The health care bill from the House of Representatives adds $14 billion dollars to the negotiated “deal” between the pharmaceutical industry and the White House, forcing PhRMa to pony up that much more than the $80 billion to which they agreed. Nancy Pelosi described it as because of the Blue Dogs forcing negotiated rates for the public option instead of Medicare + 5% rates, at a cost of $85 billion. So there will certainly be a fight between the House and Senate to preserve that deal, not to mention within the Senate itself.

“I wasn’t a party to any deal,” said Sen. Sherrod Brown (D-Ohio), telling HuffPost that he is cobbling together support for amendments that would bust the Big Pharma deal by allowing the government to negotiate with drug companies for lower prices and by limiting the amount of time biotech companies can have patent-protections.

The White House deal bars the government from negotiating drug prices, extends patent protections and blocks re-importing cheaper drugs from Canada.

Big Pharma’s ready for the fight to keep it. “At times, it’s going to be hand-to-hand combat,” said Ken Johnson, senior vice president for the Pharmaceutical Research and Manufacturers of America (PhRMA). “We’re going to have some tough floor votes.”

As the article says, Sen. Brown wants to limit those patent protections for biologics, those high-priced drugs made of living organisms which can cost as much as $50,000 a year. While the House bill did raise the paybacks for the pharmaceutical industry, it kept in the amendment by Anna Eshoo (D-CA) which would extend the patents on these blockbuster drugs to 12 years, and possibly forever, because minor tweaks could restart the clock on the patents. The Senate bill is likely to include the same provision, and that version won in the HELP Committee over a competing amendment from Sen. Sherrod Brown.

Senators Hatch (UT), Enzi (WY) and Hagan (NC) offered an amendment that would restore the original agreement. Their leadership was masterful. Senator Mikulski (MD) was eloquent in the debate last evening. Ultimately we succeeded in defeating an amendment offered by Senator Brown (OH) that would have limited data exclusivity to 7 years and then winning support for the Hatch/Enzi/Hagan amendment by a vote of 16-7. It was a stunning victory that few would have predicted was possible less than two weeks ago.

(If you didn’t guess, that post was from a biotech advocate.)

The White House had an agreement on biologics in their PhRMa deal, but there was “no agreement on details,” so dropping the 12-year extension to 7 could fall within its confines and provide enough impetus to get Democratic Senators to fall in line – in fact, the White House initially proposed a 7-year limit. However, it’s unlikely that any of the amendments, being pushed both by Brown and Sen. Byron Dorgan (D-ND), will reach the expected 60-vote threshold needed to pass amendments in the Senate. No amendments are expected to be allowed to the bill in the House.

Does this mean that the die is cast for the biologics deal? Not necessarily. Because activists, both progressive bloggers and the medical student community, are fighting hard to change the guidelines on biologics. On Friday activists held protests in front of the offices of both Anna Eshoo, lead sponsor of the biologics amendment in the House, and Sen. Kay Hagan (D-NC), one of the sponsors of the amendment in the Senate. Feeling the pressure, Rep. Eshoo wrote a rebuttal in the Huffington Post and Daily Kos, trying to tamp down netroots opposition to her point of view. This shows at the least that there’s some nervousness that insistent activism will cause a stampede to lower the bill’s limits.

Nevertheless, the pharmaceutical lobby and their allies in Congress still have plenty of means at their disposal to keep their preferred version of the legislation on track. Twenty-five members of Congress and aides who created Medicare Part D, the prescription drug benefit in Medicare, now work as lobbyists for the industry, and they certainly know how to protect profits for their paymasters. This is definitely a David-versus-Goliath fight.

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