No one should ever have to choose between making ends meet with his life or affording to live—but with the prohibitive cost of prescription drugs, many Minnesotans are faced with that fateful choice.
Alec Smith’s story is a tragic example of the devastating consequences of this choice. Alec was a young man with a promising future: he was working hard in a restaurant and managing his diabetes. But when he turned 26 and lost access to his mother’s health insurance, he couldn’t afford the prohibitive cost of insulin on his own. As a result, he resorted to rationing insulin, which eventually led to his untimely death at the age of 26 from ketoacidosis. Alec’s life mattered, and he deserved to get the medicine he needed to live. He died because he could not live.
I first heard Alex’s story from his mother, Nicole Smith-Holt, when she ran for Attorney General in 2018. One of the first things I did after taking office was to put together a task force on how to lower pharmaceutical drug costs, bringing together patients, experts, and bipartisan leaders — with Nicole as co-chair. The group made 14 clear recommendations to make the highly complex, opaque and dysfunctional drug markets work better for people. The task force’s first recommendation was to create the Prescription Drug Affordability Council (PDAB), to use our public strength to help make medicines affordable and available to Minnesotans.
When PhRMA, the lobbying arm of the pharmaceutical industry, sued our state over the Alec Smith Insulin Tolerance Act, I’m proud my office defended it in court. I’ve also pursued the state’s lawsuit against insulin manufacturers for fraudulently inflating prices, joined several other states in suing generic manufacturers for illegal price fixing and market appropriation, and fought in the legislature for bills outlawing unreasonable drug price gouging. And for more transparency in drug pricing.
For many years, drug companies have engaged in an ugly pattern of price-gouging anti-competitive Minnesotans who need access to life-saving drugs. As a result, far too many Minnesotans like Alec Smith skip medication doses or leave their prescriptions completely empty, putting their health and livelihoods at risk.
Even if you’re not taking a high-cost drug, we’re all paying the price for drug companies’ greed in our high health insurance premiums, in the cost of public health programs, and in subsidies to drug companies. Most prescription drugs are developed with taxpayer-funded research, yet Americans pay way too much for these drugs at the drugstore.
The current system works well for profits — but it certainly doesn’t work well for patients.
It’s time we had a drug watchdog — and if the Minnesota legislature approved the Prescription Drug Affordability Council, we would. PDAB is an important next step in creating a more transparent and affordable prescription drug system. It would operate like a public utility board and act as a check on the monopoly power of drug companies by setting higher payment limits for high-cost drugs. It builds on our efforts to fight Big Pharma through policy making and in court.
But make no mistake: Big Pharma won’t go bust without a fight. They will do anything to protect their profits over people’s lives.
On the Minnesota Senate floor, they amended the PDAB bill by excluding nearly every brand-name drug from review by the PDAB. They called it the “Rare Disease Amendment,” but it’s really a toxicology bill meant to exclude hundreds of drugs from the bill. It’s part of the industry’s sweeping campaign to mislead Minnesotans, create fear among patients, and bully lawmakers into curbing drug price action.
Now it’s the turn of the Minnesota House of Representatives. I encourage the House to pass a strong PDAB bill without amendments, so that we have a new tool to save Minnesotans money and lives and protect all Minnesotans from Big Pharma abuses.
A growing coalition of patients, nurses, doctors, staff, religious, farmers, and community members supports the Minnesota PDAB with full powers to hold Big Pharma to account. I am one of them. Let’s get it done now so Minnesotans never have to choose again between saving their lives and the cost of living.
Keith Ellison has served as the Minnesota Attorney General since 2019.