1962

tors, and on this motion I ask for the yeas and nays.

17415

I hope, in the hearings which are to be held, that we can bridge what I believe to be a constitutional gap, by a different wording. As I have indicated, I think the profits of the drug manufacturers have been unconscionable, and the prices of life-preserving drugs have been too high. The conduct by some members of the industry with reference to these problems has been nearly incomprehensible. Perhaps through the McClellan hearings the problem can be straightened out.

I was hoping that the Senator from Tennessee could say to the junior Senator from Colorado that there is a difference between the measure which is now before the Senate and the one on which I dissented in my separate views on the committee drug bill.

Mr. KEFAUVER. There is a difference in the present amendment as compared to what was in the bill up to the time it was considered by the Judiciary Committee.

Mr. CARROLL. I should like to know what the difference is.

Mr. KEFAUVER. The difference is that the present amendment provides that after 3 years any company would have a right to obtain licensing upon payment of a royalty in the event the Federal Trade Cominission should find that the price at which the company was selling to the druggist was more than 500 percent of the factory cost plus research; that is, that the price was unreasonably high. That is the new feature which was added.

Mr. CARROLL. I thank the able Senator from Tennessee. I still think my minority views were correct. I was concerned about the 3-year patent limitation and the royalty feature.

The idea of forcing down exorbitantly high drug profits does not worry me. But I would like further study by patent experts on this particular method of bringing into line with the rest of American industry the drug manufacturers who profiteer on the health of our Nation's families.

The PRESIDING OFFICER. The time of the Senator from Colorado has expired

The yeas and nays were ordered. The PRESIDING OFFICER. Does the Senator yield back his remaining time? Mr. MANSFIELD. I do.

The PRESIDING OFFICER. The question is on agreeing to the motion by the Senator from Montana to lay on the table the amendment offered by the Senator from Tennessee for himself and other Senators. On this question the yeas and nays have been ordered, and the clerk will call the roll.

The Chief Clerk called the roll. Mr. HUMPHREY. I announce that the Senator from Nevada [Mr. BIBLE), the Senator from Alaska (Mr. BARTLETT), the Senator from New Mexico [Mr. CHAVEZ], the Senator from Pennsylvania [Mr. CLARK], the Senator from Indiana [Mr. HARTKE), the Senator from New Jersey [Mr. WILLIAMS), the Senator from Texas [Mr. YARBOROUGH), and the Senator from West Virginia [Mr. BYRD] are absent on official business.

I also announce that the Senator from Missouri (Mr. SYMINGTON), the Senator from New Mexico [Mr. ANDERSON], the Senator from Alaska [Mr. GRUENING), the Senator from Wyoming [Mr. HICKEY], and the Senator from Missouri [Mr. LONG] are necessarily absent.

I further announce that, if present and voting, the Senator from Pennsylvania [Mr. CLARK), the Senator from Alaska [Mr. GRUENING), and the Senator from Texas (Mr. YARBorough] would each vote "nay."

On this vote, the Senator from Alaska (Mr. BARTLETT] is paired with the Senator from Nevada [Mr. BIBLE). If present and voting, the Senator from Nevada would vote "yea," and the Senator from Alaska would vote "nay."

Mr. KUCHEL. I announce that the Senator from Utah [Mr. BENNETT), the Senator from South Dakota [Mr. BorTUM), the Senator from Nebraska [Mr. CURTIS], the Senator from Arizona [Mr. GOLDWATER], and the Senator from Kentucky [Mr. MORTON] are necessarily absent.

Mr. MANSFIELD. I yield 1 additional minute, Mr. President.

The PRESIDING OFFICER. The

1 minute.

Mr. CARROLL Mr. President, I wish to close by saying that this is the only time I have not been in full agreement with the able Senator from Tennessee on this bill.

The result was announced-yeas 53, nays 28, as follows:

Carroll Case

Cooper Cotton Dirksen Eastland Ellender Ervin

Mundt Murphy Pearson

Hickenlooper Pell

Javits
Johnston

Jordan, N.C.
Jordan. Idaho
Keating
Kerr

Kuchel

Mansfield McClellan Miller Monroney

Robertson
Russell
Saltonstall
Scott
Smith, Mass.
Sparkman
Stennh
Talmadge

Thurmond
Tower
Wiley
Williams, Del.
Young, N. Dak.

