Welcome to the Week in Review.
President Trump Announces Drug Reform Framework
Yesterday, the White House released a new healthcare framework – as Americans face the final days of ACA open enrollment and rising health care costs – that raised more questions than it answered. While the president called on Congress to codify most-favored-nation (MFN) pricing, a notable signal that durable drug price reforms do in fact require statutory authority if they are to have any long-term impact for patients, the framework offers little clarity on how MFN would be implemented, applied, or enforced. Significant questions also remain about the administration’s proposals on PBMs, over-the-counter access, and other drug pricing policies. Many of the ideas outlined would require congressional action to take effect, shifting the focus to lawmakers to determine whether and how these concepts become law. As this debate moves forward, we look forward to working with lawmakers to ensure any legislation delivers lasting savings for patients. — [White House]
New Year, New Price Hikes
Here’s what we know so far about pharma’s January price grab. With some early reporting suggesting that the total number of hikes may reach as many as 900, P4AD has analyzed at least 417 drug price increases, with an average hike of $297.29, or 5.03% per month. Exorbitantly priced cancer drugs like Breyanzi and Abecma experienced the largest hikes up an eyewatering $26,567.52 and $15,849.37, respectively. Notably, 83.7% of the increases exceeded inflation, a higher share than we observed at this point last year. Cancer drugs feature prominently in this round of hikes: the pediatric cancer drug Unituxin was hiked 9.9% per vial, and Trisenox, used to treat acute promyelocytic leukemia, was hiked 9.4% per vial. For patients and families facing life-or-death treatment decisions, these increases aren’t abstract – they reflect an industry that continues to raise prices simply because it can, with little restraint and no regard for patients’ ability to pay. — [NPR]
J.P. Morgan Healthcare Conference Takeaways
GLP-1 drugs dominated the JPMorgan Healthcare Conference, highlighting how central they’ve become to pharma’s growth strategy. Pfizer CEO Albert Bourla said that the company is “all in on obesity,” while Eli Lilly CEO David Ricks pointed to direct-to-consumer (DTC) programs as a key part of the industry’s future. Despite generating tens of billions in revenue while costing a few dollars to manufacture, GLP-1s remain dramatically overpriced in the U.S., with drugs like Ozempic priced up to 16 times higher than in other wealthy countries. While voluntary deals with the White House and DTC programs may offer limited relief for some patients, price cuts will reach a record number of people next January, when several GLP-1s are scheduled to see 71% reductions through Medicare negotiation. Elsewhere at the conference, Regeneron’s chief scientist declined to commit to a price for the company’s new hereditary deafness drug and brushed off their continued refusal to publicly come to the table on most-favored-nation. Along with AbbVie, Regeneron remains one of only two companies from President Trump’s 17 letters last summer that have yet to make a deal, though the company is reportedly currently in talks with the administration. — [CNBC, BioPharma Dive, Morning Brew, STAT News, Bloomberg]
ICYMI: On Monday, the New York Times published an obituary honoring David Mitchell, P4AD’s founder, who passed away two weeks ago today after a 15-year battle with multiple myeloma, a rare blood cancer. The obituary reflects on David’s pivotal role in reshaping the national conversation on drug pricing. You can also read additional coverage and a non-exhaustive list of tributes from friends and allies, highlighting the lasting impact of his leadership and advocacy.
New York Times: David Mitchell, Who Led Fight on Drug Prices, Dies at 75
[STAT News, Detroit News, POLITICO, Real Talk MS Podcast, The Cancer Letter][AARP, Protect Our Care, CxRSP, Families USA, Public Citizen, T1 International, Friends of Cancer Research, Initiative for Medicines, Access & Knowledge, John Arnold]
Patient Advocate Spotlight: Sheldon Armus
Condition: Blood clots
Drugs: Xarelto ($197 as of January 1st, over $500 before)
Background: Former high school science teacher and former pharmaceutical sales representative from Boynton Beach, FLIn His Words: “In 2014, one month into retirement, I underwent a quadruple cardiac bypass operation — a surgery that saved my life. However, the surgery, as well as my diabetes and cardiac conditions, left me taking seven drugs each day. All of these drugs keep me alive, and I’m very thankful for their existence. However, they are also a real financial burden. But last year, I reached my out-of-pocket cap in August, and all my prescriptions were free for the rest of the year. These reforms work!”
