This Week in Drug Pricing: Projected Savings From Out-of-Pocket Cap, Rising Prices Of Cancer Therapies, Patient Advocates At HHS Roundtable, and ICYMI

Welcome to the Week in Review.

Projected Savings From Out-Of-Pocket Cap

Asthma and chronic obstructive pulmonary disease (COPD) disproportionately affects Black, Latino, and Native American communities, as a result of key social determinants of health – such as air pollution, limited access to care, and economic inequities. For many living with asthma, annual prescription drug costs can average up to $1,830 per person, forcing patients to choose between adhering to their treatment plans and affording other basic life necessities. In general, 30 percent of Black people and 42 percent of Latinos in the U.S. report not taking prescribed medication due to cost – driving higher rates of hospitalization and mortality for these communities. There is encouraging news however for some patients on Medicare with asthma and COPD who could see relief in January when the annual $2,000 out-of-pocket cap goes into effect. A new analysis published in the Journal of General Internal Medicine estimates that 360,000 patients on Medicare with asthma and/or COPD could save more than $1,000 per year, with total out-of-pocket savings exceeding half a billion dollars annually, helping to ease the financial burden that contributes to medication nonadherence and worse health outcomes. — (Asthma and Allergy Foundation of America, KFF, Politico, Journal of General Internal Medicine)

Rising Prices Of Cancer Therapies

Big Pharma’s exorbitantly high launch prices and consistent price gouging of cancer medications have reached unsustainable levels at the expense of patients. A new study in Nature reveals the staggering scale of this issue: in 2023, the U.S. spent $99 billion on cancer therapies, with projections soaring to $180 billion by 2028. Why is that? This surge is driven by two alarming trends: new cancer therapies are coming to market at astronomical prices, often exceeding $100,000 per treatment, and existing drugs are seeing perpetual price hikes that outpace the rate of inflation. And the consequences are dire for patients. The study highlights that 50 percent of older adults skip filling prescriptions for cancer therapy when their out-of-pocket expenses exceed $2,000. However, for cancer patients on Medicare, in 2025, the $2,000 cap on out-of-pocket costs mandated in the IRA is projected to save patients an average of $7,590 annually, with some patients saving up to $19,296. The Inflation Reduction Act, alongside critical reforms to our patent system, offer hope for more affordable cancer treatments in the future. — (Nature, P4AD, patientspushforcompetition.org)

P4AD Advocates Celebrate Relief At HHS Roundtable

From lower insulin costs to free vaccines, patients on Medicare are seeing benefits that will only continue to grow as the law is fully implemented. This was the theme of a virtual roundtable this week which included patient advocates, Department of Health and Human Services (HHS) Secretary Xavier Becerra, and Centers for Medicare & Medicaid (CMS) Director Dr. Meena Seshamani. P4AD founder and cancer patient David Mitchell shared how the cap on out-of-pocket costs has already saved him more than $13,000 this year. “The IRA is delivering lower prices, lower out-of-pocket costs, steady or lower premiums and all the while maintaining a strong innovation pipeline,” shared David at the virtual roundtable. “It’s a big win for me and millions of other patients like me.” Lisa McRipley, a patient advocate who lives with multiple sclerosis (MS), expressed the relief she felt knowing that next year, the annual out-of-pocket cap will save her up to $6,000. Patient advocates played a critical role in the passage of the IRA in 2022 and remain on the frontlines of ensuring its successful implementation, and educating the public on the historic drug prices reforms.

ICYMI

CMS unveiled a preliminary list of 101 generic prescription drugs for which the agency expects to cap monthly prices at $2. The drug list, which is part of a voluntary model proposal, includes common drugs for cholesterol, high blood pressure, and other chronic conditions. Serving as a companion to the drug price reforms in the IRA, this initiative would stabilize prices of widely-used generic medicines, curb rationing, and increase medication adherence.

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Welcome to the Week in Review.

CMS Guidance On 2nd Round Of Medicare Negotiation

The next round of the Medicare drug price negotiations has been designed to be more patient-centered, according to the Centers for Medicare & Medicaid Services (CMS). The next 15 drugs selected for negotiation will be released by February 1, 2025, with negotiated prices taking effect in 2027. Key elements of the new guidance include:

• Up to 15 roundtable events, as well as one town hall meeting, with patients on Medicare who use one of the 15 drugs selected.
• Revision of the negotiation timeline to allow for more back-and-forth between CMS and drug companies.
• A CMS review of drug company data and alternative treatments when determining price.
• A new system to help pharmacies and drug companies share pricing information easily.
• Drug companies will be required to follow specific guidelines to make negotiated prices available to eligible patients and pharmacies.