Humphrey Jackson Kefauver

Anderson
Bartlett

Bennett
Bible
Bottum
Byrd, W. Va.
Chaves

KAYS Lausche Long, Hawaii Long, La. Magnuson

Muskie Neuberger Pastore Proxmire Randolp Smathers

Morse

Moss

So the motion to lay on the table was agreed to.

Mr. KEFAUVER. I have one more amendment, the purpose of which concerns a situation when patent applications involve agreements between companies. The amendment would make such agreement open for inspection by the Department of Justice and the Federal Trade Commission, so that they could determine whether there had been any violation of the antitrust laws. On August 7, the House of Representatives passed a bill which is substantially the same in purpose, relating to all patent interference proceedings in all fields. It is not limited to drugs.

The PRESIDING OFFICER. The Senator will have to offer his amendment to speak on it.

Mr. KEFAUVER. I am not going to present it. The distinguished Senator from Arkansas [Mr. MCCLELLAN] has schduled hearings on the House bill for September 4. He advises me that even though he may be engaged in the work of the Government Operations Committee at that time, he will delegate to another Senator to preside over the hearings, and he will try to secure action on the proposal.

The PRESIDING OFFICER. The Senator will have to present his amendment to speak on it.

Mr. KEFAUVER. Then I will present my amendment.

Mr. MANSFIELD. The Senator need not do that. I will yield him as much time as he desires.

Mr. KEFAUVER. I should like to have 1 minute.

Mr. MANSFIELD. I yield 5 minutes to the Senator from Tennessee.

Mr. KEFAUVER. The Senator from Arkansas will try to obtain action on the bill if possible during this session of Congress. That being the case, I am not going to present the amendment.

Mr. MCCLELLAN. Mr. President, will the Senator yield?

Mr. KEFAUVER. I yield.

Mr. McCLELLAN. I have advised the Senator from Tennessee, and I also advise all my other colleagues in the Senate, that hearings have already been scheduled. They were scheduled 2 or 3 days ago. I announced that the hearings would be held. There will be no intention to delay and no dilatory tactics will be employed. I do not know anything about the merits of the bill. It must be studied. We will endeavor to hold hearings and process the bill. That is as The much as anyone can promise.

1962

Mr. KEFAUVER. Let us take the drug prednisone, which is used by arthritics.

The subcommittee staff computed. the cost on 1,000 tablets as $13.61. That was based on the sale of the drug in bulk powder form by a reliable company, testing it, compounding it into tablets, putting it in bottles and then into packages ready for shipment. On such bulk sales and on the tableting and bottling a profit was made. That is the reason why the factory cost estimated by the staff has proved to be a little high. The actual factory cost of making prednisone by McKesson & Robbins, which is a reliable concern, is $8.99 a thousand. Yet, prednisone is sold by Schering as Meticorten, under its tradename, to druggists for $170 a thousand.

The same company, Schering, when the Government put out bids for the purchase of prednisone for the Military Medical Supply Agency, offered a bid of $17.97 a thousand. Why should Schering charge druggists $170 a thousand when they make a bid to the Government of $17.97 a thousand?

England has fairly high prices. Yet prednisone was sold in England for $75.30 a thousand.

I hold in my hand a bottle of prednisone. It is for arthritics and aged patients. McKesson's factory cost, as I said, is $8.99. Its price to a druggist is $20.95. But the prices to retailers of Merck and Schering and others is $170.

It happened that prednisone is involved in a patent interference. It is widely believed that Schering is going to get the patent. If Schering licenses Merck and Upjohn, if any one of these large companies gets the patent, they will only license other large companies. The arthritics and old people will be denied the right to buy prednisone made by McKesson & Robbins and other companies at 2 or 3 cents a tablet. They will have to pay nearly 30 cents a tablet, as they do now when they buy prednisone under a trade name.

Mr. LAUSCHE. Mr. President, will the Senator yield on this point?

Mr. KEFAUVER. I yield.

Mr. LAUSCHE. Is there any dispute about the fact the Senator from Tennessee has just pointed out, that in selling to the Government 1,000 tablets were sold for $17.97, while in selling to druggists they were sold for $170?

Mr. KEFAUVER. That is the price at which Schering bid to the Government. The company which actually obtained the contract bid lower. The Government got it for less.

Mr. LAUSCHE. Then, there is no dispute about the claim that, in selling to druggists, it sold 1,000 tablets for $170, but in selling to the Government it offered them at $17.97?

Mr. KEFAUVER. The Senator is correct.

