21st Century Cures Act Sparks Lobbying Frenzy

Bill would fund cancer and Alzheimer’s research, speed FDA approvals

The 21st Century Cures Act, set for a House vote on November 30, is one of the most-lobbied health care bills in recent history, with nearly three lobbyists working for its passage or defeat for every member on Capitol Hill, according to a report from Kaiser Health News.

More than 1,455 lobbyists representing 400 companies, universities, and other organizations pushed for or against an earlier House version of a Cures bill this congressional cycle. A compromise version was released over the holiday weekend.

The bill includes funding for enhanced cancer and Alzheimer’s research and would boost funding for the National Institutes of Health (NIH) to $4.8 billion. The bill would also speed up the drug and device approval process at the FDA.

President-elect Donald Trump has vowed to eliminate “red tape” at the FDA but hasn’t specifically commented on the Cures Act.

Other than major appropriations bills, a transportation spending bill, and an energy infrastructure funding bill, the Cures Act garnered more lobbying activity than any of the more than 11,000 bills proposed in the 114th Congress, an analysis of data from the Center for Responsive Politics showed. It is also the second-most lobbied health care bill since 2011, following the Medicare Access and CHIP Reauthorization Act of 2015, which, among other things, overhauled Medicare payments to health providers.

Putting a price tag on the lobbying is difficult because spending reports don’t break down spending by specific measures. The reports show that interested groups spent as much as half a billion dollars from 2015 through the second quarter of 2016 on all lobbying disclosures that included the 21st Century Cures Act, according to the Kaiser article.

Several nonprofit patient advocacy and research groups have opposed the bill, citing concerns about endangering patients with simplified drug and device approvals.

Beyond the pharmaceutical industry, the bill’s supporters include universities, medical schools, and groups representing them, as well as patient groups funded by drug and device companies, said Diana Zuckerman of the nonprofit National Center for Health Research.

AbbVie, the maker of adalimumab (Humira), a drug used to treat arthritis, ulcerative colitis, and Crohn’s disease, reported $7.7 million in lobbying expenditures in disclosures listing the Cures Act as an issue. The company’s total lobbying was $9.5 million this cycle.

Hospitals and medical schools, which oppose rising drug costs, supported the bill because the NIH funding could propel grants to medical and research institutions, Zuckerman said.

Additional lobbyists may be working on the bill under the radar, according to Tim LaPira, a political science professor at James Madison University. He explained that lax lobbying disclosure requirements mean that some lobbyists may not disclose work on the bill, H.R. 6. That’s what he saw when the Patient Protection and Affordable Care Act was passed.

“The clerk’s office is supposed to list the bill number if they know it, but nobody ever checks,” he said. “That’s another sort of trick of the trade: to hide in plain sight.”

The 21st Century Cures Act is considered a swan song for its sponsor, Representative Fred Upton (R–Michigan), whose tenure as chair of the Energy and Commerce Committee is nearing an end. Rep. Upton garnered broad support from device makers, drug manufacturers, researchers, and patient advocacy groups. He also received more than half a million campaign dollars from pharmaceutical and health-product groups in the last two election cycles, according to the Kaiser report.

Source: Kaiser Health News; November 28, 2016.