<html><head><meta http-equiv="Content-Type" content="text/html charset=utf-8"></head><body style="word-wrap: break-word; -webkit-nbsp-mode: space; -webkit-line-break: after-white-space;" class=""><div class=""><a href="https://accessiblemeds.org/resources/press-releases/patient-groups-retirees-american-workers-doctors-manufacturers-join-voice" class="">https://accessiblemeds.org/resources/press-releases/patient-groups-retirees-american-workers-doctors-manufacturers-join-voice</a></div><div class=""><br class=""></div><div class=""><h1 style="box-sizing: inherit; font-size: 36px; margin: 0px 0px 30px; font-family: 'Alfa Slab One'; font-weight: 400; background-image: url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAUAAAAOCAYAAADnqNYmAAAAvklEQVQYlVWPvWrCYBiFn+/LoIIIhSwFhxRnp4JIBzeXrno73oGX4CVIwSzi6J6pODiprUsg0CX1B0xyOjTpV5/x4bzn5TCJcs22hf7D8yJTcnXy+ybZvm/xa4aK1VHYUcAdbx/CDh5dapfC4QRGkio53QjPANWDWy69hLn2aSFbpdax6LQgaBr+5HwPo6eyX5Lic6HeItMl+62yAOEnvLYNda88KyQNl7nev9xMGyWi4UH3wQ2w84MYB24AwA+hXXrDNDb52wAAAABJRU5ErkJggg==); line-height: 40px; padding: 0px 79.828125px 45px 0px; background-position: 0% 100%; background-repeat: repeat no-repeat;" class=""><span style="box-sizing: inherit;" class="">Patient Groups, Retirees, American Workers, Doctors, Manufacturers, Join to Voice Concern Over Proposed Trade Deal</span></h1></div><div class=""><span style="box-sizing: inherit;" class=""><p style="box-sizing: inherit; font-family: Roboto, sans-serif; color: rgb(38, 38, 38); font-size: 20px; line-height: 28px; -webkit-font-smoothing: antialiased;" class=""><em style="box-sizing: inherit;" class="">Diverse Coalition Says USMCA Violates U.S. Law, Protects Drug Monopolies and Keeps Price of Medicine High, Hurting Patients and American Businesses </em></p><p style="box-sizing: inherit; font-family: Roboto, sans-serif; color: rgb(38, 38, 38); font-size: 20px; line-height: 28px; -webkit-font-smoothing: antialiased;" class="">WASHINGTON, DC (November 5, 2018)–Today the Association for Accessible Medicines (AAM), together with 28 groups representing patients, taxpayers, workers and health care groups, submitted letters to U.S. Trade Representative Robert E. Lighthizer, Health and Human Services Secretary Alex M. Azar and congressional leadership expressing concern that the U.S. Mexico-Canada Agreement (USMCA), if left in its current form, will keep drug prices high and out of reach of Americans. The letter states that the draft agreement contains provisions that are inconsistent with U.S. law and includes monopoly protections and deterrents to competition that will slow the development of more affordable biosimilar medicines, hurt generic drug competition and disrupt the critical balance between access and medical innovation in the health care market.</p><p style="box-sizing: inherit; font-family: Roboto, sans-serif; color: rgb(38, 38, 38); font-size: 20px; line-height: 28px; -webkit-font-smoothing: antialiased;" class="">Co-signers include AFL-CIO, AARP, Kaiser Permanente, American College of Physicians, American Federation of Teachers, FreedomWorks and Patients for Affordable Drugs and SEIU.</p><p style="box-sizing: inherit; font-family: Roboto, sans-serif; color: rgb(38, 38, 38); font-size: 20px; line-height: 28px; -webkit-font-smoothing: antialiased;" class="">“Affordable, high-quality health care, including affordable prescription drugs, are a top priority for America's working families,” says AFL-CIO President Richard L. Trumka. “The rules proposed in the new NAFTA (USMCA) would keep drug prices high by tying our hands and blocking reform. Workers looking for relief from outsourcing must not be asked to trade-off their families' health in exchange for new trade rules. Working people need trade rules that protect their wages, their rights on the job, and their access to affordable medicines."</p><p style="box-sizing: inherit; font-family: Roboto, sans-serif; color: rgb(38, 38, 38); font-size: 20px; line-height: 28px; -webkit-font-smoothing: antialiased;" class="">“We are disheartened to see that the USMCA reduces competition in the pharmaceutical industry,” says FreedomWorks Vice President of Legislative Affairs Jason Pye. “Trade agreements should open up commerce across the globe to allow better, more efficient goods and services to reach consumers everywhere. This agreement instead preserves brand pharmaceutical monopolies and insulates them from competition for years to come. This is neither in the spirit of free trade nor the free market. We hope the administration will address these deficiencies.”