Last year, P4AD patient advocates participated in CMS listening sessions to share their experiences with high drug prices. Their testimonies were a crucial counterweight to pharma representatives who infiltrated the sessions with industry talking points. Along with other stakeholders, P4AD submitted comments on draft guidance for the inaugural round of Medicare negotiation, contributing to the chorus of patient voices that influenced these positive changes. We applaud CMS for including patient perspectives in this critical process and ensuring that the program truly serves the needs of those who are most harmed by high drug prices. — (CMS, Fierce Healthcare)

Medicinas Vitales, No Lujos

The high cost of prescription drugs for Latino communities takes center stage in a new P4AD ad campaign developed by Espacio, a creative collective out of El Tiempo Latino. The campaign, entirely in Spanish, is titled “Medicinas Vitales, No Lujos,” (Essential Medicines, Not Luxuries) and underscores the urgent need for reforms to lower the price of critical medicines, such as inhalers and chemotherapy drugs, used to treat chronic illnesses that disproportionately affect Latinos. The ads also draw attention to lawsuits from the pharmaceutical industry and its allies aiming to undermine the historic Medicare negotiation program. Our recent report highlighted that Latinos are more likely to require prescription medications for chronic illnesses — such as diabetes, high blood pressure, and cancer — and as a result of high drug prices set by pharma, 42 percent of Latinos report not taking their medications as prescribed due to cost. These shocking disparities are the catalyst behind the ad campaign to mobilize Latino communities to share their experiences with high drug prices and demand reforms to ensure patients can access life-saving treatments at affordable prices. The campaign includes a series of videos and digital print ads. — (El Tiempo Latino, P4AD, El Tiempo Latino)

Big Pharma CEOs Rake In Cash

Big Pharma executives continue to line their pockets as one in three Americans report difficulty affording their medicines. According to a new STAT News analysis, in 2023, health care industry CEOs averaged $11 million in annual compensation, with the median pay hitting $4.1 million – a staggering 51 times the median American household income. Topping the list, Moderna CEO Stephane Bancel, whose company amassed its huge fortune from taxpayer-invested COVID-19 vaccines, pocketed a whopping $305 million last year, which included salary, bonuses, vested stock, and other perks. And ranking among the top ten highest-paid industry executives, Eli Lilly CEO David Ricks took home an executive pay package of $73.9 million. These outrageous executive payouts are undoubtedly boosted by taxpayers who fund early development of blockbuster drugs. It’s a vicious cycle: taxpayers fund early drug development, then American patients pay inflated prices for years, all the while Big Pharma executives rake in millions of dollars in compensation.  — (KFF, STAT)

ICYMI

In a new video, P4AD’s Merith Basey illustrates how Big Pharma games the patent system to block competition and keep prices high, and how we can curb these abuses and lower drug costs. Watch here. 

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Welcome to the Week in Review.

Price Hikes Harm Black & Latino Communities

On Thursday, Patients For Affordable Drugs released a new report – based on drug price data released in July – that exposes Big Pharma’s excessive price hikes this year and details how price increases disproportionately harm Black and Latino patients. This year, big drug companies raised prices on over 1,000 essential medicines, half of which outpaced the rate of inflation. Our analysis sheds light on five cancer medications with significant price hikes in July, four of which had already been hiked in January. These medications are used to treat certain kinds of cancers like multiple myeloma, breast cancer, and prostate cancer, which disproportionately affect Black and Latino patients. “Black and Latino families are more likely to suffer from chronic conditions and certain cancers … that do require those long-term, very expensive drugs,” P4AD’s Executive Director Merith Basey told NBC BLK for their coverage of the report. “A lot of that is also linked to racial disparities in health care that have been well documented due to systemic racism.” Nearly half of Latinos and one-third of Black Americans aged 65 or older report not taking their prescribed medications due to cost, underscoring the urgent need for comprehensive drug pricing reform to address exorbitant prices, curb patent abuses, and promote affordable access to life-saving medications for all communities. — (P4AD, Black Enterprise, Rolling Out, NBC BLK, ASPE)