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Welcome to the Week in Review.
Remembering David Mitchell: A Distinguished Life In Service to Others
P4AD’s founder, David Mitchell, passed away on Friday, January 2nd, after a 15-year battle with multiple myeloma, a rare blood cancer. Confronted with drug prices exceeding $300,000 a year, David created Patients For Affordable Drugs in 2016 to ensure that patients would have a seat at the table in shaping the nation’s drug pricing policies. Without taking a single penny from the industry, he spent nearly a decade relentlessly committed to reforming the drug price system, making him one of the most trusted and influential voices in the nation on this issue. P4AD’s full statement from Board Chair Chuck Hurley’s is here. — [P4ADNow]
Medicare Negotiations’ Historic Start to 2026
January 1 marked a major milestone for U.S. prescription drug affordability, as lower negotiated prices took effect for the first time in Medicare’s history. Following two decades restricted by the “non-interference” clause that barred Medicare from negotiating prescription drug prices, the Medicare Drug Price Negotiation Program delivered lower prices on 10 of the most expensive and widely used medications. It’s a historic step that’s set to save taxpayers nearly $6 billion in 2026 alone, with the program estimated to prevent more than 656,967 premature deaths over the next decade by improving treatment adherence and access — a powerful indicator of what meaningful reform can deliver. Still, we know that the industry continues attempts to roll back this progress. The Office of the Solicitor General filed a brief last Friday urging the Supreme Court to reject a petition brought by AstraZeneca that challenged the constitutionality of the Medicare Negotiation Program. As a manufacturer with drugs included in both the first and second rounds of negotiation, AstraZeneca’s case reflects a broader industry effort to block implementation through the courts, even as patients begin benefiting from lower prices. — [P4AD, CIDSA, Healthcare Finance]
Initial Price Hikes Data Reaction
While Americans were ringing in the new year, drugmakers were up to business as usual: jacking up prices. Early reporting shows more than 350 hikes on brand-name drugs this month. The median increase of about 4% is meaningfully higher than the 2.7% inflation rate reported by the Bureau of Labor Statistics, continuing a long-running pattern of drug price hikes outpacing broader inflation. And while 4% may not sound like much, for high-priced rare disease drugs or cancer drugs that can mean additional thousands per treatment. Notably, several companies tied to the Trump administration’s recent voluntary pricing agreements — including Boehringer Ingelheim, GSK, Novartis, Pfizer, and Sanofi — appear prominently in this latest round of price hikes, with Pfizer alone raising prices on roughly 80 products. Crucially, those deals (of which details remain largely secret) cover only certain drugs and apply only when purchased through TrumpRx, a cash-only program, leaving list prices untouched and manufacturers free to raise prices across the rest of the market. This is an early snapshot of a pattern that plays out at least twice a year, and P4AD will release further analysis in the coming weeks. — [Reuters, BLS]
CMMI Models GLOBE & GUARD
In late December, the Center for Medicare & Medicaid Innovation (CMMI) announced two new mandatory payment models. The GLOBE model would apply to high-spending Medicare Part B drugs, while GUARD targets certain high-cost Part D drugs, both using international reference pricing to calculate enhanced inflation rebates for single-source products not subject to Medicare negotiation. Unlike the voluntary most-favored-nation (MFN) agreements between drugmakers and the Trump Administration — which apply only to select drugs and purchasing mechanisms — these models would require mandatory manufacturer participation and directly tie penalties to lower prices abroad. GLOBE is slated to begin later this calendar year, with GUARD launching in early 2027. GLOBE and GUARD are projected to reduce Medicare spending by a combined $27 billion over their five and nine-year respective timelines. However, CMS estimates that the GUARD model could also increase patient cost sharing and premiums, with rebates flowing to the government, not patients at the pharmacy counter. Other key questions also remain, including how these models may interfere with future rounds of Medicare negotiation. P4AD will submit comments on both models and will be closely monitoring their development. — [CMS, CMS, Federal Register, Pink Sheet]
ICYMI
TrumpRx, the administration’s proposed direct-to-consumer (DTC) drug platform, has not yet launched. While DTC programs can offer discounts that bypass intermediaries, their impact is limited: purchases are cash only, meaning they can’t be used with insurance and therefore don’t count towards deductibles. TrumpRx may help a narrow slice of consumers, but lasting affordability will require enforceable reforms that directly address drugmakers’ pricing power. We’ll be watching closely as the site launches to better understand how it operates and who ultimately benefits. — [TrumpRx]
Patient Advocate Spotlight: Tim C.
