Welcome to the Week in Review.

Next 15 Drugs Selected for Medicare Negotiations

Marking another historic step for patients, the Centers for Medicare & Medicaid Services (CMS) announced the next 15 drugs selected for Medicare negotiation. The selected medications were used by 5.3 million people on Medicare between November 2023 and October 2024 and accounted for $41 billion in Medicare spending within that period. In January this year, 12 of the 15 drugs selected for negotiation saw new list price increases, 11 of which were higher than the rate of inflation. Given the successful negotiations for the first 10 drugs, which saw an average list price reduction of more than 62%, lower negotiated prices for these additional 15 drugs will mean substantial relief to millions more patients. A lower negotiated price for Ofev, one of the selected drugs, could ensure Carole from Michigan can consistently take her treatment for chronic lung disease for which is unaffordable at $14,000 per month. A lower negotiated price for the inhaler Breo Ellipta would mean Teresa from North Carolina could finally treat her asthma with the only inhaler on that market that works for her. We remain steadfast in our commitment to supporting the successful implementation of the Medicare negotiation program, ensuring patients and taxpayers get a better deal on their life-sustaining medicines. — (P4AD, NBC News, HHS, AARP, BioPharma Dive)

Teva Joins Big Pharma’s Assault On Medicare Negotiation

Teva Pharmaceuticals has filed the 10th lawsuit representing Big Pharma and its allies aimed at blocking the drug price negotiation program. The lawsuit came just one day before Austedo and Austedo XR, Teva’s treatments for movement disorders, were officially selected for the next round of Medicare negotiations. These drugs cost patients up to $14,642 per month and generated $435 million in revenue for Teva in just three months last year. Teva’s legal argument – that Medicare shouldn’t negotiate prices for two drugs with the same active ingredient – is a new and desperate attempt to undermine negotiations. After seeing their earlier legal challenges repeatedly rejected by federal courts, the pharmaceutical industry is testing fresh claims to see if any will stick. This latest tactic is part of a broader, coordinated campaign to protect exorbitant profits at all costs, even as Americans struggle with high drug prices. Now that the next drugs up for negotiation have been announced, more lawsuits are expected. P4AD will continue to fight back, defending Medicare negotiation through amicus briefs filed in the courts, with campaigns like “US vs. Pharma,” and by mobilizing patients to protect these critical reforms. – (Bloomberg Law, FightPharma.org, Austedo, Teva Pharmaceuticals, HHS)

FTC Report Exposes PBM Price Gouging Scheme

The Federal Trade Commission’s (FTC) latest report shines a spotlight on the greed of pharmacy benefit managers (PBMs), revealing how CVS Caremark, Express Scripts, and OptumRx raked in $7.4 billion in revenue by inflating the prices of 51 lifesaving drugs between 2017 and 2022. The Big Three PBMs marked up specialty generics used to treat cancer, HIV, and heart disease, by hundreds – and in some cases thousands of dollars – at the expense of patients. For example, a month’s supply of Tadalafil, a pulmonary hypertension treatment, was acquired by pharmacies for $27 and marked up to $2,106, an increase of over 7,700%, and Tecfidera, a multiple sclerosis drug, was acquired for $177 and hiked to $3,930, a markup of more than 2,100%. The report, which expands on the FTC’s initial probe from July 2024, confirms what patients have long suspected: PBMs exploit their shadowy role in the drug supply chain to hike prices and pocket enormous profits, leaving patients to foot the bill. The findings underscore the urgent need for Congress to pass meaningful reforms to bring transparency and accountability to the PBM industry.  — (FTC, Fierce Healthcare, Axios)

Debunking Pharma Misinformation About IRA
The Federal Trade Commission’s (FTC) latest report shines a spotlight on the greed of pharmacy benefit managers (PBMs), revealing how CVS Caremark, Express Scripts, and OptumRx raked in $7.4 billion in revenue by inflating the prices of 51 lifesaving drugs between 2017 and 2022. The Big Three PBMs marked up specialty generics used to treat cancer, HIV, and heart disease, by hundreds – and in some cases thousands of dollars – at the expense of patients. For example, a month’s supply of Tadalafil, a pulmonary hypertension treatment, was acquired by pharmacies for $27 and marked up to $2,106, an increase of over 7,700%, and Tecfidera, a multiple sclerosis drug, was acquired for $177 and hiked to $3,930, a markup of more than 2,100%. The report, which expands on the FTC’s initial probe from July 2024, confirms what patients have long suspected: PBMs exploit their shadowy role in the drug supply chain to hike prices and pocket enormous profits, leaving patients to foot the bill. The findings underscore the urgent need for Congress to pass meaningful reforms to bring transparency and accountability to the PBM industry.  — (FTC, Fierce Healthcare, Axios)

ICYMI

As the Biden-Harris administration comes to an end, never-before-seen photos were recently published in People, of P4AD’s Judy Aiken sharing her experience with the high cost of prescription drugs with President Biden and how the relief being delivered through the historic drug pricing law is truly life-changing. 

Subscribe to the WEEK IN REVIEW here.