Senate HELP Hearing With Novo Nordisk CEO

At a hearing this week, the Senate Health, Education, Labor, and Pension (HELP) Committee grilled Novo Nordisk CEO Lars Jørgensen on the outrageous U.S. list prices set by the company for widely-used GLP-1s; Ozempic and Wegovy. In the U.S., Ozempic and Wegovy carry monthly list prices of $969 and $1,394 respectively, which is significantly higher than in other countries including Germany where the drugs carry $59 and $92 monthly list prices respectively. When confronted with questions about the company’s pricing practices, Jørgensen shifted the blame onto pharmacy benefit managers (PBMs), claiming the middlemen demand high rebates for favorable coverage. However, Committee Chairman Bernie Sanders shared that top pharmacy benefit managers recently pledged to not limit coverage of Ozempic and Wegovy if Novo Nordisk chose to lower the price of these treatments. This was the second time Jørgensen had testified before the committee about the company’s monopolistic pricing practices. In May 2023, Jorgensen testified alongside CEOs from Eli Lilly and Sanofi about insulin pricing practices. Holding drug manufacturers as well as PBMs accountable for actions that drive up drug prices and limit access to breakthrough medicines must remain a top priority for Congress. Innovation is worthless if patients can’t access it due to high cost. — (Endpoints, Reuters, Senate HELP Committee)

Competition Delivers Long-Awaited Relief

Robust competition within the prescription drug market continues to be the primary factor driving down drug prices. P4AD’s Lisa Ann Trainor, featured this week in Tradeoffs and STAT News, illustrated how increased competition and affordable generic medicines have helped millions of patients like herself gain access to treatments they need. In 2018, after years of living with a chronic illness, Lisa finally found Vyvanse, a drug that for the first time, was able to effectively manage her attention-deficit/hyperactivity disorder (ADHD). But two years later due to a change in insurance coverage, Lisa was forced to pay nearly $1,000 out-of-pocket for her Vyvanse — a drug with no generic alternative at the time. Overnight, Lisa’s “life-changing treatment” was priced out of reach for nearly three years until last summer when the Food and Drug Administration (FDA) finally approved a generic version of Vyvanse that she could afford. Patients like Lisa are the bedrock of P4AD advocacy efforts to ensure generic versions of drugs become available sooner to drive down prices and bring essential medicines within reach. — (Tradeoffs, STAT, patientspushforcompetition.org)

ICYMI

On 60 Minutes last week, Federal Trade Commission (FTC) Chair Lina Khan highlighted Big Pharma’s exploitation of our patent and regulatory systems which blocks competition and extends its monopoly pricing power. Khan broke down pharma’s anti-competitive tactics to Lesly Stahl, succinctly explaining how they patent every aspect of asthma inhalers as an example, without making any change to the active ingredients in the formula. Watch here.

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Welcome to the Week in Review.

Spotlight On Costly GLP-1s

The astronomical prices for blockbuster GLP-1 medications Ozempic and Wegovy have ignited a fierce debate over patient access and affordability. With monthly list prices in the U.S. of $969 and $1,394 respectively, these drugs manufactured by Novo Nordisk have become poster children for the pharmaceutical industry’s contentious pricing practices. While these treatments carry outrageous prices, with roughly half of patients reporting difficulty affording them, Ozempic could in fact be manufactured for less than $5 per monthly injection, and Novo Nordisk would still make a profit on the drug. In addition, there are growing concerns around the financial burden being placed on our health care system and on taxpayers. Medicare spending on GLP-1s skyrocketed to $5.7 billion for Ozempic, Wegovy, and Mounjaro in 2022 , up from $57 million in 2018. Lawmakers have called on Novo Nordisk CEO Lars Fruergaard Jørgensen to testify before the Senate Health, Education, Labor & Pensions (HELP) Committee on September 24th to respond to concerns about these pricing practices. Ozempic may also be one of 15 additional drugs selected for the second round of Medicare drug price negotiation — which will be announced by February 1, 2025 — due to its high cost and lack of competition. — (NBC News, CNBC, KFF, KFF, Reuters, Senate HELP Committee)