Background: AFIB and COPD
Drug: Eliquis ($700 to $800 every month) and Trelegy ($800 per month)
Background: Retiree from Chicago, Illinois
In His Words: “For folks that I know who are on fixed incomes like myself, it can make us take a hard look at the month’s budget to try to determine what needs to be either postponed or eliminated for the sake of contingencies that always seem to occur and are never accounted for in advance. These painfully high prescription costs seem to also occur concurrently with newly incurred and often unforeseen doctor and hospital charges which make it all that more difficult to divvy up a month’s fixed income without getting to situations where you start having to play catch up with one bill after another.”
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WASHINGTON, D.C. — Today, we honor the life, legacy, and friendship of David Mitchell – a tireless public health leader and the founder of Patients For Affordable Drugs – who died on Friday, January 2, 2026. Below is a statement from Chuck Hurley, David’s great friend and Board Chair of Patients For Affordable Drugs, reflecting on David’s extraordinary impact and the values that guided his life’s work.
“I was privileged to call David Mitchell a close friend for more than forty years, and to work alongside him on a number of his extraordinary public health initiatives. Throughout his life, David was guided by two great loves: his family – first and always – and public health.
Much of David’s work happened outside the spotlight, but its impact was profound. Time and again, he took on problems that had defied solutions and helped save lives most people will never know he touched. Because of his work, hundreds of thousands of American families are not missing a loved one at their table today.
Over the course of his career, David helped shape some of the most effective public health campaigns of our time, from the National Safe Kids Campaign to Click It or Ticket and the National Air Bag and Seat Belt Safety Campaign, to DaimlerChrysler’s Fit for a Kid initiative, and Mothers Against Drunk Driving’s Campaign to Eliminate Drunk Driving. No matter the issue, David brought the same approach: rigorous analysis and data, proven solutions, broad coalitions, and communications strong enough to turn public support into lasting change. I will deeply miss the lively conversations we shared on important issues and the wisdom and commitment he brought to the work.
In 2016, David launched what he regarded as the crown jewel of his public health work: Patients For Affordable Drugs. Confronted personally with an unjust drug pricing system that put lifesaving medicines out of reach for millions, David once again took on a powerful and entrenched industry. His goal was simple and audacious – to hold drug companies accountable for extreme, nonnegotiable prices that ignored patients’ ability to pay.
It was through Patients For Affordable Drugs that David stepped into the public eye, not because he sought attention, but because he felt a responsibility to speak up. He knew his personal story, combined with a lifetime of public health and communications experience, gave him a platform to challenge a system that had gone unchallenged for far too long. Under his leadership, P4AD became a trusted, bipartisan force for reform, centering patient voices in a debate long dominated by corporate interests and helping change the trajectory of drug pricing in this country.
David’s genius was not just in identifying public health problems, but in knowing how to solve them – and how to build the momentum needed to drive real solutions. Those of us who knew him and worked with him stand in awe of what he accomplished. David Mitchell lived a distinguished life in service to others, and the world is safer, fairer, and more humane because he was in it.
I look forward to continuing this work alongside Merith Basey as we carry forward David’s vision and honor his legacy through action.”
