Welcome to the Week in Review.

Another Patient Victory: Federal Court Rejects BMS and Janssen’s Case Against Medicare Negotiation

Yesterday morning, the U.S. Court of Appeals For The Third Circuit rejected Bristol Myers Squibb (BMS) and Janssen’s challenge to the Medicare Drug Price Negotiation Program. This latest decision marks the 13th ruling in favor of the program, following pharma’s three legal defeats over just 48 hours in August. Once again, a federal court has found that the program is constitutional, that drugmakers are not being coerced, and that participation in Medicare is voluntary. P4AD submitted an amicus brief on behalf of patients in this case as part of our ongoing work to stand against pharma’s multi-pronged legal campaign and to ensure patients are represented inside and outside the courtroom. — [P4AD, IP Watchdog, P4AD, P4AD, POLITICO, Bloomberg Law, Endpoints News]

Pharma Continues to Shatter Lobbying Records

In 2024, the pharmaceutical industry spent a record $388 million on lobbying. This year, they’re on track to shatter that record again — already pouring $227 million into federal lobbying in just the first half of 2025, and the spending isn’t slowing down. Just two weeks ago, four major drug manufacturers joined together to launch a brand new lobbying group aimed squarely at undermining Medicare negotiation. As the year goes on, we anticipate even more spending from the industry on their never-ending influence campaign as they work to claw back patient progress. — [Sludge, Open Secrets, STAT News]

For PBMs, Government Scrutiny Continues

PBMs remain under scrutiny this week with the House Oversight Committee expanding its inquiry and Chair James Comer sending letters to Cigna and UnitedHealth’s OptumRX about efforts “to evade transparency and oversight” in the U.S. At the same time the FTC is advancing a complaint against Cigna, OptumRX, and CVS’ Caremark, alleging anticompetitive practices related to inflated list prices for insulin drugs. PBMs profit from opaque “rebate” deals while offering little in the way of benefits to patients. Congress came close to enacting bipartisan PBM reform at the end of 2024, and there is still solid interest in getting those reforms signed into law. P4AD welcomed the FTC’s initial findings on PBMs’ harmful practices last July, and we’ll be watching closely to ensure that real transparency is brought to the PBM black box and that reforms will help lower drug prices for patients. — [House Oversight, Endpoints News, Roll Call, P4AD, FTC, Axios, Becker’s Hospital Review, Healthcare Finance] 

ICYMI

Health Affairs published two new articles dissecting the harmfulORPHAN Cures Act and the impact of rare disease exemptions on the Medicare Negotiation Program: “Exemptions and delays to the negotiation of orphan drugs are poised to erode [Medicare negotiation] savings by more than previous analyses suggested,” and “the impact of exemptions and delays will grow.” — [Health Affairs, Health Affairs]

Patient Advocate Spotlight: Aarolyn McCullough

Condition: Diabetes

Drugs: Everolimus, Zortress, and Ozempic ($100, but would be $2,000 per month without coverage)

Background: Michigan resident and liver transplant survivor

In her words: 

“I can thankfully afford [my prescriptions] due to manufacturer assistance and health coverage benefits I receive through my former employer: the United States Postal Service. But without such assistance, a situation which I have faced before in the past, I would be paying about $2,000 per month for all of my medications.”

“In these circumstances, I’ve either had to change prescriptions or cope with the fact that I may die, and that is a fact that runs constantly in my thoughts.”

“As a retired individual, this should not be my reality. As an American citizen, I believe we deserve lower cost prescription drugs because we are simply overpaying compared to the rate other countries pay for the same or equivalent medications.” 

Subscribe to the WEEK IN REVIEW here.