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Here's what the CEO of a $50 billion drug company wants out of health reform

Shire CEO Flemming Ornskov is concerned about whether the legislation would make changes to how people with existing illnesses get coverage.

While Republicans in Congress try to overhaul the healthcare system, the pharmaceutical lobby has largely been silent — at least in public.

But that doesn't mean drugmakers don't have skin in the game, or that they aren't doing anything to make sure they're represented.

For he CEO of $50 billion drugmaker Shire, that's meant pushing back against efforts to dismantle the parts of the Affordable Care Act that ensure patients get continuous and lifetime coverage.

Shire, which is headquartered in Dublin, counts on the US for as much as two-thirds of its annual revenue. It's known for making ADHD medicine, like Adderall and Vyvanse, and its focus on rare diseases like the blood disorder hemophilia, many of which affect people starting at an early age.

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Ornskov said he's concerned about whether the legislation would make changes to how people with existing illnesses get coverage. In both the bill that passed the House and a revised version of the Senate bill, there is the possibility that people with so-called "preexisting conditions" might have a harder time getting affordable and comprehensive healthcare compared to otherwise healthy people.

As such, Ornskov said the company is spending lobbying efforts on pushing back on changes that could dismantle some of the key parts of the ACA. Specifically:

  • the most expensive by list price in the US.

That transparency, in some cases, can be more critical than the issue of having insurance or not.

"Oftentimes it's not 'I'm covered or I'm not covered,'" Ornskov said about patients trying to get access to medication. "It is maneuvering in a system which is very complex." For example, patients might have to answer a lot of questions before insurance can sign off on a medication, or they might come across limitations to how much of a prescription they're allowed to have.

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