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Patients For Affordable Drugs Now is the only national, patient advocacy organization focused exclusively on policies to lower drug prices. We empower and mobilize patients and allies, hold accountable those in power, and fight to shape and achieve system-changing policies that make prescription drugs affordable for all people in the United States. P4ADNow is bipartisan and does not accept funding from organizations that profit from the development or distribution of prescription drugs. To learn more, visit: PatientsForAffordableDrugsNOW.org
Welcome to the Week in Review.
White House Announces Deals with Nine Pharmaceuticals Companies
This afternoon, the White House announced it has reached agreements with nine more pharmaceutical giants to lower the prices of certain prescription drugs for patients who purchase them directly, without insurance, through the administration’s new TrumpRx direct-to-consumer (DTC) program, expected to launch in January 2026. Steps to reduce drug prices for patients are welcomed, especially by patients who rely on one of the over-priced essential medicines named in today’s announcement, but voluntary agreements with drug companies — especially when key details remain undisclosed — are no substitute for durable, system-wide reforms. Further, we caution against any approach that encourages drug companies to raise prices for patients in other countries. Pharmaceutical corporations already generate massive profits in every country where they sell their products, and increasing drug prices internationally will do nothing for American patients. — [P4ADNow]
$16 Billion Sent to Cover Medicare Drug Spending
In the largest reconciliation payment since 2006, the federal government sent $16 billion to Medicare drug plans to cover higher-than-expected prescription drug spending. The surge reflects not only the growing use of high-cost cancer and GLP-1 drugs, but also the impact of the $2,000 out-of-pocket cap, which was introduced this year, and which ensures patients on Medicare never pay more than the out-of-pocket limit for their prescription drugs. The cap is a real win for patients — protecting people like Jackie from price spikes and financial hardship — but it doesn’t address the root cause of sky-high costs: the ability of pharmaceutical companies to set and raise prices at will. Drugmakers continue to raise list prices year after year, leaving Medicare and taxpayers to pick up the tab. Drugmakers continue to raise list prices year after year, leaving Medicare and taxpayers to pick up the tab. That’s why Medicare negotiation’s ability to target the underlying problem is so critical. It gives the government leverage to bring down drug list prices directly, establishing structural reforms that don’t merely shift costs around.— [STAT News, P4AD]
New AARP Report Extols Medicare Negotiation
Patients taking prescription drugs in the first round of Medicare negotiation are projected to see their out-of-pocket costs fall by an average of over 50% once the prices take effect on January 1, 2026, according to brand new analysis from AARP. The report also found that 7 of the 10 negotiated drugs are expected to cost patients under $100 per month in 2026, saving $1.5 billion in total patient out-of-pocket) spending next year alone. — [AARP]
P4AD Announces Retirement of Founder David Mitchell
This week, Patients For Affordable Drugs announced that Founder and President of the Board, David Mitchell, has retired. After his diagnosis with multiple myeloma and facing drug costs exceeding $300,000 a year, David founded Patients For Affordable Drugs in 2016 to ensure that patients would have a seat at the table in shaping the nation’s drug pricing policies. Today, the organization has grown into a community of half a million, and David’s relentless commitment to reforming the drug price system — without taking a penny from the industry — made him one of the most trusted and influential voices in the nation on this issue. — [P4AD]
ICYMI
P4AD CEO Merith Basey’s new op-ed in El Tiempo Latino celebrates the lower negotiated prices announced for the second round of Medicare negotiation — and what that means for patients in the Latino community in particular. The Latino community is 18% more likely to report being unable to afford healthcare costs and faces higher rates of illnesses such as diabetes and chronic liver disease, making outreach and education efforts in both English and Spanish critical. — [El Tiempo Latino]
Patient Advocate Spotlight: Jackie Trapp. P4AD Patient Advocate of the Year
Background: Multiple Myeloma, an incurable blood cancer
Drug: Revlimid ($180k / year before the $2k cap) and Xarelto
Background: Former high school teacher from Muskego, WI
From traveling to D.C. to meet with her lawmakers during our bipartisan Hill Day, to sharing her story in media interviews, to participating in a roundtable with HHS Secretary Kennedy and NIH Director Bhattacharya, Jackie has been at the forefront of patient advocacy in 2025. We’re proud to announce Jackie as our Patient Advocate of the Year!