I see present in the Chamber the Senator from Michigan (Mr. MCNAMARA] who has investigated the problem of the aged and aging and who has testified before our committee. These older people cannot take a drug only one day a week; they have to take it every day.

Mr. KEFAUVER. In just a minute. The price to the druggist is 17.9 cents apiece. When the druggist sells it to the patient, the patient has to pay 28 cents a tablet for it.

Early in our experience with a drug service we invited the Food and Drug Administration tc inspect our drug facilities and services as

Mr. KEFAUVER. Iyield.

Mr. MCNAMARA. I wish to verify what the Senator from Tennessee has said. We obtained that testimony from all over the country regarding this particular drug, as well as others. It was brought out that patients had to pay 30 cents a tablet in some cases to obtain the drug.

This is no small part of the problems of retired persons.

tainers. We requested their comments and suggestions and their recommendations were accepted and carried out. We are not in the drug service by choice, but because our members take the position that they have no other way of securing the medicine they need at a price they can afford to pay.

Some organizations resent our entry into the drug field. As associations, we pay the Lame cost of drugs as they do. We ask no favors nor concessions. We pay more than conduct an ethical pharmacy. We share our the going wage to our pharmacists. We potential profits with our members to koop them self-supporting on a limited incorne. This sharing seems to be the point of cuntention of those who resent our operation in the drug feld. Yet we stand shoulder to shoulder with our critics in the defense of

There being no objection, the testimony was ordered to be printed in the RECORD, as follows:

TESTIMONY OF ERNEST GIDDINGS

Mr. Chairman and members of the committee, my name is Ernest Giddings. I am director of legislation for two nonprofit organizations of older persons, the National Retired Teachers Association and the American Association of Retired Persons. I am appearing today on behalf of the 500,000 members of our associations to urge an early favorable report by your committee on H.R. 11581 in order that the bill may be taken to the floor of the House of Representatives for debate and action during the next few weeks before adjournment.

The associations I represent were organized to help older persons help themselves and to encourage them to accept a major share of the responsibility for making their later years meaningful and independent. Membership in the National Retired Teachers Association is open to any retired teacher. Membership dues are $2 a year. Membership in the American Association of Retired Persons is open to any person 55 years of age or over upon payment of the annual membership fee which is also $2. Both organizations are nonprofit and nonpartisan. The combined membership of the two organizations is approximately 500,000.

NRTA and AARP are dedicated to the purpose of serving the needs of their elderly membership.

When our campaign for insurance protection was initiated there was no hospitalization or medical program exclusively for retired persons, and most programs designed to serve employed men and women arbitrarily excluded them from participation in the plan the day they reached the age of 65, or advanced the premiums with lowered benefits. To break this age barrier the officers of the two organizations worked for 7 years before convincing an insurance company to be daring enough to ploneer with us. The success of this breakthrough is attested by the fact that today more than 350,000 retired men and women are covered by a hospitalization program which was denied them until a few years ago, on no more valid grounds than that of age.

During the years 1958 and 1959 our members by the thousands protested the cost of the drugs. As a final result we established and have conducted for several years a nonprofit drug service for our membership. The major function of our drug service is to All

Our members are vitally concerned with the subject before your committee for many

reasons:

1. The incomes of our people who were retired from public and private retirement systems were fixed 5, 10, 15, or 20 years ago and cannot readily be adjusted upward as our economy grows and as prices rise;

2. Their ability to purchase the needed drugs often makes the difference between sickness and health and sometimes between life and death;

3. When physicians, as is the general practice in writing prescriptions, identify the drug by its trade name instead of by its official name they leave our aged sick little or no opportunity for reducing costs. The patient must buy the prescribed brand and is left no opportunity of shopping around to buy at a price he can afford;

4. Those who exist on a bare subsistence level must often sacrifice on food or some other necessity in order to afford the prescribed drug or else deny themselves or ask for charity;

5. The opportunity to buy drugs they need at a cost they can afford, will keep them physically fit, able to work part or full time to supplement their retirement incomes and thus continue to do their part in the productivity of the Nation, and at the same time maintain their self-respect;

6. When elderly people living on a subsistence income can be saved on drug purchases as much as $100 to $300 in 1 year, this saving alone may preserve their sense of self-sufficiency, their feeling of dignity. and keep them from being placed on the relief roles of their local communities or State.

MONOPOLY

It is certainly to be expected that the work of your committee will result in a bill requiring improvement in the quality of drugs, requiring that physicians be provided with more adequate and complete information about drugs, and restricting the use of advertising matter of the overstated and misleading kind.

