No one should ever have to choose between affording their lives and affording to live — but with the exorbitant cost of prescription drugs, too many Minnesotans face 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 at 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 high cost of insulin on his own. As a result, he resorted to rationing his insulin, which ultimately led to his untimely death at the age of 26 due to ketoacidosis. Alec’s life mattered, and he deserved access to the medication he needed to live. He died because he couldn’t afford to live.
I first heard Alex’s story from his mom, Nicole Smith-Holt, when I ran for attorney general in 2018. One of the first things I did after I took office was to convene a task force on how to bring down pharmaceutical drug costs, bringing together patients, experts, and bipartisan leaders — with Nicole as co-chair. The group made 14 clear recommendations to make the overly complex, opaque, and dysfunctional prescription drug markets work better for people. The task force’s number one recommendation was to establish a Prescription Drug Affordability Board (PDAB), to use our public power to help make drugs more affordable and accessible for Minnesota residents.
When PhRMA, the lobbying arm of the pharmaceutical industry, sued our state over the Alec Smith Insulin Affordability Act, I’m proud that my office defended it in court. I’ve also continued the State’s lawsuit against insulin manufacturers for fraudulently inflating prices, joined many other states in suing manufacturers of generic drugs for illegal price-fixing and market allocation, and fought at the Legislature for bills to ban unconscionable price-gouging on pharmaceutical drugs and for more transparency in drug pricing.
For many years, pharmaceutical companies have been engaged in an ugly pattern of anticompetitive price-gouging of Minnesotans who need to access lifesaving drugs. As a result, far too many Minnesotans like Alec Smith are skipping medication doses or leaving their prescriptions unfilled altogether, putting their health and livelihoods at risk.
Even if you aren’t on a high-cost drug, we all pay the price for drug companies’ greed through the high health insurance premiums we pay, in the cost of public health programs, and in subsidies to pharmaceutical companies. Most prescription drugs are developed through taxpayer-funded research, yet Americans pay too much for these drugs at the pharmacy.
The current system works well for generating profits — but it’s certainly not working well for patients.
It’s time we had a watchdog on pharmaceutical companies — and if the Minnesota Legislature passes a Prescription Drug Affordability Board, we will. The PDAB is an important next step in creating a more transparent and affordable prescription drug system. It will act like the Public Utilities Board and be a check on the monopoly power of pharmaceutical companies by setting upper payment limits for high-cost drugs. It builds on our efforts to fight Big Pharma through policymaking and in court.
But make no mistake: Big Pharma won’t go down without a fight. They’ll do anything to protect their profits over people’s lives.
On the floor of the Minnesota Senate, they rammed through an amendment to gut the PDAB bill by excluding nearly every brand-name medicine from being reviewed by the PDAB. They called it a “rare-disease amendment,” but it’s really a poison bill meant to exclude hundreds of medicines from the bill. It’s part of the industry’s all-out campaign to mislead Minnesotans, create fear among patients, and bully lawmakers into limiting action on drug prices.
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’s abuses.
A growing coalition of patients, nurses, doctors, workers, people of faith, farmers, and community members supports a Minnesota PDAB with full powers to hold Big Pharma accountable. I’m one of them. Let’s get it done now so no Minnesotan ever has to choose again between affording their lives and affording to live.
Keith Ellison has served as Minnesota Attorney General since 2019.