US Senator Bernie Sanders (I-VT) has said, "If the pharmaceutical industry will not end its greed, which is literally killing Americans, then we will end it for them.”

US Senator Elizabeth Warren (D-MA) has said we need to fix markets because giant drug companies are lining “their pockets at the expense of American families.”

Sanders introduced three bills in January 2019 to lower prescription drug prices. The bills are for importation price limits in the U.S. based on what companies charge in other countries, and Medicare negotiation. Warren co-sponsored each of these bills.

In December 2018, Warren introduced a bill for the federal government to manufacture prescription drugs. Her bill didn’t get any co-sponsors, probably because of the timing. The Congressional term was almost over, and it’s impossible to co-sponsor a bill from a previous term. But Sanders supports Warren’s pharmaceutical manufacturing bill and he will co-sponsor her bill when she re-introduces it, says Warren Gunnels, his policy director.

Sanders’ importation bill is S.97 The Affordable and Safe Prescription Drug Importation Act, which would "allow patients, pharmacists and wholesalers to import...from Canada and other major countries.” In 2007, similar legislation passed the Senate 63 to 28. Sanders noted at the time that millions of “Americans were going across the Canadian border to purchase safe and affordable medicine. The American people want action.”

Sanders’ international price-indexing bill is S.102 The Prescription Drug Price Relief Act, which would require that drug companies charge similar prices in America as in other developed countries. Otherwise, “the drugmaker’s monopoly would be ended” and other companies could sell generic versions. According to Dean Baker, senior economist at the Center for Economic and Policy Research, this would lower drug prices in the U.S. by 50%.

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Sanders’ Medicare negotiation bill is S.99 The Medicare Drug Price Negotiation Act. Under current law, Medicaid and the Veterans Administration are allowed to negotiate. Medicare Part D isn’t. The result is that “Medicare Part D pays on average 73% more than Medicaid and 80% more than VA for brand name drugs.” The bill would fix that disparity.

Warren’s bill for the federal government to manufacture prescription drugs is S.3775 Affordable Drug Manufacturing Act of 2018. It would establish a federal “Office of Drug Manufacturing.” The office could manufacture pharmaceuticals when no company is making a needed pharmaceutical, and when only one or two companies are making a needed pharmaceutical and “the price is a barrier to patient access.”

There is a crisis in recent price increases for insulin and, as Reuters reports, “costs per patient nearly doubled from 2012 to 2016.” Warren’s Affordable Drug Manufacturing Act specifically addresses insulin, saying: “Not later than 1 year after the date of enactment of this section, the Secretary (of Health and Human Services) shall begin the public manufacturing of insulin.”

Sanders and Warren both support the bills described above to address drug prices. Are there any differences between these Senators on drug pricing? Yes. Sanders is the only U.S. Senator who supports replacing drug patents with prizes for innovation. A company would be paid by the federal government for coming up with a new prescription drug. The amount of money would be based on how much the drug improves treatment and how many people would benefit. Then any company would be allowed to manufacture the drug.

Another difference between Sanders and Warren involves Medicare-for-All, which would have a tremendous effect on lowering drug prices by giving the government leverage to negotiate lower prices for everyone in the country. They both support Medicare-for-All Single-Payer healthcare. But Sanders talked about it in his stump speech for the 2016 presidential primary. Warren has yet to talk about it in her stump speech for the 2020 presidential primary, suggesting that Medicare-for-All, overall, is a bigger priority for Sanders than for Warren.