However, the bill makes little or no attempt to deal with the factor chiefly responsible for the high drug costs. Most sales of drug prescriptions are of patented drugs. The drug patent like patents for a door lock or firearm rua for 17 years. that the owner of a drug patent is protected for 17 years in his exclusive monopoly regardless of the fact that this monopoly

This means

17488

control may be the single factor which prevents thousands of our members and millions of others of all ages from use of the drug. Cost is an extremely effective deterrent from the benefit of needed drugs in the case of older people with limited incomes, Much as we believe in the principles of free enterprise and protection of the profit motive it is our position that no person or corporation should be allowed to withhold from public use products which relieve pain and suffering and which may make the difference between life and death. Only two other nations Belgium and Panama grant so much protection as we do in the nature of product patent monopolles on drugs without limitations on the drug producer to protect the public welfare.

Drug costs are not fiction, they are very real. Some reasonable part of the high costs can be charged to research. On the other hand all the evidence indicates that drug industry profits lead all the rest by a wide margin.

Profits after taxes were 19.7 percent of investment in the drug and medicine manufacturing industries in 1961 according to reports published by the First National City Bank. This rate is almost double that of all manufacturing which was shown to be 10.1 percent in that year.

Markup on many drugs is appalling. Prednisone widely used in relieving pain from arthritis has until recently cost the patient about 28 cents a pill or close to $30 a month. Until recently the pill cost the druggist 17 cents each. After some investigations into drug costs McKesson & Robbins commenced manufacture of the Prednisone

pill and found its costs to be approximately 1 cent per pill.

Our evidence is that tetracycline, an antibiotic, costs about 2 cents a pill to produce; costs the druggist about 30 cents and costs the patient about 50 cents.

We believe the interests of the drug industry can be adequately served and that the welfare of the sick and ailing at any age can be better served if your committee will write legislation to restrict the existing 17 years exclusive patent legislation now protecting the drug manufacturer at the cost of the consumer. We urge your committee to give full consideration to the licensing procedure proposed in S. 1552 in its original form.

Such a provision would require that the owner of a drug pateut after a 3-year exclusive monopoly, license for production of the drug any qualified drug manufacturer, that manufacturer being permitted to agree to pay the patent owner up to an 8-percent royalty on all sales for the 14-year period.

Under such a plan competition would to a limited extent replace monopoly and drug costs to the ill and suffering of all ages should gradually become adjusted downward by a competitive marketing of the drug.

REGULATION OF LICENSE AGREEMENTS

A second factor contributing heavily to high drug costs is a practice common in the drug industry which results in price fixing by agreement. Such agreements are frequently entered into during the course of Patent Office hearings between rival applicants for a patent. The contracts thus agreed upon in these proceedings determine who shall receive the patent, who shall be licensed to produce the drug and the price, usually uniform and identical, which each producer will charge for the drug.

We urge your committee, as it writes up the bill, HR. 11581, to include an amendment requiring that all patent interference settlements be filed with the Patent Office.

Terms of the agreements would therefore be Available to both the Department of Justice and the Federal Trade Coinmission for use of either in any investigations into possible violations of the Sherman Act. We believe such requirement would be of

im

measurable assistance to these agencies. Since the Pharmaceutical Manufacturers Association has agreed to the desirability of such a provision it is our hope that your committee will write this requirement into HR. 11581 before reporting out the bill. We believe such a requirement would greatly assist in lowering the excessively high prices of many drugs.

PROOF OF EFFICACY

Present law requires only that the Food and Drug Administration be satisfied that a drug is "safe" before it may be manufactured and sold to the public. Present law does not provide the Food and Drug Administration authority to require proof that the drug is effective in treating the sickness for which it is sold. In fact, and in practice therefore a drug may be legally marketed which is "safe" under current requirements but which is ineffective when taken by the patient for a specific illness. Frequently, the patient may be given the "safe" drug when he should be given one both "safe" and effective and in such a case the drug is positively injurious and harmful to the health of the patient.

Medicines are too expensive and good health is too precious to receive so little protection from either the drug industry or from our Federal Government. By Federal law we give better protection than this to the products we sell to treat plant or animal diseases. It is our plea, therefore, that your committee insist upon perfecting section 102 of HR. 11581 not only to require proof with application for a patent that the new drug meet a rigid efficacy test, but also proof of efficacy of every claim made for the drug after the patent has been granted and the drug is on the market.

