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Stop The 21st Century Cures Act

For more than 40 years, Public Citizen has fought to keep dangerous drugs and medical devices off the market. Each year, millions of patients are injured by medical products and billions of dollars are wasted on harmful or inappropriate treatments.

Congress has now passed the 21st Century Cures Act, a huge gift to the pharmaceutical and medical device industries. This bill remains a bad deal for patient safety, offering a small, temporary and non-guaranteed increase in public research funding at the expense of permanently weakening oversight by the Food and Drug Administration (FDA). Yet the final bill does far less harm than it could have, thanks to the work of Public Citizen and other consumer groups, as well as defenders in Congress like Elizabeth Warren and Bernie Sanders, who stood up against industry and over a thousand lobbyists who swarmed Washington seeking public handouts.

What We Fought to Remove from Cures:

  • 21st Century Cures does NOT further undermine the FDA's ability to ensure the safety and efficacy of medical devices by increasing FDA’s use of medical journal articles as a risky shortcut for approving the highest-risk devices.
  • 21st Century Cures does NOT include some of the worst provisions attacking FDA approval standards for antibiotics and antifungals.
  • 21st Century Cures does NOT weaken reporting requirements of the Physician Payment Sunshine Act, allowing for secret influence by pharmaceutical and medical device companies.
  • 21st Century Cures does NOT hasten the rise of resistant superbugs by giving hospitals incentives to use new antibiotics rather than conserving them for appropriate use.
  • 21st Century Cures does NOT delay generic entry of medicines into the market for longer periods, costing the public as much as $12 billion and denying patients access to affordable, life-saving medicines.

What is Still in Cures:

There are still provisions in this mega-bill that will be bad for patients, including:

  • Creating a double standard for new uses of already-approved drugs, pressuring the FDA to approve new uses based on poorer quality evidence than the evidence that justified the drug’s initial approval.
  • Pressuring the FDA to rush approval for new medical products, including cell therapies, antibiotics, and devices, based on weaker evidence of safety and efficacy.
  • Expanding industry’s ability to pressure insurance companies to cover off-label uses.
  • Making it harder for the FDA to review combination drug/device products, like drug-eluting stents used in heart surgery, under the higher standards used for drugs.
  • The NIH funding is lower than originally proposed, and remains a drop in the bucket compared with the massive decline in inflation-adjusted funding to NIH over the past decade. Worst of all, the funding is non-guaranteed, and Congress will have to pass future legislation in order to release the promised funding, opening the possibility that NIH funding may be held hostage again in exchange for further weakening the FDA.

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