P4AD Advocates Take Action

P4AD patient advocates from across the country took action this week to push for comprehensive patent reforms and spread the word about how the historic drug price law is lowering costs.P4AD patient advocates met with legislators from both sides of the aisle to urge them to pass bipartisan legislation aimed at curbing pharma’s abuse of our patent system. Flying in from Wisconsin, South Carolina, Massachusetts, Kentucky, and Colorado, the advocates shared their experiences with high drug prices with their representatives and explained how the passage of these bipartisan bills would ensure more timely entry of generic and biosimilar competition to lower drug prices.  Judy Aiken, a retired nurse from Portland, Maine who lives with psoriatic arthritis and psoriasis, testified before the Senate Finance Committee at a hearing about the relief being delivered to patients through the Inflation Reduction Act. Judy shared how the out-of-pocket cap saved her nearly $6,000 in 2024 and that her Enbrel will see a 67 percent reduction in price in 2026 thanks to Medicare negotiation. Lisa McRipley, a patient advocate from Richmond, Texas who lives with multiple sclerosis and Jackie Trapp, a retired educator from Muskego, Wisconsin who lives with multiple myeloma, both participated in White House events this week and shared how the IRA has significantly reduced the financial burden of their prescription drugs. Lisa shared with President Biden how the out-of-pocket cap will save her $6,000 next year, and during a panel focused on Women and Aging, Jackie shared that her out-of-pocket costs are now capped at about $3,300, after years of spending up to $21,000 annually for her Revlimid medication alone. 

FTC Takes On PBM Industry

Yesterday, the Federal Trade Commission (FTC) filed a lawsuit against the big three pharmacy benefit managers (PBMs) — CVS Caremark, Cigna’s Express Scripts, and United Health’s Optum Rx — for engaging in anticompetitive practices that “artificially inflated” list prices of insulin and blocked patient access to life-saving treatments. Earlier this week, Express Scripts filed a lawsuit against the FTC for claims made in the agency’s “scathing report” on the opaque practices of PBMs. Released in July, the report underscored some of the shady practices of the highly consolidated PBM industry and exposed the middlemen’s outsized influence on patient access and affordability of essential medicines. During the aforementioned Senate Finance Committee hearing this week, members across the political spectrum, including Chairman Ron Wyden and Senator Lankford as well as several other members of the committee, called for reforming the middlemen’s practices. P4AD and legislators on both sides of the aisle agree that we urgently need to increase PBM transparency to help shed light on what is going on behind the curtain and to better ensure that savings are passing on to patients. — (Fierce Healthcare, Axios, The New York Times, Senate Finance Committee)

Court Watch: US v. Pharma

Yesterday, P4AD filed an amicus brief in the Third Circuit Court of Appeals in lawsuits brought by Bristol Myers Squibb (BMS), Janssen, and AstraZeneca. The brief incorporates the stories of several patients on Medicare who have struggled to afford their medications due to high cost and highlights how lower negotiated prices will make their drugs more affordable. It also counters pharma’s misleading claims about the Inflation Reduction Act, explaining how Medicare negotiation fosters innovation while expanding patient access to life-saving treatments. Additionally, the brief pushes back against industry-funded groups that falsely claim to represent patients, exposing their role in preserving pharma’s monopoly pricing. Earlier this week, the Department of Health and Human Services (HHS) filed an opposition brief in the cases brought by BMS and Janssen, underscoring the voluntary nature of Medicare negotiations. Oral arguments will be presented in all three cases on October 28th. Despite the drug industry’s seven failed attempts to block Medicare negotiations in court, patients remain vigilant, continuing to defend the law both in the courtroom and in public advocacy efforts. — (P4AD, Bloomberg Law, O’Neill Institute, FightPharma.org)

ICYMI

On Thursday, the Senate Judiciary Committee was scheduled to mark up two controversial bills, S. 2220 (PREVAIL Act) and S. 2140 (Patent Eligibility Restoration Act). If enacted, these bills would make it easier for drug companies to secure undeserved patents and take away a key mechanism to challenge invalid patents that should have never been granted — meaning that pharma could more readily quash competition and continue charging high prices. Last week, P4AD sent a letter to members of the Senate Judiciary Committee to urge them to vote no on these bills. The markup for these two bills has been rescheduled for next Thursday, September 26th. P4AD remains committed to stopping any industry attempts to exploit the patent system and extend monopoly pricing power.

