Just a Pharm Boy From Delaware

Though Delaware today is most associated with financial services, bankruptcy, and corporate tax dodging — not least thanks to the figure of Biden himself — its biggest city, Wilmington, continues to be known as the “chemical capital of the world.” This is mostly thanks to chemical companies like Hercules Inc. and, especially, DuPont.

But it’s also due to the pharmaceutical industry, which, according to the sector’s premier lobbying and trade group, the Pharmaceutical Research and Manufacturers of America (PhRMA), supports 17,176 jobs in the state (about 3.4 percent of its labor force) and contributes $3.8 billion worth of economic output. That’s about 6 percent of its total GDP.

The industry’s deep pockets have been good to Delaware’s politicos. Pharmaceuticals and health products firms have given the current Delaware delegation — made up of Coons, senator Tom Carper, and representative Lisa Blunt Rochester — a total of more than $1.2 million over their careers. A little over $500,000 of this has gone to Coons during his ten years on the job. And it’s been a smart investment.

Coons has taken heat during the Trump era for several high-profile pro-pharma votes. The first came in the final days of the Obama administration, when senators Bernie Sanders and Amy Klobuchar put forward an amendment to allow pharmacists and distributors to import cheaper drugs from Canada and other countries. The bill was exactly the kind of sensible Washington deal-making Coons claims to prefer: popular, incremental, deficit-neutral, and bipartisan, with twelve Republicans crossing the aisle to support it, including conservatives like Ted Cruz, Jeff Flake, and John McCain.

Unfortunately, Coons and Carper joined the eleven other Democrats who helped kill the measure, which fell just four votes short of passing. It was a repeat of five years earlier, when Coons and a host of other pharma-sponsored senators voted against a John McCain–authored amendment to do the same thing.

To justify their 2017 vote, both Delaware senators regurgitated the objections lodged by PhRMA, which warned that “the importation of unapproved and potentially counterfeit medicines . . . presents a serious risk to public health.” “With the increasing danger of counterfeit and sometimes harmful drugs, we can’t afford to risk the health and well-being of our patients,” said Coons. Sanders called it “a laughable statement.”

The next came a year later, when Coons and Carper again teamed up on a crucial vote, this time to confirm Alex Azar, former top lobbyist and price-gouging president of pharma giant Eli Lilly, as Trump’s Health and Human Services (HHS) secretary. Azar’s nomination was controversial: he wanted to repeal Obamacare and opposed its birth-control mandate, was hostile to drug importation, and thought Medicaid should be converted to block grants (the same way Bill Clinton had gutted welfare in the 1990s).

But Coons, who had “known Mr. Azar for several decades” since their days together at Yale Law School and had “always been impressed with his intellect and work ethic,” decided his “wealth of experience” would make him a “competent leader” at HHS. Coons personally vouched for him to Carper, convincing him to join Coons and the four other Democrats who narrowly carried Azar over the line, 55–43. (Since then, Coons has seen an uptick in generosity from Eli Lilly, getting nearly half of his career-total $17,500 from the company in the 2020 cycle alone — though there are likely other factors behind this, including Biden’s potential presidency).

Needless to say, Azar’s tenure has been exactly the disaster his critics worried about. He’s stacked the agency with pharma and other health-care-industry executives, introduced work requirements for Medicaid, pushed the block grant idea and other Trump cuts to public health, and stood by as the Trump administration sabotaged Obamacare. And while Azar has made noise about lowering drug prices, he slow-walked and ultimately abandoned proposals to do so, so that no progress has been made on that front. In fact, drug prices and health care costs more generally have continued their upward course under Azar.

In other words, Azar’s performance at HHS has made a mockery of the reasons Coons had given for supporting his confirmation. Coons claimed he had “pressed him” in December 2017 on “the Affordable Care Act, drug pricing, and continued progress on health care system delivery reform,” and concluded that “he is committed to representing the interests of Delawareans and Americans everywhere.” It’s hard to maintain that Azar has lived up to any of this.

It’s these votes, together with his pharma donations, sponsorship of bills related to drug prices, and public statements on the issue, that have saddled Coons with an F grade from Prescriptive Justice, a consumer advocacy group focused on bringing US drug prices down. (By contrast, Sanders, Klobuchar, and Elizabeth Warren all have A+ grades, while Cory Booker, who also voted against the 2017 amendment, has a B).

