Column: Your drug lobby at work: How did two witnesses come to submit identical testimony to Congress?

The internal mechanisms of the Washington lobbying game were inadvertently placed on public display Tuesday during a House committee hearing on an Obama Administration move to reduce prescription drug costs. Two witnesses opposing the proposal, ostensibly from two different interest groups, somehow submitted statements that contained identical passages.

They were outed by Rep. Jan Schakowsky (D-Ill.), who said she found the similarities “very curious.”

But it wasn’t such a mystery. Both groups are represented by the same Washington lobbying shop, Hart Health Strategies, which prepared their witness statements. Hart represents a passel of doctor and patient advocacy organizations in Washington as well as pharmaceutical companies, which may provide a clue to what was really going on here.

Tim Yehl, a spokesman for Hart, attributed the blunder to an “inadvertent clerical error” that occurred because of the “haste” to get the witness statements done.

The issue before the Committee on Energy and Commerce was a proposal aimed at reducing the incentive for doctors to administer the most expensive drugs to their patients in their offices and clinics. The current system under Medicare Part B, which covers outpatient care, reimburses doctors the average sale price of the drug plus 6%, whatever the cost. Since doctors get paid more for more expensive drugs, they have no financial incentive to try cheaper alternatives.

Medicare has proposed a pilot program in which some doctors would be paid the average sale price plus a 2.5% premium and a flat $16.80 premium. This would reduce, though not eliminate, the incentive to choose the higher-priced option.

The drug industry doesn’t like this plan for obvious reasons: It’s happy that doctors have an incentive to go big. Given their crummy public image, the drug companies were understandably shy about saying so outright. Luckily for them, there were patient and provider groups willing to make the case for them.

That’s what brought Marcia Boyle, president and founder of the Immune Deficiency Foundation, and Dr. Michael Schweitz of the Coalition of State Rheumatology Organizations before the House committee.

Both had similar cases to make. Schweitz maintained that doctors aren’t influenced by the reimbursements when choosing treatments, but that the lower reimbursements might make treatments unaffordable for some physicians. Boyle said previous reimbursement cuts already had made it unaffordable for some doctors to provide intravenous treatments to immunodeficient patients in their offices or clinics. But both used virtually identical language in their written statements to describe the Medicare proposal and their “process concerns” with it.

The Boyle statement is here, and the Schweitz statement is here, with the identical passages highlighted. That’s what prompted Schakowsky to tell Schweitz, “I found it very curious ... that there’s over two pages within your testimony that are exactly the same [as Ms. Boyle’s]. ... I thought that odd.” (Schakowsky actually attributed the similarities to testimony by Schweitz and Deborah Patt, a Texas oncologist, but she meant Schweitz and Boyle.)

We reached out to Boyle’s and Schweitz’s organizations for comment, but did not get replies. But both witnesses must be valued Hart clients: On Wednesday, they both were featured on the firm’s home page praising its actions on their behalf.

It may well be that rheumatologists and immunodeficiency sufferers will be disadvantaged by the Medicare proposal. But do Boyle and Schweitz have any credibility? Their statements were fashioned, at least in part, by a Washington lobbying firm they share with drug companies. So how can we know whose interests are really being represented? Are Boyle and Schweitz for real, or only fronts?

This episode pulls wide the curtain on the Washington lobbying dance. Congressional committees hold hearings and invite testimony from self-interested witnesses (whose interests may well be concealed). These affairs aren’t designed to elicit information for the lawmakers to consider, but merely to give every special interest a chance to come forward and be counted, for the record. What they actually say is so unimportant that their statements can be cobbled together from boilerplate, with the expectation that no one will notice.

It was noticed this one time. Think of how often it gets by. That may tell you why the interests of people truly affected by congressional actions — those without high-priced lobbyists speaking on their behalf — are so often ignored.

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