</p><p style="box-sizing: inherit; font-family: Roboto, sans-serif; color: rgb(38, 38, 38); font-size: 20px; line-height: 28px; -webkit-font-smoothing: antialiased;" class="">“We look forward to working with the Administration and Congress to foster a free, fair and balanced trade agreement with Mexico and Canada that ensures an adequate balance between access to affordable medicines and support for pharmaceutical innovation,” says AAM President and CEO <a href="https://www.accessiblemeds.org/about/our-team/chester-chip-davis-jr" target="_blank" style="box-sizing: inherit; color: rgb(29, 141, 238);" class="">Chip Davis</a>.</p><p style="box-sizing: inherit; font-family: Roboto, sans-serif; color: rgb(38, 38, 38); font-size: 20px; line-height: 28px; -webkit-font-smoothing: antialiased;" class="">The letter is available at <a href="https://www.medsforamerica.org/" target="_blank" class="0" rel="nofollow" style="box-sizing: inherit; color: rgb(29, 141, 238);">MedsForAmerica.org<span class="0" style="box-sizing: inherit;"></span></a> at <a href="http://bit.ly/USTR-USMCA-letter" target="_blank" class="0" rel="nofollow" style="box-sizing: inherit; color: rgb(29, 141, 238);">http://bit.ly/USTR-USMCA-letter<span class="0" style="box-sizing: inherit;"></span></a>. The <a href="http://MedsforAmerica.org" class="">MedsforAmerica.org</a> website provides patients with an opportunity to contact their members of Congress to encourage more prescription drug competition in USMCA to bring down high prices.</p></span></div><div class=""><br class=""></div><br class=""><div apple-content-edited="true" class="">
<span class="Apple-style-span" style="border-collapse: separate; border-spacing: 0px;"><span class="Apple-style-span" style="border-collapse: separate; color: rgb(0, 0, 0); font-family: Helvetica; font-size: 12px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-border-horizontal-spacing: 0px; -webkit-border-vertical-spacing: 0px; -webkit-text-decorations-in-effect: none; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; "><div style="word-wrap: break-word; -webkit-nbsp-mode: space; -webkit-line-break: after-white-space; " class=""><div class="">Arthur Stamoulis</div><div class="">Citizens Trade Campaign</div><div class="">(202) 494-8826</div><div class=""><br class=""></div></div></span><br class="Apple-interchange-newline"></span><a href="https://accessiblemeds.org/sites/default/files/2018-11/AAM-USTR-USMCA-Ally-Group-Letter-Trade.11.5.18.pdf" class="">https://accessiblemeds.org/sites/default/files/2018-11/AAM-USTR-USMCA-Ally-Group-Letter-Trade.11.5.18.pdf</a>
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<div class="column"><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">November 5, 2018
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<div class="column"><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">The Honorable Robert E. Lighthizer
U.S. Trade Representative<br class="">
600 17th Street, NW<br class="">
Washington, D.C. 20508
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Dear Ambassador Lighthizer:
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">We are writing jointly to express our serious concern that the recently renegotiated version of the North
American Free Trade Agreement (NAFTA) – now proposed to be called the U.S.-Mexico-Canada Free
Trade Agreement (USMCA) – will exacerbate the problem of high prescription drug prices in the United
States. This trade agreement, if left in its current form, will keep drug prices high in the United States,
to the detriment of our nation’s patients, job creators, workers, and taxpayers. Furthermore, several
provisions within the agreement are inconsistent with U.S. law and, if left unchanged, could lead to
inappropriate modifications to U.S. law or cause the United States to be in violation of the agreement
on day one of its enactment. We call on you, together with the other Administration and Congressional
leaders copied on this letter, to help improve the agreement before it is finalized to assure American
patients and taxpayers that neither the market for affordable generic and biosimilar medicines, nor U.S.