The drug budget of our members is so limited and the health of all citizens is too vital to themselves and the national welfare to permit any degree of deception, however slight, in advertising a drug for human consumption.

NEW DRUG APPLICATIONS

Our recent experience with the baby-deforming drug thalidomide is ample proof that our Food and Drug Administration needs more protection by Federal statute in its terribly important duty to refuse any and every new drug application as long as there is a shadow of a doubt about its possible dangerous side effects. A public official with less dedication to his or her tremendous reEponsibility than Dr. Kelsey might well have Fielded to 1 of the more than 40 contacts from the new-drug applicant, the Merrill Co. In such a case deformed children would have been born by the thousands in our country.

The major impact of the thalidomide catastrophe occurred after the bill was introduced on May 3 of this year. It is to be assumed that you will greatly improve section 104 which, as it stands today, simply extends by a short time the opportunity of the Food and Drug Administration to require proof of safety of the new drug. We believe the present requirement of automatic approval, whether after 90 days following application or after any other specified number of days, places unnecessary and dangerous pressure on the Food and Drug Administra tion staff. Some better plan than the automatic approval procedure must be devised. In this brief statement I have tried to emphasize to your committee the position of our membership that drug prices are excessive. The incomes of older people are static and therefore buying power diminishes with every increase in the cost of living. If drug prices are needlessly high it is our po sition that the Congress has a responsibility to the national welfare to seek out and apply the proper remedy. When freight rates became discriminatory decades ago the Congress provided a partial remedy in enacting

August 23

the Interstate Commerce Act. When the combinations known as trusts needed regulation in the last century the U.S. Congress passed the Sherman Antitrust Act.

It seems to us that the Congress has ample evidence of the genuine need for the passing of an effective drug bill before the present Congress adjourns.

In our drug service at 1000 Vermont Avenue, here in Washington, we fill approximately 6,000 prescriptions weekly. If these could all be filled with generic drugs, rather than with the same drugs carrying trade names, the savings to our members would be tremendous. As an illustration, we have many members using a trademarked drug prescribed for heart conditions.

In a 4-month period we dispense some 335,000 tablets of this drug Sold under the trade name, this would amount to $13,187. If they were dispensed under the generic name, they would cost only $7,662, or a av ings of $5,525.

To use another illustration, a popular prescription for high blood pressure sells in the amount of 190,000 tablets per month for a total of $10,250. This generic could be purchased for $3.945, or . saving of 6,301.

A well-known tranquilizer sells up to 120.000 per month, with a cash value of $6,840. Purchased under the generic name they would cost $3,000 or a saving of $3,840.

These three drugs alone would have saved our members a total of $15,666 if bought under their generic name.

Mr. EASTLAND. Mr. President, will the Senator yield?

Mr. KEFAUVER. I yield.

Mr. EASTLAND. The Senator's argument is beside the point. What the Senator wants to do is reduce the patent right from 17 years to 3 years. That is the point at issue.

Mr. KEFAUVER. No.

Mr. EASTLAND. If the patent right is reduced to 3 years, there will be no research. Millions of Americans are living today because of research. That is the point at issue.

Mr. KEFAUVER. Let me point out that licensing as carried on today does not prevent companies from making profits. CIBA, and its widely licensed reserpine, makes excellent profits, for example.

Mr. EASTLAND. The Senator is not going to put a noose around the drug industry's neck and still get research.

Mr. KEFAUVER. Iyielded for a question, not for argument. I point out that companies that have licensed other companies voluntarily do not suffer from loss of profit. Merck is licensed, and it does not suffer from lack of profit or research.

The chart shows, for example, with reference to methyltestosterone, that there is only one producer but among the major companies there are seven sellers. It is licensed to six others by the maker.

Progesterone has one producer, but it is licensed to eight others. Reserpine is made by CIBA, and is licensed to five others. The same is true in many other cases.

The result of my proposal would be that the drug companies would not hold up the public in the manner in which they do now. They would not be selling their products at more than 500 percent of the cost of production plus research.

I emphasize this point to the Senator from Mississippi. I ask Senators to look at the definition of "cost of production"

1962

in the amendment. Senators will see that it includes research on any particular product. I ask Senators to look at page 4:

"Cost of production" means cost of materials and labor used to produce the drug in finished form and packaged; a fair allocation of plant overhead; royalties paid, if any, for the use of any product or process patent in connection with the production of the drug: and the drug's share of the patentee's total research expense as determined by the relationship of the annual sales of that drug to the patentee's total annual sales of drugs for the last preceding annual or fiscal year;

In no industry other than the drug such markups. there industry are

Even Coca-Cola has a smaller markup, and it has about the highest, outside the drug industry.