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Retired Nurse Judy Aiken Highlighted Her Lived-Experience With High Drug Prices, Shared How The Out-of-Pocket Cap And Medicare Negotiation Feels Like A “Lifeline”

WASHINGTON, D.C. — Judy Aiken, a retired nurse and P4ADNOW patient advocate from Portland, Maine testified today before the Senate Finance Committee at a hearing titled “Lower Health Care Costs for Americans: Understanding the Benefits of the Inflation Reduction Act” about the relief being delivered to patients via the drug price reforms in the historic Inflation Reduction Act. 
 
Judy, who has battled psoriatic arthritis and psoriasis for over four decades, emphasized how the drug price law has already reined in her soaring out-of-pocket costs; Prior to the passage of the Inflation Reduction Act, Judy paid more than $9,000 out-of-pocket in a single year for Enbrel alone.The Inflation Reduction Act’s out-of-pocket cap reduced her prescription drug costs to about $3,300 in 2024 — nearly a third of what she paid last year. In 2025, her annual out-of-pocket expenses will be capped at $2,000.Judy also highlighted the additional relief she will experience beginning in 2026 thanks to the historic Medicare negotiation program, which for the first time in two decades allows Medicare to negotiate some of the costliest and most common drugs covered by Medicare; Enbrel, one of her prescribed medications, is among the first 10 drugs selected for negotiation.Starting in 2026, Enbrel’s negotiated price will be $2,355 per month, a 67 percent reduction from its current monthly list price.As someone who has worked as a nurse for four decades, Judy knows firsthand the importance of adhering to a consistent medication regimen. “But the cruel irony is that I’ve sometimes found myself skipping doses, unable to follow my own advice due to the prohibitive cost,” Judy shared in her testimony. 
 
But now, the drug price reforms are lessening the financial strain of high-cost prescription drugs for millions of patients like Judy. She also shared that, “The impact of these changes cannot be overstated. My husband and I can now breathe easier. We’re addressing those long-postponed home repairs. And we may even be able to take a trip. But most importantly, I no longer have to choose between my health and our financial stability.
 
This is the real, tangible impact of the Inflation Reduction Act. It’s not just about numbers on a page or political talking points. It’s about people – seniors like me, who have worked hard their whole lives, and who can now afford the medications we need to live healthier, more productive lives with dignity.”

FIND JUDY’S FULL TESTIMONY BELOW: 
 
Chairman Wyden, Ranking Member Crapo, Committee Members
 
Thank you for inviting me to share my story today.
 
I’m Judy Aiken – a 70-year-old retired nurse, born and raised in Portland, Maine, where I live with my husband of 47 years.
 
I have been battling psoriatic arthritis and psoriasis for over four decades. These conditions have taken a heavy toll on my body, but the financial strain of the medications I need has been equally challenging.
 
Seventeen years ago, my doctor prescribed Enbrel to manage my condition. It’s been a lifeline, but one with a staggering price tag. Since its introduction 26 years ago, Enbrel’s price has skyrocketed by more than 700 percent. Today, it is priced at $7,106 for a 30-day supply.
 
Last year alone, I paid over $9,000 out-of-pocket just for this one medication. The cost was overwhelming. As a nurse, I spent years counseling patients on the importance of taking their medications consistently. But the cruel irony is that I’ve sometimes found myself skipping doses, unable to follow my own advice due to the prohibitive cost.
 
Every trip to the pharmacy was a source of anxiety. How much would it cost this time? Could we afford it? What else would we have to sacrifice? My husband and I were constantly juggling our budget – we postponed home repairs and stopped going out to eat. 
 
Then came the Inflation Reduction Act, and with it, a glimmer of hope.
 
This year, I braced for another 12 months of expensive pharmacy visits. But after paying $2,150 in January and $1,141 in February, a real shock came in March. I went to pick up my prescription and discovered my out-of-pocket cost would be $0 for the rest of the year. I nearly cried at the pharmacy counter. Even after advocating for the passage of the drug price reforms in the Inflation Reduction Act, I was skeptical it would actually benefit me. But it has, and this year my out-of-pocket costs have been capped at $3,300. 
 
And there’s more relief on the horizon. Next year, the out-of-pocket limit will drop further, capping at $2,000 for everyone on Medicare Part D. For patients like me who rely on expensive medications, this is truly life-changing.
 
But that’s not the only IRA provision that I will benefit from. Enbrel was one of the first 10 drugs selected for Medicare price negotiation. After the inaugural round of negotiated prices were released in August, I learned that beginning in 2026, Enbrel’s price will be reduced to $2,355 per month – a 67 percent reduction. 
 
