Welcome to the Week in Review.
Spotlight On Costly GLP-1s
The astronomical prices for blockbuster GLP-1 medications Ozempic and Wegovy have ignited a fierce debate over patient access and affordability. With monthly list prices in the U.S. of $969 and $1,394 respectively, these drugs manufactured by Novo Nordisk have become poster children for the pharmaceutical industry’s contentious pricing practices. While these treatments carry outrageous prices, with roughly half of patients reporting difficulty affording them, Ozempic could in fact be manufactured for less than $5 per monthly injection, and Novo Nordisk would still make a profit on the drug. In addition, there are growing concerns around the financial burden being placed on our health care system and on taxpayers. Medicare spending on GLP-1s skyrocketed to $5.7 billion for Ozempic, Wegovy, and Mounjaro in 2022 , up from $57 million in 2018. Lawmakers have called on Novo Nordisk CEO Lars Fruergaard Jørgensen to testify before the Senate Health, Education, Labor & Pensions (HELP) Committee on September 24th to respond to concerns about these pricing practices. Ozempic may also be one of 15 additional drugs selected for the second round of Medicare drug price negotiation — which will be announced by February 1, 2025 — due to its high cost and lack of competition. — (NBC News, CNBC, KFF, KFF, Reuters, Senate HELP Committee)
P4AD Advocates Take Action
P4AD patient advocates from across the country took action this week to push for comprehensive patent reforms and spread the word about how the historic drug price law is lowering costs.P4AD patient advocates met with legislators from both sides of the aisle to urge them to pass bipartisan legislation aimed at curbing pharma’s abuse of our patent system. Flying in from Wisconsin, South Carolina, Massachusetts, Kentucky, and Colorado, the advocates shared their experiences with high drug prices with their representatives and explained how the passage of these bipartisan bills would ensure more timely entry of generic and biosimilar competition to lower drug prices. Judy Aiken, a retired nurse from Portland, Maine who lives with psoriatic arthritis and psoriasis, testified before the Senate Finance Committee at a hearing about the relief being delivered to patients through the Inflation Reduction Act. Judy shared how the out-of-pocket cap saved her nearly $6,000 in 2024 and that her Enbrel will see a 67 percent reduction in price in 2026 thanks to Medicare negotiation. Lisa McRipley, a patient advocate from Richmond, Texas who lives with multiple sclerosis and Jackie Trapp, a retired educator from Muskego, Wisconsin who lives with multiple myeloma, both participated in White House events this week and shared how the IRA has significantly reduced the financial burden of their prescription drugs. Lisa shared with President Biden how the out-of-pocket cap will save her $6,000 next year, and during a panel focused on Women and Aging, Jackie shared that her out-of-pocket costs are now capped at about $3,300, after years of spending up to $21,000 annually for her Revlimid medication alone.
FTC Takes On PBM Industry
Yesterday, the Federal Trade Commission (FTC) filed a lawsuit against the big three pharmacy benefit managers (PBMs) — CVS Caremark, Cigna’s Express Scripts, and United Health’s Optum Rx — for engaging in anticompetitive practices that “artificially inflated” list prices of insulin and blocked patient access to life-saving treatments. Earlier this week, Express Scripts filed a lawsuit against the FTC for claims made in the agency’s “scathing report” on the opaque practices of PBMs. Released in July, the report underscored some of the shady practices of the highly consolidated PBM industry and exposed the middlemen’s outsized influence on patient access and affordability of essential medicines. During the aforementioned Senate Finance Committee hearing this week, members across the political spectrum, including Chairman Ron Wyden and Senator Lankford as well as several other members of the committee, called for reforming the middlemen’s practices. P4AD and legislators on both sides of the aisle agree that we urgently need to increase PBM transparency to help shed light on what is going on behind the curtain and to better ensure that savings are passing on to patients. — (Fierce Healthcare, Axios, The New York Times, Senate Finance Committee)
Court Watch: US v. Pharma
Yesterday, P4AD filed an amicus brief in the Third Circuit Court of Appeals in lawsuits brought by Bristol Myers Squibb (BMS), Janssen, and AstraZeneca. The brief incorporates the stories of several patients on Medicare who have struggled to afford their medications due to high cost and highlights how lower negotiated prices will make their drugs more affordable. It also counters pharma’s misleading claims about the Inflation Reduction Act, explaining how Medicare negotiation fosters innovation while expanding patient access to life-saving treatments. Additionally, the brief pushes back against industry-funded groups that falsely claim to represent patients, exposing their role in preserving pharma’s monopoly pricing. Earlier this week, the Department of Health and Human Services (HHS) filed an opposition brief in the cases brought by BMS and Janssen, underscoring the voluntary nature of Medicare negotiations. Oral arguments will be presented in all three cases on October 28th. Despite the drug industry’s seven failed attempts to block Medicare negotiations in court, patients remain vigilant, continuing to defend the law both in the courtroom and in public advocacy efforts. — (P4AD, Bloomberg Law, O’Neill Institute, FightPharma.org)
ICYMI
On Thursday, the Senate Judiciary Committee was scheduled to mark up two controversial bills, S. 2220 (PREVAIL Act) and S. 2140 (Patent Eligibility Restoration Act). If enacted, these bills would make it easier for drug companies to secure undeserved patents and take away a key mechanism to challenge invalid patents that should have never been granted — meaning that pharma could more readily quash competition and continue charging high prices. Last week, P4AD sent a letter to members of the Senate Judiciary Committee to urge them to vote no on these bills. The markup for these two bills has been rescheduled for next Thursday, September 26th. P4AD remains committed to stopping any industry attempts to exploit the patent system and extend monopoly pricing power.
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