Former CMS Administrator Andy Slavitt summed up the insulin crisis in eight numbers:
3
6
21
39
275
4,000 – 6,000
30 million
Read it all here, and welcome to the Week in Review in prescription drug pricing!
1. The Price is Not Right
2. #GlaxoSmithLies
3. You Get a Yacht!
4. All the Excuses
5. It Has to End
This week the world welcomed a royal baby! However, unless your name is Archie Harrison Mountbatten-Windsor, you’ll probably still have to worry about the high cost of prescription drugs.
Welcome to the week in review in prescription drug pricing!
1. “It’ll be a big fight”
2. Sky high in July
3. Reference this
4. Patently absurd
5. Robber barons would blush
We would be remiss if we did not note the passing of one of the deans of health journalism, The New York Times’ Robert Pear. We will miss his kind spirit, tenacious reporting, and brilliant mind.
Robert, Thank You.
HARRISBURG, Pa. — As Pennsylvania state lawmakers weigh key measures to protect residents from Big Pharma’s skyrocketing drug prices, patients are calling for reform. One bill would require more transparency from drug manufacturers, triggered by price increases that hit certain thresholds. A second measure would establish a Prescription Drug Pricing Task Force to study the issue of rising drug prices and recommend legislative solutions.
HB 568 would:
HB 1042 would:
“Pennsylvanians are desperate for relief from crushing drug prices,” said David Mitchell, a cancer patient and the founder of Patients For Affordable Drugs Now. “While there is still work to be done to lower the list prices of drugs, these important bills could give state residents more information about rising costs and reasonable solutions to assuage unrelenting price increases.”
Today, Patients For Affordable Drugs Now published a series of patient stories on its website to underscore the urgency of the drug pricing crisis in Pennsylvania.
Melissa Evans, Wilkes-Barre, PA: “Affording all of the medications I need to survive has become such a burden. I have to make many difficult decisions to make sure my needs are met. Half of the time I don’t even take my prescriptions because the co-pays are just far too high. I don’t fill it if I can’t afford it –– it’s as simple as that.”
Michelle Rzeplinski, McAdoo, PA: “These drug prices are killing me, both in the physical and the financial sense. If my drugs were more affordable, my health would greatly improve. Lower prices would mean better access to the medications that are prescribed to me.”
Lynn Seabrook, Wilkes-Barre, PA: “It is sad to say, but I sometimes feel like I would be better off dead –– especially at the end of the month, after prescriptions have been purchased and we are completely broke. My husband has not had a new pair of shoes in years, and I worry about the burden my drug costs places on my family.”
BACKGROUND:
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WASHINGTON, D.C. — In light of today’s news that Senators John Cornyn (R-TX) and Richard Blumenthal (D-CT) introduced a groundbreaking bipartisan bill that would outlaw two tactics Big Pharma wields to maintain monopoly pricing power, David Mitchell, a cancer patient and the founder of Patients For Affordable Drugs Now, issued the following statement:
“Drug corporations have run amok — abusing our patent system and leaving Americans bankrupt and sick. Two egregious tactics they use to maintain high prices are patent thickets and product hopping. Drug companies file scores of patents in an effort to thwart generic competition, or they bring a new drug to market with small, inconsequential differences in order to prevent a competitor from entering at a lower price. These tactics block free-market competition and keep drug prices high.
“We wholeheartedly endorse the Affordable Prescriptions for Patients Act, and we applaud the work of Senators Cornyn and Blumenthal. This bill will speed generic drugs to market without hurting innovation.
“Momentum is building as Republicans and Democrats collaborate to fix our broken system. We look forward to working in support of this legislation, and we hope today’s bill will be included in any upcoming package of reforms.”
BACKGROUND:
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WASHINGTON, D.C. — Patients For Affordable Drugs founder David Mitchell will tell his story of living with incurable blood cancer and will debunk Big Pharma’s claim that patients won’t get innovative drugs without paying high prices at a 10:00 AM hearing today on rising drug prices.
Read his full testimony here.
Mitchell’s testimony will highlight stories of patients skipping doses and going into debt to afford rising prescription drug prices. And he’ll focus on the fact that right now, nearly 1 in 3 adults report not taking their medicines as prescribed because of the cost. He’ll also discuss three legislative solutions to fix our broken system:
Key Points From Mitchell’s Testimony:
Patients For Affordable Drugs is a national patient organization focused exclusively on policies to lower prescription drug prices. We amplify the voices of Americans struggling under crushing drug prices to make policymakers and elected officials see the heavy toll of high-priced drugs. Patients For Affordable Drugs does not accept contributions from any organizations that profit from the development or distribution of prescription drugs.
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WASHINGTON, D.C. — On Tuesday, May 7 at 10:00 AM, Patients For Affordable Drugs Founder David Mitchell will testify before the Senate Judiciary Committee during a hearing on rising prescription drug prices.
Mitchell will discuss his journey as a patient with incurable blood cancer and will offer a number of solutions to lower drug prices. He will encourage bipartisan action to address this issue, including reforming the country’s patent laws, ending the days of monopoly pricing power without taxpayer negotiations, and forcing transparency from drug middlemen.
