Joe Grogan has been in a position to potentially benefit his former employer, Gilead Sciences. Grogan, who worked as Head of Federal Affairs for Gilead Sciences, Inc. before entering the Trump administration, was elevated in February 2019 from Associate Director of Health Programs at OMB to his current post as the Director of the Domestic Policy Council. In this new role, Grogan has had tremendous influence over policy decisions affecting the healthcare choices and costs for millions of Americans, and was reportedly among the most strident voices pushing the administration to support a Texas-led lawsuit that seeks to overturn the ACA in its entirety.

Even as Grogan’s influence in the administration has continued to expand, the Office of Management and Budget and the Centers for Medicare & Medicaid Services are unlawfully refusing to release documents that could answer questions about whether Grogan has run afoul of ethics obligations. Emails previously obtained by Democracy Forward show that Grogan worked with drugmaker Novartis to develop a potentially lucrative drug pricing pilot program for CAR-T therapy, a specialized cancer treatment. While Grogan was at Gilead, Gilead was moving towards acquisition of another manufacturer of CAR-T therapies (Kite Pharma), but he continued to work on CAR-T policy once he left Gilead for the Trump administration. According to the emails we obtained, Grogan only recused himself from the CAR-T project after Gilead publicly announced its acquisition of Kite Pharma, raising questions about whether Grogan should have been working on the CAR-T pricing demonstration project at all. In April 2019, the federal government proposed raising the reimbursement rate for CAR-T therapy by $56,000, which would generate an approximately $110 million increase in payments for CAR-T therapies in 2020, a major windfall for Gilead.

We filed suit to uncover the documents we requested through the Freedom of Information Act. Records Democracy Forward uncovered through its prior FOIA work prompted Representative Elijah Cummings, now Chair of the House Committee on Oversight and Reform, to submit a letter requesting documents regarding what he described as Grogan’s apparent conflict of interest in the CAR-T project. In July 2018, Democracy Forward filed a complaint with the Office of Government Ethics requesting an investigation into Grogan’s role in the project.

More recently, Gilead has been ensnared in controversy for not paying the government for use of the government-held patent underpinning Gilead’s anti-HIV medicine Truvada, for which it charges between $1,600 and $2,000 for a single month’s supply. While the Trump administration has opened a review, it has not taken any substantive action to defend its patent and drive down the cost of this drug. Following public pressure, Gilead announced it would allow the sale of a generic replacement, but will continue to profit for 15 months. President Trump previously called the cost of medicine “outrageous,” but under his administration prices have only continued to climb. A recent report found that in a stretch of 2018, there were almost 100 times more price hikes than price cuts for pharmaceutical products.

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