“Nobody is going away,and even if it means using our power to compel the drug companyCEOs to show up, they will come before thiscommittee,” Sen. Ron Wyden of Oregon says ofinvestigations into high drug prices. (Photo:Shutterstock)

Senators railed against pharmaceutical executives Tuesday fordeclining to testify before Congress about out-of-control drug prices, as lawmakers onboth sides of the U.S. Capitol kicked off investigations sure torattle one of the nation's most powerful industries.

Sen. Chuck Grassley of Iowa, the Republican chairman of theSenate Committee on Finance, signaled he could compel drugmakers toappear before the committee, saying he was “extremely disappointed”that only two companies have agreed to testify at a later date.

“We will extend the opportunity again in the future, but we willbe more insistent the next time,” Grassley said.

Related: A chance to put an end to high drugprices?

And in a blow to the pharmaceutical industry, Sen. Ron Wyden ofOregon, the committee's top Democrat, agreed with Grassley,suggesting the parties are largely united in their determination toaddress skyrocketing drug costs.

“Nobody is going away, and even if it means using our power tocompel the drug company CEOs to show up, they will come before thiscommittee,” Wyden said.

While Congress has examined rising drug costs before, the issuehas benefited from the attention of President Donald Trump, who hasvowed to address the problem. The Trump administration has floateda handful of possible solutions, including a proposal to tie theprice Medicare pays for some drugs to the prices paid for the samedrugs overseas.

Across the Capitol on Tuesday, the House Committee on Oversightand Reform also held the first hearing in its own “sweeping”investigation into drug prices. Rep. Elijah Cummings, the MarylandDemocrat who took control of the committee this month, recently wrote to 12 drug companies demanding information abouttheir pricing practices.

Cummings has made it clear that he is interested in working withthe Trump administration on drug prices. Cummings met with Trump in2017, weeks after Trump was sworn in as president, to discuss howthe parties could work together. Two weeks ago, Cummings discussedthe issue with Health and Human Services Secretary Alex Azar.

Tuesday, one Republican lawmaker close to Trump, Rep. MarkMeadows of North Carolina, said he had spoken with Trump and agreedto pass along a message to Cummings: “On this particular subject,not only is he serious, but he's serious about working in abipartisan way to lower prescription prices,” Meadows said.

Cummings asked Meadows to tell Trump “we are willing, ready andable to work with him to get it done.”

Lawmakers heard heart-wrenching testimony Tuesday from twomothers about the impact of rising costs on their insulin-dependentchildren. Antroinette Worsham described how her daughter, a collegestudent with Type 1 diabetes, began rationing her insulin becauseshe couldn't afford it — and how her son later found her dead inher bed.

Now, Worsham told the House committee, she worries about heryounger daughter, who also has diabetes. “I fear the same is goingto happen to her,” Worsham said.

On the Senate side, Kathy Sego — whose son with Type 1 diabeteswas profiled by Kaiser Health News in 2017 — had a message forabsent drug companies. “I don't know how any person would be OKwith knowing that their medication is priced so high you have tomake a decision between life or death,” she said. “That shouldnever be a decision a person needs to make.”

It remains to be seen how drugmakers might react to mountingpolitical scrutiny.

Both Grassley and Cummings have the power to subpoena witnesses— such as drug company executives — to appear before Congress,though Grassley told reporters afterward that he was not yetprepared to invoke that option.

Grassley said several drug companies had declined to testifypublicly, offering a variety of excuses. One company, for instance,argued their testimony would “create a language-barrier problem.”Unmoved, Grassley remarked that he “thought we all spokeEnglish.”

Wyden expressed his frustration with drug companies by comparingthem to a more traditional villain, the tobacco companies.

“Even the Big Tobacco CEOs were willing to come to Congress andtestify, and they made a product that kills people,” he said. “Theyall lied to me, but at least they showed up. The drugmakers won'teven do that much.”

While lawmakers noted that both hearings were only the first ofmany, an early consensus emerged that something must be done aboutdrug rebates, which provide discounts to middlemen in the supplychain but often push patients toward pricier brand-name drugs.

Senators also targeted drug discount coupons, which lower theprice for patients at the cash register but don't address thelarger struggle between manufacturers and insurance companies.

“We know who's winning. It's the people who print the coupons,”said Peter Bach, director of the Center for Health Policy andOutcomes at the Memorial Sloan Kettering Cancer Center. “Patientsare entirely caught in the middle.”

The long political reach of the drug industry was on displayTuesday, though, suggesting it could be an uphill battle to holdpharmaceutical companies accountable. Drugmakers' political actioncommittees give millions of dollars to the campaigns of hundreds ofmembers of Congress.

The Project on Government Oversight, a nonpartisan watchdoggroup, noted even some of the experts who testified Tuesday havebenefited from drugmaker cash. The Pharmaceutical Research andManufacturers of America, which lobbies on behalf of drugmakers,has given millions to the advocacy arm of the American ActionNetwork — a conservative-leaning organization whose president,Douglas Holtz-Eakin, testified before senators.

Bach has also received money from pharmaceutical companiesdirectly, the watchdog group said. Bach said he was paid for givingspeeches.

Another potential obstacle: House Republicans on Tuesday showedlittle interest in cooperating with the investigation, with somearguing that there were bigger fish to fry in the nation's healthcare system.

Rep. Jim Jordan of Ohio, the House committee's top Republican,opened by enumerating several failings of the Affordable Care Act,noting Democrats are “eager to blame the private sector.”

“The problem is not that the free market has failed us,” Jordansaid. “It's that government interventions in the market havedistorted incentives, creating barriers to competition and leftthings in a mess.”

Kaiser HealthNews (KHN) is a national health policy news service. It is aneditorially independent program of the Henry J. Kaiser Family Foundation whichis not affiliated with Kaiser Permanente.

Read more:

• Merck lowers prices as Trump's attacks on drugprices gain steam
• Reference-based pricing: a panacea for high drugprices?
• HHS, FDA open to importing prescriptiondrugs