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WASHINGTON, D.C. — The White House announced it has reached agreements with nine more pharmaceutical giants to lower the prices of certain prescription drugs for patients who purchase them directly, without insurance, through the administration’s new TrumpRx direct-to-consumer (DTC) program, expected to launch in January 2026.
Amgen, Bristol Myers Squibb, Boehringer Ingelheim, Genentech, Gilead Sciences, GSK, Merck, Novartis, and Sanofi have agreed to offer Most-Favored-Nation (MFN) prices on select medicines sold through the website and will provide state Medicaid programs access to MFN pricing on their products. The companies have also made an agreement to apply MFN prices to all new innovative medicines they bring to market, though the details of how this commitment will work, including any enforcement mechanisms, remain unclear.
The White House highlighted several examples of steep discounts that would apply through TrumpRx. These include Bristol Myers Squibb lowering the price of its HIV drug Reyataz from $1,449 to $217, Novartis reducing the price of its multiple sclerosis drug Mayzent from $9,987 to $1,137, and Boehringer Ingelheim cutting the price of its type 2 diabetes medication Jentadueto from $525 to $55, among others.
“When 47% of Americans are concerned they won’t be able to afford a health care cost next year, steps to reduce drug prices for patients are welcomed, especially by patients who rely on one of the over-priced essential medicines named in today’s announcement,” said Merith Basey, CEO of Patients For Affordable Drugs Now. “But voluntary agreements with drug companies — especially when key details remain undisclosed — are no substitute for durable, system-wide reforms. Patients are overwhelmingly calling on Congress to do more to lower prescription drug prices by holding Big Pharma accountable and addressing the root causes of high drug prices, because drugs don’t work if people can’t afford them.”
P4ADNow also cautions against any approach that encourages drug companies to raise prices for patients in other countries. Pharmaceutical corporations already generate massive profits in every country where they sell their products. Drug corporations set and raise prices in the U.S. because Congress allows it, and increasing prices internationally will do nothing to lower prices for American patients
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Patients For Affordable Drugs Now is the only national, patient advocacy organization focused exclusively on policies to lower drug prices. We empower and mobilize patients and allies, hold accountable those in power, and fight to shape and achieve system-changing policies that make prescription drugs affordable for all people in the United States. P4ADNow is bipartisan and does not accept funding from organizations that profit from the development or distribution of prescription drugs. To learn more, visit: PatientsForAffordableDrugsNOW.org
WASHINGTON, D.C. — Patients For Affordable Drugs has released the following statement on the retirement of its Founder and President of the Board, David Mitchell.
“After 15 years living with cancer and in continuous treatment, David Mitchell is stepping down as President of the Board and retiring from Patients For Affordable Drugs to focus on his health and family.
David was diagnosed with multiple myeloma, an incurable blood cancer, in 2010. Confronted with drug prices exceeding $300,000 a year, he founded Patients For Affordable Drugs in 2016 to ensure that patients would have a seat at the table in shaping the nation’s drug pricing policies. Today, the organization has grown into a community of half a million, with tens of thousands of patients having shared their stories and struggles with high drug prices.
For nearly a decade, David’s relentless commitment to reforming the drug price system – without taking a penny from the industry – made him one of the most trusted and influential voices in the nation on this issue.
David and other P4AD patient advocates played a pivotal role in advancing system-changing reforms and blocking numerous pharma-funded bills that would have harmed patients. Most critically, the drug price reforms in the Inflation Reduction Act – the most transformative piece of health legislation in decades – were passed in 2022, changing the trajectory of drug pricing in the United States. Across six Congresses and three administrations, both Democratic and Republican, David helped turn the tide against Big Pharma’s unchecked power.
