval, then they cost us outrageously excessive costs. 

What we are able to and should do—what we name ‘reasonable pricing’—is that if the federal authorities offers help to an organization to develop a drug, and it is a profitable drug, then the worth of that drug should be cheap right here within the United States.

The pharmaceutical trade, which is subsequent to Wall Street, is probably the most highly effective political power within the nation. They have proper now as we communicate 1800 effectively paid lobbyists right here in Washington, D.C., to make it possible for Congress does nothing to influence their revenue margin. 1800 for 535 lawmakers. On high of that they contribute big quantities of cash to a number of political events when it comes to marketing campaign contributions. 

Given the extent of energy that the pharmaceutical trade has, and given how divided Congress has been, what are you hoping to get out of the Senate listening to on Thursday?

We’re hoping to get two issues. Number one, to proceed to elevate public consciousness on the greed of the trade, and the ache that they’re inflicting so many Americans. 

Number two, up till now, since I’ve been chairman, we had managed to get some commitments out of the pharmaceutical trade. Moderna, the producer of one of many two main COVID-19 vaccines within the nation, promised to present that vaccine free at drugstores and group well being facilities for individuals who couldn’t afford it, they usually’ve stored that dedication. So now there are numerous folks getting free vaccines as a result of we introduced the CEO of Moderna earlier than the committee. In one other listening to, Eli Lilly, a significant producer of insulin merchandise, promised not to elevate their insulin costs, after having lowered their costs. And they’ve stored that dedication as effectively. 

At the top of the day, you are proper. This is a divided Congress, and a divided nation politically. But there may be one subject the place the American individuals are not divided. Whether you are Democrat, Republican, impartial, conservative, progressive, you already know that the pharmaceutical trade is ripping us off. 

Do you assume that the Biden Administration is doing sufficient when it comes to decreasing drug costs?

Well, let me simply say this: they’re doing greater than some other administration in historical past. What now we have seen now could be for the primary time, Medicare is starting to negotiate prescription drug costs.   Is it taking place as quick or as extensively as I would really like? No, however it’s a important, important begin. 

Number two, working with President Biden, we are actually shifting in direction of ensuring that no senior citizen in Medicare pays greater than $35 a month for insulin. That’s a giant deal. And inside a few years, there might be a cap on what seniors pays for out of pocket prices. So I reply your query in two methods. One, is that the Biden Administration has finished greater than some other administration in taking on the pharmaceutical trade. That’s the excellent news. The dangerous information is I feel they need to be doing much more than that. 

How a lot credit score ought to President Biden get for the reductions that we have seen in insulin costs?

A few years in the past, after I was working for President, I took some people from the Midwest to buy insulin. We left from Detroit and went to Ottawa. And we bought insulin in Ontario, Canada for 1/tenth of the worth that they have been paying right here within the United States. 

So I feel it is a mixture of things. I’m happy with what the HELP committee has finished on this, happy with what the Biden Administration has finished, and I’m happy with what the grassroots organizations have finished. 

Do you assume that is going to resonate with voters in November?

I hope it does. 

Is there something you assume that Americans are misunderstanding when it comes to how their medication are priced and the way that course of occurs?

I feel most individuals do not know that we’re paying actually for a similar actual bottle of pharmaceuticals, generally 10 occasions greater than different folks world wide. Number two, they could not know that the pharmaceutical trade is enormously worthwhile. They could not know that these firms pay their CEOs exorbitant compensation packages of $20, $30, $50 million a 12 months. And they could not know that one out of 4 folks stroll right into a drugstore to fill the prescription that their physician prescribed can’t afford to do this. So you may have a significant, main healthcare downside when it comes to the excessive price of pharmaceuticals.