sovereignty over drug price regulation, is put at risk as a result of the USMCA.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">I. The Proposed USMCA Will Slow Biosimilar Development and Harm Generic Drug
Competition in the U.S.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Encouraging biosimilar development and enhancing generic and biosimilar competition is critical to
lowering drug prices. Yet the USMCA would establish new monopolies for already costly brand-name
medicines. Raising barriers to affordable medicines through trade agreements delays patient access to
competitive generic and biosimilar medicines that have lower prices than their brand-name
counterparts. We are deeply concerned that the 10-year brand-name biologic exclusivity provision
proposed in the USMCA, as well as the other barriers it adds to generic and biosimilar competition, will
slow the development of biosimilars and limit patient access to more affordable medicines. Even if
Congress later decides that these pharmaceutical monopoly periods are not needed to incentivize the
development of new medicines, as currently written, this trade agreement will prevent Congress from
taking corrective action and lowering drug prices.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">II. Improving USMCA to Enhance Access to Affordable Medicines
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Contrary to the intent of Congress, the USMCA provisions on pharmaceuticals do not adequately
balance the joint priorities of innovation with access to medicine.</span><span style="font-size: 7.000000pt; font-family: 'ArialMT'; vertical-align: 5.000000pt" class="">1
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">While the proposed USMCA text includes numerous monopoly protections and deterrents to
competition — extended biologics exclusivity, broad exclusivities for drugs, patent term extensions and
patent term adjustments, to name a few — the agreement lacks critical features of U.S. law that
encourage generic and biosimilar competition. The imbalance in the proposed USMCA should be
addressed through changes to the proposed agreement such as including: a more robust regulatory
review provision (“Bolar”); an appropriate incentive to encourage market entry by generic and biosimilar
applicants; requirements for transparency around patents and exclusivities; and, a “best mode”
requirement. Only with the addition of such provisions can we be assured that, consistent with the
Administration’s goal of lowering drug prices, price competition from affordable generic and biosimilar
medicines will be available to American patients, taxpayers, and healthcare payers. In addition, USTR </span><span style="font-family: ArialMT; font-size: 11pt;" class="">and Congress should ensure that the USMCA is consistent with the terms used in U.S. law, particularly
the Drug Price Competition and Patent Term Restoration Act (known as the Hatch-Waxman Act) and
the Biologics Price Competition and Innovation Act, as well as the balance provided in U.S. law. The
USMCA should not extend brand-name drug patents or exclusivities beyond U.S. law in any</span></p></div></div></div><div class="page" title="Page 2"><div class="layoutArea"><div class="column"><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">way, including through definitions of terms in the agreement, such as biologics, nor should it interfere
with future Congressional actions to promote generic and biosimilar competition, reform U.S. patent
law, or otherwise promote affordable life-saving medicines.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">In conclusion, we look forward to working with you and Congress to foster a free, fair, and balanced
trade agreement with Mexico and Canada that ensures an adequate balance between access to
affordable medicines and support for pharmaceutical innovation.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Sincerely,
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">AARP<br class="">
Academy of Managed Care Pharmacy (AMCP)<br class="">
AFL-CIO<br class="">
Alliance for Retired Americans<br class="">
America’s Health Insurance Plans (AHIP)<br class="">
American College of Physicians<br class="">
American Consumer Institute<br class="">
American Federation of State, County and Municipal Employees (AFSCME)
American Federation of Teachers<br class="">
Association for Accessible Medicines<br class="">
Blue Cross Blue Shield Association<br class="">
Center for Freedom and Prosperity<br class="">
Coalition to Reduce Spending<br class="">
Consumer Action<br class="">
FreedomWorks<br class="">
Frontiers of Freedom<br class="">
Global Healthy Living Foundation<br class="">
Healthcare Supply Chain Association (HSCA)<br class="">
Innovation Defense Foundation<br class="">
Jubilee USA Network<br class="">
Kaiser Permanente<br class="">
Knowledge Ecology International<br class="">
National Coalition on Health Care<br class="">
NETWORK Lobby for Catholic Social Justice<br class="">
Ohio Public Employees Retirement System<br class="">
Patients for Affordable Drugs<br class="">
Public Sector HealthCare Roundtable<br class="">
R Street Institute<br class="">
SEIU
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class=""><br class=""></span></p><p class=""><span style="font-size: 6pt; font-family: ArialMT; vertical-align: 3pt;" class="">1 </span><span style="font-size: 9pt; font-family: ArialMT;" class="">Bipartisan Congressional Trade Priorities and Accountability Act of 2015, Pub. L. No. 114-26, Sec. 102(b)(5)(C) (creating a principle trade objective “to ensure that trade agreements foster innovation and promote access to medicines.”)</span></p><div class=""><br class=""></div><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Cc: The Honorable Mitch McConnell, Majority Leader, United States Senate<br class="">
The Honorable Charles Schumer, Democratic Leader, United States Senate<br class="">
The Honorable Paul Ryan, Speaker, United States House of Representatives<br class="">
The Honorable Nancy Pelosi, Democratic Leader, United States House of Representatives
The Honorable Alex M. Azar II, Secretary, Department of Health and Human Services<br class="">
The Honorable Scott Gottlieb, M.D., Commissioner of Food and Drugs<br class="">
The Honorable Seema Verma, Administrator, Centers for Medicare and Medicaid<br class="">
The Honorable C.J. Mahoney, Deputy U.S. Trade Representative
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