As David takes time to focus on his family and ongoing fight against cancer, his legacy endures in the work ahead. While this marks the end of an extraordinary chapter, P4AD’s bipartisan community of patients and allies, led by a committed team, remains steadfast in carrying forward and building on David’s vision: a system in which every person in this country can get the medicines they need at prices they can afford.
To ensure a strong and seamless transition, Executive Director Merith Basey has been elevated to Chief Executive Officer, where she will continue to lead the organization’s mission and day-to-day work. In addition, two current board members, Charles Hurley and Robert Jones, will serve as the Chairs of the Patients For Affordable Drugs (C3) and Patients For Affordable Drugs Now (C4) boards, respectively. Over the next year, the board will be expanded to further strengthen governance and ensure continued momentum.
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Patients For Affordable Drugs Now is the only national, patient advocacy organization focused exclusively on policies to lower drug prices. We empower and mobilize patients and allies, hold accountable those in power, and fight to shape and achieve system-changing policies that make prescription drugs affordable for all people in the United States. P4ADNow is bipartisan and does not accept funding from organizations that profit from the development or distribution of prescription drugs. To learn more, visit: PatientsForAffordableDrugsNOW.org
Welcome to the Week in Review.
New MFN Deals Expected This Month
More most-favored-nation (MFN) drug pricing deals are expected this month, according to CMS Administrator Dr. Oz. Since the administration sent letters to 17 pharmaceutical companies in July demanding adherence to MFN pricing, only five — Pfizer, AstraZeneca, EMD Serono, Eli Lilly, and Novo Nordisk — have announced agreements. The Trump administration has used the threat of pharmaceutical tariffs to bring drugmakers to the table, but those tariffs have repeatedly been delayed. Months after the initial September deadline, the slow pace of new deals highlights the limits of voluntary, company-by-company agreements in securing broad price reductions. Despite the administration’s aggressive posture, most manufacturers have yet to engage — suggesting that without structural reform or enforcement mechanisms, pharma can continue to delay meaningful concessions while appearing cooperative. — [Washington Post, White House, Endpoints News, Truth Social, Reuters]
More Work Needed to Deliver Low-Cost Biosimilars
The FDA’s new draft guidance to accelerate biosimilar approvals is a promising step toward lowering drug costs, but experts say its potential impact is limited without broader reforms. The proposal, supported by P4AD, would remove unnecessary human trials, known as interchangeability studies, when advanced testing already shows that a biosimilar works the same as the brand-name drug and would make it easier for doctors and pharmacists to substitute lower-cost biosimilars, much like generic drugs. Still, barriers remain. Patent thickets, pay-for-delay agreements, and PBM practices continue to block or slow biosimilar entry, even years after approval. Biologics make up more than half of U.S. prescription drug spending, with biosimilars accounting for less than 20% of the market share. Biosimilars have generated $56 billion in savings since 2015, and expanding their use would unlock further savings for patients and for taxpayers. In interviews, experts noted that fixing these problems is critical to ensuring the FDA’s action translates into real affordability for patients. P4AD has been pushing for comprehensive bipartisan reform measures that would help close these loopholes and ensure faster access to affordable medicines for patients. — [Bloomberg Law, P4AD]
Patient Advocate Spotlight: Kevin Baker
Background: 22-year-old college student from Idaho living with Crohn’s disease
Drug: Rinvoq ($6,431)
In the words of his wife Janet:“I’ve lived with Crohn’s disease since I was 11. My current medication, Rinvoq, has a list price of $6,431, and past treatments like Remicade, Humira, and Stelara range from $1,100 to $14,000 per month before insurance. I believe life-saving medicine is a human right.”
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Welcome to the Week in Review.