Coons’s obedience to the industry has at times led him to oppose the most radical attacks on the welfare state. He and Carper opposed Medicare cuts in late 2016, for instance — this also happened to be opposed by Delaware’s biotech sector, which worried that cutting reimbursements for advanced new treatments would hurt the industry.

But it goes both ways. As an honorary cochairman of the Wall Street–funded think tank Third Way, Coons backed the 2010 Simpson-Bowles plan that aimed to slash the federal deficit on the back of Medicare and other entitlements.

Patent Medicine

Coons’s more important work for the pharma industry has arguably been in the realm of patent law.

The abuse of the patent system is central to the pharmaceutical sector’s mistreatment of the public, granting companies market exclusivity for new drugs for as long as decades, and in the process stifling competition, innovation, and all the other good things we’re told capitalism is supposed to foster. This is the main force allowing unscrupulous companies to raise drug prices to new, stratospheric heights .

Coons’s presence in the Senate has been central not just to the maintenance of this system, but to its opening to further abuse by Big Pharma. Almost as soon as he got into the Senate, Coons cosponsored the Patent Reform Act of 2011, which became law that September. At the time, critics warned that its provisions — not least from a “first-to-invest” to a “first-to-file” patent system — would benefit large biotech corporations with well-funded legal teams over smaller companies. The Generic Pharmaceutical Association, meanwhile, cautioned that, by making it harder to challenge patents obtained by deceit or withholding information, it would make it tougher to bring generic, typically cheaper drugs to the market.

Not surprisingly, the bill’s passage was backed and celebrated by organizations like PhRMA and the Biotechnology Innovation Organization (BIO), as well as the Coalition for 21st Century Patent Reform, a group of corporate giants that included the Delaware industrial mainstays of DuPont and pharma heavyweight AstraZeneca.

“He’s listening carefully to what folks who practice in this area are saying,” a local intellectual property lawyer said of Coons at the time.

Coons’s early support for the bill signaled he would be pliant toward Delaware’s pharmaceutical and wider corporate interests. By 2018, he was fully cocooned in the industry, attending an intellectual property legal forum sponsored by the Delaware BioScience Association and held in the Wilmington offices of life sciences company Agilent Technologies, where he told attendees the US patent system was under threat — not from industries abusing the system at the expense of ordinary Americans, but from its critics, especially those who charged that patent law created monopolies damaging to the public interest.

“We don’t want to destroy the patent system that has worked so well for us,” Coons told the assembled local chemical and bioscience bigwigs. He added that compulsory licensing — letting someone use a patent without the patent holder’s authorization, something experts are now calling for so the government can introduce generic drugs during the coronavirus pandemic — threatened both that system and the pharma sector.

To that end, Coons introduced the STRONGER Patents Act three years in a row, aimed at strengthening the position of existing patent holders by, for example, making it harder to challenge a patent and making it easier to get an injunction on products that have been claimed to infringe on one. Its supporters included corporate trade groups like the Medical Device Manufacturers Association and the Innovation Alliance, whose members include pharma company AbbVie. Its opponents included tech firms, who worried it would stifle innovation, and the Coalition Against Patent Abuse (CAPA), which called it “an inconceivable gift to Big Pharma” that would “expand their drug monopolies and keep patients from accessing more affordable alternative medicines and treatments.”

Last year, Coons also successfully weakened a measure meant to rein in patent abuse. With pharma companies spooked by a provision taking aim at “patent thickets” — or the practice of obtaining patent after patent for small changes in order to stretch market exclusivity as long as possible — Coons, worried the bill was “overly broad and could have had unintended consequences,” sprang into action. He and North Carolina senator Thom Tillis demanded changes before they would allow the bill to move through the Senate Judiciary Committee, getting language that offered pharma companies potential loopholes and allowing manufacturers up to twenty patents for small changes.

But, arguably, Coons’s most controversial move has been his and Tillis’s attempt, in partnership with the industry, to rewrite patent eligibility law to the benefit of big pharma. The draft bill took aim at a decade’s worth of Supreme Court decisions that narrowed the scope of what can be patented, including the 2013 opinion in Association for Molecular Pathology v. Myriad Genetics, which ruled that naturally occurring genes and their products couldn’t be.

“No implicit or other judicially created exceptions to subject matter eligibility, including ‘abstract ideas,’ ‘laws of nature,’ or ‘natural phenomena,’ shall be used to determine patent eligibility,” read the bill, directly referencing language, used in the Myriad decision, that the Court has long used to define exceptions to patent law.