These lower negotiated prices come after decades of advocacy from patients like me and represent the first time in Medicare’s history that the program has directly negotiated drug prices with pharmaceutical corporations. These 10 drugs cover treatments for common conditions such as diabetes, heart disease, and blood clots, and the roughly nine million patients on Medicare who take at least one of these drugs are projected to save $1.5 billion out of pocket in 2026 alone. 
 
It’s important to note that the out-of-pocket savings are made possible by lowering the prices. We cannot do one without the other.
 
The impact of these changes cannot be overstated. My husband and I can now breathe easier. We’re addressing those long-postponed home repairs. And we may even be able to take a trip. But most importantly, I no longer have to choose between my health and our financial stability.
 
This is the real, tangible impact of the Inflation Reduction Act. It’s not just about numbers on a page or political talking points. It’s about people – seniors like me, who have worked hard their whole lives, and who can now afford the medications we need to live healthier, more productive lives with dignity.
 
The IRA demonstrates that when our elected leaders take action, real change is possible. While there’s still work to be done to make prescription drugs affordable for all Americans, this is a huge step in the right direction.
 
I urge you to continue supporting and strengthening these life-saving reforms. They are making a real difference in the lives of millions of American patients.
 
Thank you for your time and attention to this crucial issue. I look forward to answering your questions.

###

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.

Retired Nurse Judy Aiken Highlighted Her Lived-Experience With High Drug Prices, Shared How The Out-of-Pocket Cap And Medicare Negotiation Feels Like A “Lifeline”

Welcome to the Week in Review.

P4ADNow Six-Figure Ad Campaign

P4ADNow has launched a six figure ad campaign featuring patients urging legislators to pass a package of bipartisan bills to reform our patent system and lower drug prices. These ads are part of our “Push For Competition To Lower Drug Prices” to advance key legislation in both the House and Senate. The bills include:

• In the House: H.R. 6986 to address patent thickets; H.R. 9070, the Affordable Prescriptions for Patients Act; H.R. 1717, the Interagency Patent Coordination and Improvement Act; and, H.R. 5429, the Medication Affordability and Patent Integrity Act.
• In the Senate: S. 142, to ban pay-for-delay agreements; S. 148 and S. 1067, to reform the citizen petition process; and S. 79 to establish a task force between USPTO and FDA in order to improve communication in the implementation of each agency’s patent-related activities.

The Senate has already unanimously passed an amended version of S.150, which would address patent thickets, signaling a growing appetite from legislators on both sides of the aisle to reform the patent system. Collectively, these Senate bills are estimated to save taxpayers $4.5 billion over the next 10 years. Building on this momentum and to continue pushing for additional bills, P4ADNow and other organizations are planning lobby days on The Hill over the coming weeks. 
 
Big Pharma and its allies are simultaneously pushing harmful patent legislation, including S. 2220 (PREVAIL Act) and S. 2140 (Patent Eligibility Restoration Act). On Wednesday, we sent a letter to members of the Senate Judiciary Committee to urge them to vote NO on these bills which would hurt patients. We will continue in our efforts to protect patients and ensure that they are prioritized over industry profits. With growing bipartisan support and patient voices leading this effort, we’re closer than ever to achieving meaningful patent reform. — (Inside Health Policy)

Court Watch: US v. Pharma

Yesterday, P4AD filed an amicus brief in the Third Circuit Court of Appeals in lawsuits brought by Bristol Myers Squibb (BMS), Janssen, and AstraZeneca. The brief incorporates the stories of several patients on Medicare who have struggled to afford their medications due to high cost and highlights how lower negotiated prices will make their drugs more affordable. It also counters pharma’s misleading claims about the Inflation Reduction Act, explaining how Medicare negotiation fosters innovation while expanding patient access to life-saving treatments. Additionally, the brief pushes back against industry-funded groups that falsely claim to represent patients, exposing their role in preserving pharma’s monopoly pricing. Earlier this week, the Department of Health and Human Services (HHS) filed an opposition brief in the cases brought by BMS and Janssen, underscoring the voluntary nature of Medicare negotiations. Oral arguments will be presented in all three cases on October 28th. Despite the drug industry’s seven failed attempts to block Medicare negotiations in court, patients remain vigilant, continuing to defend the law both in the courtroom and in public advocacy efforts. — (P4AD, Bloomberg Law, O’Neill Institute, FightPharma.org)

