Zigzagged Paths for Dueling Spokesmen in Drug-Pricing Debate

Foes Brendan Buck and Robert Zirkelback have even held the same job.

SAN FRANCISCO, CA - MAY 29: Karen Ignagni, President and C.E.O., Americas Health Insurance Plans, speaks onstage during The New York Times Health For Tomorrow Conference at Mission Bay Conference Center at UCSF on May 29, 2014 in San Francisco, California. (Photo by Michael Loccisano/Getty Images for New York Times)
National Journal
Billy House
May 29, 2014, 3:40 p.m.

Just two weeks in­to his new job as vice pres­id­ent of com­mu­nic­a­tions for the largest group rep­res­ent­ing the health in­sur­ance in­dustry, Speak­er John Boehner’s re­cently de­camped press sec­ret­ary Brendan Buck is help­ing to lead a bar­rage of at­tacks on the phar­ma­ceut­ic­al in­dustry.

In press re­lease after press re­lease, email after email, Buck and his new staff have dished out cri­ti­cism — primar­ily on the top­ic of pre­scrip­tion-drug pri­cing — on be­half of his new em­ploy­er, Amer­ica’s Health In­sur­ance Plans, which rep­res­ents thou­sands of in­surers. Buck of­fi­cially joined AHIP on May 14.

But in a twist, the man Buck fol­lowed as spokes­man for the health in­sur­ance group, Robert Zirkel­back, is now a mouth­piece for the drug com­pan­ies that are be­ing at­tacked by his former em­ploy­er. Zirkel­back left AHIP in April to be­come seni­or vice pres­id­ent of com­mu­nic­a­tions for the Phar­ma­ceut­ic­al Re­search and Man­u­fac­tur­ers of Amer­ica, and star­ted work there on May 5.

The res­ult has been quite a feud, with the two as op­pos­ing gen­er­als in a war of words over the cost of pre­scrip­tion drugs.

Good-gov­ern­ment watch­dogs, such as Craig Hol­man, seni­or le­gis­lat­ive dir­ect­or for Pub­lic Cit­izen, call this an­oth­er il­lus­tra­tion of the re­volving-door syn­drome of Wash­ing­ton polit­ics and lob­by­ing.

Hol­man says the cross-pol­lin­a­tion and re­la­tion­ships among Cap­it­ol Hill, K Street, and busi­ness in­terests are nur­tured for short-term and longer-term mu­tu­al be­ne­fits. And con­sist­ency in al­le­gi­ances can be fleet­ing.

In the drug-pri­cing fight, some are ar­guing that man­u­fac­tur­ers need to bal­ance their profits with the pub­lic good. They fear that the es­cal­at­ing prices for spe­cialty drugs, in par­tic­u­lar, are go­ing to im­pact every­one in the health care sys­tem through in­creased premi­ums and cost-shar­ing.

In­surers, mean­while, are un­der pres­sure to rein in rising premi­ums, and ar­gue that keep­ing drug costs down is one way to ac­com­plish that goal.

Enter hired guns Buck and Zirkel­back.

In his three years work­ing for Boehner, which in­cluded a stint as a spokes­man for vice pres­id­en­tial can­did­ate Paul Ry­an, Buck was a prom­in­ent voice against the Af­ford­able Care Act, and the main re­spon­der for the speak­er against the White House gen­er­ally. As re­cently as this spring, Buck was still de­fend­ing the po­s­i­tion that the health care law should be re­pealed and re­placed.

But now he’s the voice of a lob­by­ing group that has be­come grudgingly sup­port­ive of most of the law — and also tasked with de­fend­ing or ex­plain­ing rising premi­ums or in­sur­ance-net­work short­com­ings.

In the past 10 days, Buck has pos­ted and sent out emails with such head­lines as “In States, High Price of Spe­cialty Drugs Threaten Ac­cess” and “Spot­light Shines Brightly on Ex­or­bit­ant Prices of Spe­cialty Drugs.” An­oth­er missive dis­patched by Buck’s dir­ect­or of com­mu­nic­a­tions was en­titled ” ‘Light­ning Rod’ Drug Sparks ‘Fierce De­bate’ Over RX Prices.” That item talked about news cov­er­age (in­clud­ing in Na­tion­al Journ­al) that sug­ges­ted the con­tro­versy over the high price of the latest Hep­at­it­is C drug is, to many, “a sign of what’s to come.”

And on Thursday, Buck’s staff put out an­oth­er item con­tain­ing ex­cerpts of AHIP Pres­id­ent and CEO Kar­en Ig­nagni dis­cuss­ing how she sees pro­vider con­sol­id­a­tion and spe­cialty-drug prices driv­ing “un­sus­tain­able health care costs.”

Mean­while, PhRMA has re­spon­ded with a blog this week by Zirkel­back on “The Real­ity of Pre­scrip­tion-Medi­cine Costs in Three Charts.” The blog ar­gues, among oth­er things, that medi­cines ac­count for a small and de­clin­ing share of health care spend­ing costs.

PhRMA also has re­leased a study it com­mis­sioned show­ing that high de­duct­ibles and cost-shar­ing for medi­cines un­der the Obama­care ex­changes put en­rollees at risk and in­creased costs. And the drug in­dustry re­leased a “Can­cer Chart Pack,” which in­cludes a sec­tion that dis­cusses how “in­sur­ance cov­ers a lower share of pre­scrip­tion drug-costs than of oth­er med­ic­al ser­vices.”

On Thursday, both men offered only lim­ited com­ment on their roles in this fight, say­ing they’d prefer not be to drawn in­to the lime­light and would prefer the at­ten­tion be on the is­sues at hand.

“The fo­cus should be about the is­sues and not the role of spe­cif­ic in­di­vidu­als,” said Zirkel­back, who also had a brief stint as press sec­ret­ary for former Iowa GOP Rep. Jim Nussle.

Buck ac­know­ledged that the fact that he’s left Boehner’s of­fice for his job at AHIP — and that his pre­de­cessor is now a main voice for the drug makers in fend­ing off the in­sur­ance group’s at­tacks — “is in­ter­est­ing.”

But he ad­ded, “I would also say it’s not rel­ev­ant.” Asked later for a com­ment from Ig­nagni about Zirkel­back — who un­til re­cently was her top spokes­man — switch­ing to the oth­er side in the de­bate, Buck re­spon­ded in an email, “You must be jok­ing.”

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