The Week in Review in Prescription Drug Pricing

Happy Lunar New Year! May the year of the rabbit bring you peace, longevity, prosperity, and lower drug prices 🐇

Welcome To The Week In Review.

1. Inflation Reduction Act Lowers Insulin Costs (And More) For People On Medicare

• Americans are continuing to feel relief from the Inflation Reduction Act this week, starting with the $35 monthly insulin copay caps for people on Medicare. Steve Lubin, a retired intensive-care nurse from Philadelphia living with type 2 diabetes, is one of millions of people on Medicare who will see savings this year from the implementation of the new law. Last year, Steve’s out-of-pocket costs for his insulin totaled a shocking $1,582. In 2023, his copays will be capped monthly at $35 per prescription for a total end-of-year cost of $630. For thousands of patients, this is going to make a huge difference – between 2007 and 2020, people who received coverage through Medicare saw their out-of-pocket insulin costs quadruple and many were “rationing their insulin or couldn’t take it at all.” AARP’s Leigh Purvis put this new insulin copay cap into perspective in several TV interviews, explaining that this year, the Inflation Reduction Act will help 230,000 people on Medicare who use insulin in Florida, 140,000 in Ohio, and 60,000 in Wisconsin. Millions more throughout the country will feel relief as all of the drug price reforms in the Inflation Reduction Act go into effect over the next few years, including free vaccines for people on Medicare, curbs to drug company price gouging above the rate of inflation, a cap on Medicare Part D out-of-pocket costs, and finally direct Medicare negotiation for lower drug prices. Thanks to the Inflation Reduction Act, Purvis told Spectrum News, many people on Medicare “are going to be seeing lower drug prices and lower drug costs.” — (The New York Times, ABC Action News, Spectrum News, News8000)

2. State Efforts To Curb High Prescription Drug Costs

• Following the passage of federal drug price reforms, state legislatures and administrations are pursuing state-level drug price reforms to further rein in prices for their constituents. In California, Attorney General Rob Bonta filed a lawsuit accusing Eli Lilly, Novo Nordisk, Sanofi, and three of the largest pharmacy benefit managers (PBMs) of violating the state’s Unfair Competition Law by increasing the price of insulin far beyond the cost of development and rate of inflation. Bonta characterizes the shady business relationship between PBMs, who negotiate prices on behalf of insurance companies, and pharmaceutical companies as “pure profit padding.” California is the sixth state to sue drug companies for insulin prices, joining Arkansas, Kansas, Kentucky, Minnesota, and Mississippi. In Virginia and New Mexico, lawmakers are championing bills to establish prescription drug affordability boards that will oversee drug prices in the state. And Indiana lawmakers introduced Senate Bill 8, which would limit PBM greed by requiring the middlemen to pass discounts and rebates back to patients. Thank you to all these state lawmakers for boldly kicking off the year advocating for patients and combating high drug prices! — (The New York Times, The Center Square, KKOB, WFYI) 

3. Case Study: Biosimilar Competition Reduces Drug Prices

• The Journal of Clinical Oncology published a new study that found that the entry of biosimilar drugs for anticancer medication Herceptin, significantly lowered the price of both brand-name Herceptin and its five biosimilar competitors. Herceptin was granted FDA approval in 1998 to treat HER2+ breast cancer; since then, its manufacturer, Genentech, raised the price to a peak of $89,706 in 2019. The first biosimilar finally came to market that same year. After three years and with the introduction of five biosimilars, Herceptin’s price fell almost 30 percent to $63,592 in 2022. Today, biosimilar treatments are 40 percent less than Herceptin with a price of $38,173. This is a fantastic case of the drug price system working as it should – biosimilars drive competition and lower drug prices for patients who need this life-sustaining medicine — (The American Journal Of Managed Care) 

Bonus: On Thursday, our all-star Legislative Director Sarah Kaminer-Bourland spoke as part of a panel at a joint public listening session held by the U.S. Patent and Trade Office and the Food and Drug Administration, where she discussed needed reforms that the two agencies can take on together to fix the rigged patent system, identify actors perpetuating the lack of equity, and lower drug prices as a result. Go Sarah!

Have a great weekend, everyone!