Gene patenting is top of the wish list for big pharma, who would love exclusive rights to genetic testing for certain genes, or to dictate their use in research. Unsurprisingly, the efforts of Coons and Tillis got the thumbs-up from seventy-two companies and trade associations, including BIO, PhRMA, and pharma giant Bristol Myers Squibb, who in June 2019 sent the lawmakers a letter applauding them.

“Unfortunately, recent judicially created loopholes now deny some of our best inventions the patent protection they deserve and are in fact receiving in China, Europe, and elsewhere,” the letter read.

Coons explicitly sought out the input of this corporate sector from the start of the drafting process, holding closed-door meetings in August 2019 with tech, biotech, and pharma companies, including representatives from BIO, PhRMA, and even Myriad Genetics, the firm at the center of the 2013 Supreme Court case. They were given thirty minutes each to look over drafts of the bill and discuss revisions. Meanwhile, as countless news outlets pointed out, Coons and Tillis were the two biggest recipients of pharma cash in the first six months of 2019, the very period they were drafting the bill.

For all of Coons’s insistence that the bill was not about gene testing but simply making the patent system more predictable, critics weren’t having it. The ACLU, which had led the charge in the Myriad decision, sent Coons and his partners its own letter in June 2019, this one signed by more than one hundred health care associations and warning that “one hundred and fifty years of case law will be wiped out by this bill and the legal battles central to and correctly decided in each of the cases mentioned will have to be fought again.”

It “would result in a quagmire of patent claims and legal impediments to the normal scientific exchange,” said cancer biologist and former National Cancer Institute director Harold Varmus. CAPA charged that it “emboldens and empowers big pharma at the expense of everyday Americans” and enables patent abuse. A slew of other critics told Coons, who insisted that “we do not intend to overrule that holding of the 2013 Myriad decision,” that that’s exactly what his bill would do.

Fortunately for most Americans, the bill is currently stalled. Perhaps it’ll become a top priority again if Coons’s power is strengthened by a Biden presidency.

Taking Care of Business

It’s tempting to explain Coons’s actions by pointing to Washington’s system of legalized bribery. But much of his work in the Senate is owed to the pharmaceutical sector’s presence in the Delaware economy, and the kind of ideological thinking this drives.

Like so many politicians in today’s neoliberal era, Coons’s political philosophy can best be described as a sort of soft corporatism. In this vision, it’s US industrial leaders who guarantee safety and security for working Americans. To the extent that government has a meaningful role in the economic lives of its citizens, it is to grease the wheels for business to make this happen.

Coons used his maiden speech in the Senate to outline his philosophy. The best way to “advance social justice and fight poverty,” he said, is by making sure Americans have access to good jobs, and the way to do that is to focus on “innovative and high-performance manufacturing” like pharmaceuticals, and to tailor an “encouraging environment” for such businesses.

“It will be the private sector and America’s entrepreneurs and innovators that will create jobs,” he explained. “It is our job in government, though, to ensure our country is the most attractive choice for business investment. We can do it by reducing bureaucratic hurdles and investing in an educated workforce capable of high productivity and ongoing innovation.”

This business-first vision soaks through virtually everything Coons has done in the Senate, including his work on behalf of big pharma.

“In my view, patents are absolutely the center of our global leadership and innovation,” Coons said in 2015 about the subject of patent reform. “That’s not just because of my eight years spent at a materials-based science company. It’s also growing up in Delaware, where a little mom and pop called DuPont was sort of the dominant player in my community, and later entrants like AstraZeneca were really central features in my community.”

“I think I now understand the stakes here in these administrative proceedings,” Coons added; “which I think is, particularly in the area of pharmaceuticals, nothing less than our leadership in the world.” It was for this reason, Coons explained, that the United States needed a “strong patent system.”

As Coons told the tech, pharma, and other industrialists at the 2016 forum of the Information Technology and Innovation Foundation (ITIF) — a business-friendly think tank that he has served as honorary cochair of since 2015 — what’s good for Delaware’s corporate giants is good for its citizens.

“In little old Delaware, AstraZeneca is doing world-class pharmaceutical research, but they’re also manufacturing,” he said. “They’re one of our best, highest-quality manufacturers in Delaware. And I emphasize that every time I talk. Globalization and trade, led by innovation, can be a winning outcome for American workers.” He talked about the “wonderful jobs” brought to the state by Amazon, and the great things that companies like Microsoft “make possible.” The manufacturing jobs of old weren’t coming back, he explained, but there were new, more skilled, tech-heavy jobs American workers could fill.

