Welcome to the Week in Review.
House Reintroduces The EPIC Act
Big Pharma is at it again. This week, the House reintroduced the EPIC Act (H.R. 1492), a pharma-backed bill that would extend the Medicare negotiation exemption period for small molecule drugs from nine years to 13 years, forcing patients and taxpayers to pay higher prices for longer. The truth is, this bill is nothing more than a giveaway to the pharmaceutical industry. The 2022 prescription drug law already strikes the right balance to ensure innovation we need at prices we can afford. The law allows Medicare to negotiate after drugs have been on the market for several years while still allowing drugmakers to set prices and raise them in early years. Lawmakers who truly stand with patients must reject this dangerous bill and any other attempts to weaken Medicare negotiation, as extending drugmakers’ monopoly pricing power would only hurt patients and taxpayers. — (Inside Health Policy, STAT, Congress.gov, P4ADNow)
P4AD Files Fourth Amicus Brief Defending Medicare Negotiations
This week, Patients For Affordable Drugs (P4AD) filed an amicus brief in the Third Circuit Court of Appeals, defending Medicare’s ability to negotiate lower drug prices against a lawsuit brought by Novartis. This marks the fourth patient-centered amicus brief filed as part of P4AD’s US v. Pharma campaign, pushing back on the industry’s baseless claims that Medicare negotiation will stifle innovation and limit patient access. The brief highlights the experience of Bob Parant, a P4AD patient advocate, who has been living with type 1 diabetes for more than 50 years and began taking Entresto after emergency triple bypass surgery. As a patient on Medicare who needed both Entresto and insulin, Bob wasn’t able to afford both medications until key reforms in the historic prescription drug law went into effect. Prior to the law taking effect, Bob was forced to switch to a cheaper insulin that he found to be less-effective while posing potential risk to his longterm health. Last week, the Department of Justice filed its brief defending Medicare negotiations in the Novartis case. This was the first government brief of the Trump administration and marked an important moment as questions loomed over whether the new administration would defend the program in the courts. Today’s deadline for drugmakers to agree to enter into negotiations for the next 15 drugs is another key test – both for the administration’s commitment to lower prices and for Pharma’s willingness to engage rather than obstruct. — (P4AD, IP Watchdog, Fightpharma.org, P4AD, Commonwealth Fund, STAT)
Push To Revive PBM Reforms
Pharmacy benefit managers (PBMs) are black boxes in the drug supply chain that operate in secrecy. On Wednesday, the House Energy and Commerce Health Subcommittee held a hearing on the role of PBMs in driving up prescription drug costs. Lawmakers on both sides of the aisle called out the shady middlemen for their anti-competitive practices, highlighting how the three largest PBMs control 80% of the prescription drug market and use their dominance to manipulate formularies – prioritizing high-cost drugs while blocking lower-cost generics and biosimilars. And patients are the ones left paying the price. Stacy in Michigan shared with P4AD that her PBM refused to cover her husband’s life-saving insulin, even after changing jobs for better insurance coverage. Stories like hers are all too common as PBMs restrict access, inflate prices, and profit at the expense of patients. Congress has a critical opportunity to revive long-overdue reforms to increase transparency within the PBM industry that were excluded from the year-end funding deal in December. Patients are counting on Congress to hold PBMs accountable. — (House Energy and Commerce Health Subcommittee, Axios, Modern Healthcare)
In Case You Missed It
According to an HHS Office of Inspector General report, Medicare spending on 10 diabetes drugs, including seven GLP-1 treatments, increased 364% over four years from $7.7 billion in 2019 to $35.8 billion in 2023. Rising spending on these high-cost treatments raises serious concerns about the financial strain on patients and our health care system.
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