WHAT: Full Senate Judiciary Committee Hearing, “Intellectual Property and the Price of Prescription Drugs: Balancing Innovation and Competition”
WHEN: Tuesday, May 7 at 10:00 AM
WHERE: Dirksen Senate Office Building 226, or watch online
WITNESSES:
Joshua D. Barker, Director of the South Carolina Department of Health and Human Services
David Mitchell, President and Founder of Patients For Affordable Drugs
James Stansel, Executive Vice President and General Counsel of the Pharmaceutical Research and Manufacturers of America
Michael Carrier, Professor of law at Rutgers Law School
David S. Olson, Associate Professor at Boston College Law School
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WASHINGTON, D.C. — In response to the House Judiciary Committee passing a legislative package that would stop REMS abuses, curb anti-competitive pay-for-delay deals, address sham citizen petitions, and regulate PBM spread pricing, David Mitchell, a cancer patient and the founder of Patients For Affordable Drugs Now, issued the following statement:
“We are encouraged by continued Congressional action to address an array of abusive tactics Big Pharma uses to block competition and keep drug prices high. I am grateful to Chairman Nadler, Ranking Member Collins, and members on both sides of the aisle for their work on one of the most critical issues facing Americans — skyrocketing prescription drug prices.
“We still have a long way to go to fix our broken system and lower drug prices for all Americans. Today’s actions are a step forward, but certainly not the last. We are eager to work with Congress to continue down this path of reform.”
BACKGROUND:
Today’s hearing is the latest in a flurry of action on Capitol Hill to address what 8 in 10 Americans say is the “unreasonable” cost of prescription drugs. This year, the Senate Finance Committee, Senate Aging Committee, House Committee on Oversight and Reform, House Ways and Means Committee, and the House Energy and Commerce Committee have all held hearings or markups on the topic of skyrocketing drug prices. The latter two committees have both passed a bipartisan package of bills aimed at addressing Pharma abuses.
The topics included in today’s bipartisan-passed legislative package address:
REMS ABUSES: Brand drug companies use a safety program called Risk Evaluation and Mitigation Strategies (REMS) as a pretext for not selling drug samples to generic companies, which need the brand product in order to develop an equivalent and lower-priced competitor. The CREATES Act — part of today’s legislative package — would address delay tactics that are used by brand drug manufacturers to block lower-priced generic drugs. Taxpayers could save $3.9 billion by stopping this abuse, which the FDA has called “unfair and exploitative.”
PAY-FOR-DELAY: Brand drug companies pay off generic companies that plan to bring a competitor to market. In exchange for this payment, the generic manufacturer delays its product’s entry into the market and the companies share in the fruits of the extended monopoly. The Preserve Access to Affordable Generics and Biosimilars Act, passed by the Judiciary Committee today, would limit deals in which brand and generic drug manufacturers use anti-competitive pay-off agreements to delay cheaper generic and biosimilar drugs from reaching patients.
SHAM CITIZEN PETITIONS: Citizen petitions can be filed at the Food and Drug Administration requesting FDA action. But brand name drug makers filed 92 percent of all citizen petitions between 2011 and 2015 — all aimed at blocking cheaper generic drugs. The FDA denied more than 9 of every 10 of those petitions. Today, the Judiciary Committee took a step toward ending that abuse by passing the Stop STALLING Act.
PBM SPREAD PRICING: Pharmacy Benefit Managers, the drug pricing middlemen, rip off taxpayers and patients with a practice called spread pricing, in which PBMs retain the difference between what they bill insurers and employers and what they pay to pharmacies. States like West Virginia, Ohio, Arkansas, Connecticut, and Kentucky have already investigated or cracked down on spread pricing in state Medicaid programs. The Prescription Pricing for the People Act of 2019, passed by the Judiciary Committee today, would authorize the FTC to study reimbursement practices of PBMs and issue a report with policy recommendations.
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WASHINGTON, D.C. — Today’s congressional briefing featured a bipartisan panel of experts who agreed that International Reference Pricing can lower drug prices in the U.S. while maintaining innovation.
The speakers refuted drug companies’ unfounded claim that reference pricing will harm access or the development of new drugs. And the speakers explained how reference pricing is not price setting any more than the current system of ASP + 6 is price setting. Right now, Medicare sets prices based on a domestic reference price.
John O’Brien, Senior Advisor to the Secretary at the U.S. Department of Health and Human Services, noted that under HHS’ International Pricing Index, Medicare would receive a share of the discounts that drug companies voluntarily give to other countries, saving patients and Medicare $17 billion over the next five years while protecting innovation and access to medicine.
Rena Conti, Associate Professor at Boston University, argued that an International Pricing Index will lower drug prices, increase quality of treatment, and realign incentives for innovation that will lead to the breakthrough drugs we want.
Peter Bach, Director at the Center for Health Policy and Outcomes at Memorial Sloan-Kettering Cancer Center, focused on the fact that current incentives in Medicare Part B reward doctors for choosing higher-priced prescription drugs. He noted that innovative and effective drugs garner high prices in other countries. But drugs with competition or of limited value have lower prices. International reference pricing will reflect those market dynamics for this country.
Avik Roy, President of the Foundation for Research on Equal Opportunity, noted that there is no free market for drugs under Part B now. He explained how Medicare is required by law to pay for nearly all FDA-approved physician-administered drugs, regardless of a drug’s quality, price, or value. The IPIM as proposed by HHS would keep the coverage requirement in the US but peg prices to other nations that consider value and price.
David Mitchell, cancer patient and founder of Patients For Affordable Drugs Now,mentioned that there is no evidence the proposed HHS Part B demonstration or any current Congressional bills that utilize reference pricing would harm patient access to drugs, or hurt innovation.
BACKGROUND: How Reference Pricing Works
Right now, American taxpayers pay twice as much for prescription drugs as citizens in other wealthy nations. An International Pricing Index could bring American prices more in line with what other wealthy nations pay.
A Department of Health and Human Services Advanced Notice of Proposed Rulemaking as well as separate bills introduced by Senators Bernie Sanders, Jeff Merkley, Rick Scott, and Josh Hawley use International Reference Pricing as a tool to lower drug prices in the US while maintaining innovation and access.
Under an international reference price, Medicare would pay no more than a set percentage of the price other wealthy countries pay for certain prescription drugs.
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