To that end, beyond his work on behalf of big pharma, Coons is most associated with the “Manufacturing Jobs for America” initiative, an attempt to revive US manufacturing jobs not through jobs programs or by renegotiating or jettisoning corporate-friendly trade deals — Coons firmly backs those — but by reorienting government around private-sector needs. At various times, Coons has pushed for the transformation of US cities into “innovation hubs,” the creation of an “American Innovation Bank” to help fund tech start-ups, workforce retraining to align with private-sector needs, and a funding boost to STEM education to help universities churn out workers for the advanced manufacturing sector.

This last one was based on an ITIF report that stated that “in contrast to the debt-driven, consumption-oriented economy of years past, this new economic growth model places great emphasis on innovation activity and advanced manufacturing capacity, which together improve the nation’s competitiveness in the global marketplace.” It urged US universities to move away from their “research for the sake of research and knowledge accumulation” approach and to instead “align it much more with the knowledge needs of manufacturers in America.”

In accord with the philosophy of doing what’s best for business, Coons has, in the past, backed deregulating small and midsize banks, authored a bill to expand and extend bankruptcy judgeships in Delaware, and rallied against a Warren-sponsored bill meant to make it harder for companies to file for bankruptcy outside their home states. Bankruptcy is, after all, big business in the state.

In 2019, he successfully slipped a bill into that year’s National Defense Authorization Act eliminating the federal funding limit for the National Institute for Innovation in Manufacturing Biopharmaceuticals, a private-public partnership that supports research from academia, as well as pharma firms like AstraZeneca.

“With this bill, and the vital federal funding opportunity it creates, Delaware’s innovators will continue to not only save lives, but also create jobs for generations of high-skilled Delawareans who will manufacture these life-saving drugs,” Coons said at the time.

Even while objecting to Pfizer’s attempted 2014 takeover of AstraZeneca, on account of the potential job losses it would lead to, Coons made sure to nod to “our country’s outdated corporate tax system” and promise to be “engaged in and committed to revising the code to help American companies grow and profit.”

As Helen Stimson, president and CEO of the Delaware BioScience Association, explained in 2018, Coons and the rest of the state’s congressional delegation “are genuinely interested in making sure that if a company puts its roots down here that it gets what it needs to succeed.”

The rewards he’s gotten in return aren’t always in the form of political donations. This past August, in a video meeting with a collection of health care advocates, Coons received the 2020 Champion for Healthy Seniors Award from the Partnership to Fight Chronic Disease (PFCD).

Yet a closer look at the attendees suggests not all was as it appeared. One attendee owns a Wilmington consultancy, while another doubles as a media and public relations strategist for businesses. Meanwhile, one of the PFCD representatives is a longtime GOP operative, and a lobbyist and executive at a DC public affairs firm who once represented PhRMA. The other PFCD representative is the head of that same firm, and in the past has lobbied for Paratek Pharmaceuticals, and for PhRMA “on behalf of the Partnership to Fight Chronic Disease & We Work For Health.”

The PFCD, it turns out, is a subsidiary of PhRMA. And We Work For Health? It’s a communications front for PhRMA developed by DC public relations firm 720 Strategies. We Work For Health has won “the approval of member companies to directly engage their employees in a cohesive, industry-sponsored grassroots program,” the firm explains, to “help advance policies that promote medical innovation in the U.S.” And this is not their first run-in with Coons: here they are in 2014 thanking him for paying tribute to bioscience–friendly former Delaware governor Jack Markell at the Delaware BioScience Association’s awards gala, held in Wilmington’s DuPont Country Club.

Scratch the surface of even the most innocuous aspects of Coons’s career, it seems, and you’ll soon find the pharmaceutical and other corporate interests that have dominated Delaware’s economy for eons.

Our Coonsian Future

Should Coons survive his primary, and should Biden win the presidency in November, he may well play a leading role in deciding the Democratic Party’s post-Trump agenda. Judging by Coons’s time in the Senate thus far, that agenda will be defined by a corporate-tinted, upside-down vision of the relationship between the state, citizen, and business — where the role of the government and ordinary people is to serve the economy rather than the other way around.

The United States and the world are facing an interlocking set of crises brought about by decades of bipartisan support for unfettered corporate malfeasance. Steering away from disaster will mean breaking from the business-as-usual that led to this. The question is: Can any administration that embraces Coons be up to that task?