About a dozen years ago, I was interviewing for a job at The Wall Street Journal when I was asked by an editor what I thought would be the most important story in the coming year for the pharmaceutical industry.
“Pricing,” I responded immediately.
Prescription drug pricing, to be specific. I explained that the problem was coming to a head as more people were angry about rising costs but felt helpless. Bus rides to Canada for cheaper drugs and cases in which people rationed insulin often made headlines but failed to accomplish much.
Two years later, David Mitchell came along — and started to make a difference, which is why he will be missed. He passed away on Friday. He was 75 years old.
A former public relations specialist at a firm in Washington, D.C., Mitchell had planned to retire a decade ago but instead embarked on a new act by creating an advocacy group, Patients for Affordable Drugs, to raise awareness of the increasingly dire circumstances confronting a growing number of Americans.
The idea was to agitate in a way that, up to that point, hadn’t really been done effectively — using real patients across the country in an organized fashion to tell their stories about the struggle to afford their medicines.
Mitchell was uniquely suited for this role. Not only did he understand how to push buttons and pull levers when it came to getting the attention of lawmakers and policy influencers, he also had been diagnosed with multiple myeloma, an incurable blood cancer.
Unlike many others, Mitchell had the resources to afford the health insurance and related expenses for medicines that, at the time he launched his campaign in 2016, cost about $440,000 a year. Yet he shared the outrage many Americans felt about price tags and was itching to push back on industry explanations that high prices pay for needed cures.
“I want to tell the drug companies that it’s time for patients to say we’re not going to be frightened any longer by your threats not to give us drugs we need if we don’t pay prices you demand,” he told me back then.
“It’s like extortion. It’s no different than Tony Soprano walking into a store and saying, ‘Someone may get hurt if you don’t give us the money.’ We believe there is plenty of money in the system to get money to your shareholders and still get the research and development done.”
Tough talk, and evidence that Mitchell was not a pushover. He was articulate and savvy, he understood how change can occur. Plus, he had significant backing early on from the Laura and John Arnold Foundation, which was created by the hedge fund manager and his wife to fund research and campaigns that focus on health care, education, and other issues.
And to borrow a cliché, he was also willing to put his own money where his mouth was — Mitchell donated $75,000 each year to the group.
Mitchell wasn’t naïve, though. He knew that getting lawmakers — particularly at the federal level — to squarely address the problem would be challenging. But he hoped that regularly conveying horror stories told by real people might work.
“We have no illusions about the degree of difficulty,” he said. “But there’s a better chance of succeeding if there’s a patient voice in the mix.”
To be sure, countless Americans had been mentioned in news stories about drug pricing issues over the years, but Mitchell saw an opening to harness the collective power of people who were frustrated, bitter, and often just plain scared.
In doing so, he arguably became the public voice of a growing movement to constrain prescription drug prices. Many journalists — including me — often reached out to him for comment on the latest developments. Mitchell also regularly testified before Congress, lending a refined but pointed demeanor to a contentious and complicated topic.
I don’t want to suggest that Mitchell was somehow single-handedly responsible for the progress made addressing drug costs. There are many other groups and individuals who at various times have also played important roles in pushing for change, particularly the federal law that now allows Medicare to negotiate prices for some drugs.
And it’s certainly easy to stake out the moral high ground when sorting through the mysterious interplay between drugmakers and pharmacy benefit managers, who create the formularies for determining health coverage. Both have contributed to escalating pricing that have upset consumers.
But Mitchell was noteworthy — he was clear-headed, generally unflappable, and, most of all, knowledgeable. You could discuss the vagaries of drug pricing with him and almost always come away with a useful insight, not just a quick quote. Sure, he had his shpiel — he was an advocate, after all — but he knew his stuff. And he was truly vested in the topic.
Nearly a decade has gone by since Mitchell began his crusade and, for many consumers, prescription drug pricing still remains a hot-button issue, and a hot story. But Mitchell was sober about the odds. “I don’t have any illusions that this is a short-term thing,” he told me when the group launched. “We’re in this for years. And I hope I have years.”
Unfortunately, his time ran out. But Mitchell helped create a template for pushing back on companies that too often took consumers for granted and for pushing lawmakers to respond.
As he liked to say to anyone who would listen, “Drugs don’t work if people can’t afford them.” It is a mantra for which he should be remembered.
