This Week in Drug Pricing: First Patient Advocate of the Year, Healthcare Package Negotiations Heat Up, and ICYMI

Welcome to the Week in Review.

Patient Advocate Of The Year

P4AD proudly began a new tradition: our Patient Advocate of the Year Award. The award honors a patient advocate who has gone above and beyond in the fight for lower drug prices. This year’s recipient was Judy Aiken — a name that should be familiar to Week In Review readers and who was presented with the award yesterday in Washington, DC. Judy is a retired nurse from Maine who has been living with psoriatic arthritis and psoriasis for over four decades. She made headlines earlier this year when she introduced President Biden and Vice President Harris and shared her experience with high drug prices at an event celebrating Medicare’s first 10 new, lower negotiated prices. Judy also testified before the Senate Finance Committee this year to share how the Inflation Reduction Act’s annual $2,000 out-of-pocket cap would rein in the cost of her prescribed medications. Judy’s unwavering commitment to this cause and her willingness to share her personal story continues to help P4AD have a measurable impact. She inspires us all to keep up the fight. — (Portland Press Herald, The New York Times, Fierce Pharma)

EOY Health Care Package Negotiations

As Congress approaches a deadline to pass critical funding bills, negotiations over a health care package are intensifying, with new developments from both parties. Congressional Republicans provided an initial proposal that included provisions that would address the lack of transparency within the pharmacy benefit manager (PBM) industry and delink PBM compensation from list prices. In response, Democrats have put forward a counteroffer that builds on these PBM policies while adding additional drug pricing measures, including S.150, the Affordable Prescription for Patients Act. This bipartisan legislation, which passed the Senate unanimously, targets patent thickets on biologics to accelerate biosimilar competition, lowering costs for patients and potentially generating $1.8 billion in federal savings over 10 years. On Wednesday, P4ADNow, AARP, The ERISA Industry Committee, CSRxP, and The National MS Society sent a letter to House and Senate Leadership urging them to pass S.150 to lower drug costs and generate savings to offset other critical healthcare priorities. Another provision still on the table is Q1/Q2, which P4AD supports, which would expedite the approval process of generic drugs and generate $871 million in government savings over 10 years. These measures align with P4AD’s mission and would help rein in the shady practices of the industry middlemen – while also holding drug manufacturers accountable for their role in setting high list prices. — (STAT, Congressional Budget Office, DC Journal)

ICYMI

The Biden-Harris administration announced that Bluebird Bio and Vertex Pharmaceuticals, two drug makers with FDA-approved gene therapies for sickle cell disease (SCD), have agreed to participate in the Cell and Gene Therapy Access Model. This voluntary model will test outcome-based agreements that tie payments to whether these multi-million dollar therapies improve health outcomes for people living with SCD on Medicaid. Given that over half of the entire community of 100,000 people in the U.S. with SCD are on Medicaid, the model is part of the Administration’s broader effort to increase access to novel therapies and drive down prescription drug costs by making it easier for states to pay.

Subscribe to the WEEK IN REVIEW here.