Round 2 Medicare Negotiation Prices Announced
Last Tuesday, the Centers for Medicare and Medicaid Services (CMS) announced new lower prices for the second round of Medicare drug price negotiations. It’s a major milestone for the program that’s delivering continued savings for patients and taxpayers. Over 5 million patients on Medicare take one of the 15 drugs included in this round, which accounted for $42.5 billion in Medicare Part D spending from November 2023 to October 2024. The announced prices are consistent between both rounds, and according to CMS, Medicare savings will double to $12 billion in 2027, due in part to the inclusion of five additional drugs this round and significant discounts on high-cost GLP-1s. Patients on these 15 drugs have struggled to afford them for years — including patients in our community like Aarolyn from Michigan, and Janet from South Carolina. If these new prices had already been in effect in 2024, patients would have saved $685 million in out-of-pocket costs. For patients who’ve been forced to work multiple jobs, cut pills in half, or choose between filling a prescription and buying groceries, these lower prices will bring long-overdue relief, flexibility, and stability. — [CMS, P4AD, The Hill, CBS News, STAT News, Inside Health Policy, Healthcare Finance]
Entresto, Stelara, and Xarelto to be Removed from Negotiations
In another significant shift for the Medicare negotiation program, CMS announced that Entresto, Stelara and Xarelto will be removed in 2027 after determining that the drugs now face generic or biosimilar competition. These three drugs were included in round one of Medicare negotiations, and their lower negotiated prices will take effect in less than a month, meaning that these prices will be in place for only one year. Medicare negotiation was established as a check on pharma’s monopoly power, specifically targeting drugs that have evaded competition and kept Americans paying between 4 and 8 times more than patients in other high-income countries. One of the criteria for a drug to be included in the program is being single-source, meaning that the product doesn’t have generic or biosimilar versions available in the same class and therefore no bona fide competition on the market. While we don’t yet know the extent to which the new competition will lower the prices for these three drugs — the main concern for the patients who need them — incentivizing generic or biosimilar rivals to enter the market is a win that has historically lowered prices and benefited patients. — [CMS, Inside Health Policy, POLITICO]
Pharma Celebrates New U.S. & U.K. Deal
The U.K. has committed to increasing its spending on new drugs, entering an agreement with the U.S. after facing pressure from the Trump administration and potential pharmaceutical tariffs. The U.K’s National Institute for Health and Care Excellence (NICE) will increase its cost-effectiveness threshold by 25 percent to £35,000 per quality adjusted life year (QALY), meaning that the National Health Service (NHS) will pay more for medicines. This is a massive win for pharma, and predictably the industry’s lobbyists quickly responded by urging other European countries to mirror the agreement. Imposing higher prices on patients in other countries does nothing to reduce the burden on Americans who are forced to decide between paying rent and obtaining life-saving medications. Indeed, the Pharma CEOs that testified at a Senate Finance Committee hearing in 2019, confirmed under oath that they make a profit in every country where they sell their drugs. Hiking expenditures for the U.K. government only boosts the bottom line for one of the most profitable industries on the planet. — [POLITICO, STAT News, POLITICO]
ICYMI
Eli Lilly has officially hit $1 trillion in value — the first “healthcare” company to reach this milestone. Like nearly all pharmaceutical companies industry-wide, Eli Lilly has consistently complained that transformative programs like Medicare negotiation and reforms to rein in drug monopolies will force them to scale back innovation and R&D investment, preferring instead to promote voluntary, one-off agreements, like last month’s GLP-1 deal with the Trump administration. The news of Eli Lilly’s record-high valuation makes their arguments against lowering prices offensive, particularly when 1 in 3 Americans can’t afford the cost of their prescription drugs. — [New York Times, CNBC, Reuters, BioPharma Dive]
Patient Advocate Spotlight: Joe Kerrigan
Background: Patient advocate from Myrtle Beach, South Carolina
Drug: Janumet ($740 per 60-day supply)
In the words of his wife Janet: “Janumet is not just helpful — it’s necessary. But the cost is outrageous. Merck charges our insurance $740 for a 60-day supply. Even with coverage, we end up paying anywhere between $324 and $631, depending on which pharmacy we go to. That’s on top of our $185 monthly Medicare premium. My husband lives on $14,000 a year from Social Security – once we pay for his medicine, we have less than $10,000 left to live on for the year. We’ve come close to bankruptcy — not once, but multiple times — just trying to afford the medications that keep us alive.”
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