Goodyear Tire & Rubber Co.

130

241

Georgia-Pacific Corp-----

356

Worthington Corp..

130 128

355

Food Machinery & Chemical

127 126

352

International Harvester Co...

126

343

American Radiator & Standard

Sanitary Co...

125

208

Schenley Industries-------

125

227

Bigelow-Sanford, Inc.

124

371

General Motors Ccrp-

124

365

Radio Corp. of America...

123

374

Westinghouse Air Brake Co... 122

262

West Virginia Pulp & Paper Co.- 122

American Can Co.---

119

366

Raytheon Co.___.

221

349

206

361

Mr. BUSH. Mr. President, will the Senator yield for a brief question?

Mr. KEFAUVER. I will yield to the Senator in a moment.

I have a list of 14 major drug companies which have markups representing their entire operations of from 242 to 463 percent of the cost of production.

I also have a representative list of markups of large firms in other industries. The Coca-Cola Co. has the highest markup of all the othersmarkup is only 234 percent. range down to as low as 104 percent, for Douglas Aircraft Co., Inc. Many, if not most of these large and wellknown companies in other industries, with lower markups, are able to carry on extensive research.

I ask unanimous consent that these two lists may be printed in the RECORD at this point.

There being no objection, the lists were ordered to be printed in the RECORD, as follows:

Company sales as percent of cost of goods sold: 15 drug companies, 1959

117 116

268 249 243 242

Mr. MILLER. This does not concern me very much, because it seems to me that if the product is the same and if there is such a differential in price, people naturally will buy the $20 bottle of pills instead of the $170 bottle of pills. What is the point the Senator was trying to make?

Mr. KEFAUVER. The detail men from Merck and Schering and Upjohn impress the trade name upon the doctors on whom they call.

Schering calls its product "Meticorten." When a prescription is written for "Meticorten," the patient is forced to pay nearly 30 cents a tablet for it. He cannot shop around. If the doctor should write down "prednisone," the patient could shop around. He might go to a druggist who sells the McKesson & Robbins product, which he can buy for 3 cents a tablet.

17409

A patent will soon be issued on prednisone. When it does, McKesson & Robbins will, and other competitive companies, be prevented from giving the people the break they are now giving them. The patient will have no alternative but to pay the high price of 30 cents a tablet charged the trade-name product.

I should like to show Senators what has happened in regard to some of these other drugs.

I see the Senator from Florida (Mr. SMATHERS] in the Chamber. He knows of this situation. He was the first witness before our committee. He talked about the foreign prices for the same drugs made in the United States, and sold here and overseas-either by the American manufacturer or a subsidiary. There was a great difference in price.

Those drugs were selling overseas for as little as one-fifth as much as the American people had to pay for the same drugs.

Mr. BUSH. Mr. President, will the Senator yield for a brief question?

Mr. SMATHERS. Mr. President, will the Senator yield to me, since he mentioned my name?

Mr. KEFAUVER. I yield to the Senator from Florida.

Mr. SMATHERS. The Senator is absolutely correct in what he is saying. I received some information several years ago concerning drugs which were being sold. That information is in the record. The name of the particular drug escapes me at the moment, but it is a drug which is being sold in the United States.

It was selling for a high price. The then Governor of the State of Florida happened to be traveling in Berlin. He had been a victim of a certain type of disease and needed this particular drug. He was able to get it in Europe. He is the person who first called the situation to my attention. He was able to get the drug in the foreign country at something like 80 percent less than the cost in the United States. He started a little investigation on his own, and discovered that the same company made the drug in the United States and shipped it overseas, there to sell it for some 80 percent less than it was sold to the people of the United States. I am not sure exactly what is the answer to the problem, but I think the able Senator from Tennessee has rendered a great service to all of us by bringing this situation to the attention of the Senate and to the attention of the public.

I believe in the free enterprise system. I think we must have research. On the other hand, I do not believe we need to have a private enterprise system and a free enterprise system which demands what amount to unconscionable profits, particularly when the profits come, in most cases, out of the pockets of sick people or elderly people who really are in no position to pay high prices for their drugs.

My own father suffers from arthritis. He has been taking prednisone and other drugs. He was among the first on whom the drugs were tried. I know from personal experience that he has had to pay a great deal of money for such drugs, much more than he was actually in a