Out-Of-Pocket Cap Delivers Savings

The Inflation Reduction Act’s annual cap on out-of-pocket costs has already delivered substantial cost savings for patients living with cancer. A University of Michigan study published in JAMA found that the average median cost savings for patients on Medicare Part D taking oral cancer medications, as a result of the out-of-pocket cap, is estimated to be more than $7,000 in 2024. Patients with cancer routinely face steep out-of-pocket costs, upwards of $10,000 a year for their medications. For almost a decade, Jackie Trapp paid over $15,000 annually for her cancer medication Revlimid, but this year because of the IRA her costs were capped at $3,300. The IRA is a victory for patients faced with expensive prescription drugs and we look forward to further savings for patients next year when the cap is further reduced to $2,000. — (MedicalXpress, JAMA, P4AD) 

ICYMI

Reforms to lower drug prices continue to have broad bipartisan support from voters. New polling from Navigator Research reveals that 86 percent of Americans support expanding Medicare’s authority to negotiate for lower drug prices and 82 percent support capping the price of insulin at $35 a month, viewing these measures as an essential step towards delivering relief to American families. 

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Patients For Affordable Drugs NOW Steps Up Push For Competition to Lower Drug Prices Including Six-Figure Ad Campaign 

Ads, Letters, Lobby Day in Coming Weeks Urge Congress To Pass Bills To Boost Competition and Reform Patent Law To Lower Drug Prices

 WASHINGTON, D.C. —  Patients For Affordable Drugs Now (P4ADNow) has launched a six-figure ad campaign to urge Congress to pass a package of bipartisan bills that crack down on the drug industry’s anti-competitive practices in order to lower prescription drug prices for patients. The ads are the latest effort in P4ADNow’s continued “Push For Competition To Lower Drug Prices”, focusing on reforming patent laws and closing regulatory loopholes to promote generic and biosimilar competition and curbing anti-competitive tactics that allow drug companies to keep prices high by extending unwarranted monopolies on life-saving medications.

The campaign, which includes a combination of video, audio, and static ads, are running on digital and social media platforms and features Lisa McRipley, a patient with multiple sclerosis (MS), whose vital medications have a price of nearly $7,500 each month, and Jacqueline Garibay, a patient who lives with ankylosing spondylitis, an autoimmune disorder, and has had to go without her medication at times because of the $6,000 per month cost. View Lisa’s ad here. 

“Patients like Lisa and Jacqueline are struggling to afford the medications they depend on because drug companies have been manipulating the patent system for decades to maintain their monopoly power and keep prices high,” said Merith Basey, Executive Director of Patients For Affordable Drugs Now. “Legislators can act during this Congress to pass this package of bipartisan legislation to increase competition and curb pharma’s abusive practices to ensure that affordable generics and biosimilars can enter the market, lower prices, and begin to bring overdue relief to patients.

“Lowering drug prices isn’t just a policy priority – it’s a public mandate. Patients, consumers, and taxpayers are calling for action – with 9 in 10 voters saying Congress should prioritize policies to lower drug prices. Congress has the power and the bipartisan support to pass these competition bills and make medications more affordable for all Americans. It’s high time we curb drug companies’ abusive practices – Congress can get it done this year.”

Anti-competitive practices in the pharmaceutical industry including patent thicketing, pay-for-delay agreements, and product hopping, have led to inflated drug prices, costing patients and taxpayers billions. When generic or biosimilar versions enter the market, prices can fall dramatically – by nearly 40 percent when there is one additional competitor and 85-95 percent when there are six or more competitors.

In 2023, the Senate Judiciary Committee unanimously passed several bipartisan bills to improve competition in the prescription drug market and in July this year, the Senate unanimously passed the amended Affordable Prescriptions for Patients Act of 2023 (S.150) – which targeted the pharmaceutical industry’s use of patent thickets.

The House now has the chance to build on that momentum. By advancing additional bipartisan competition bills, including H.R. 9070 and H.R. 6986, Congress can bring relief to patients like Lisa, Jacqueline, and millions of others burdened by excessive drug costs. These bills are projected to save taxpayers more than $4.5 billion over the next ten years.

BACKGROUND

• P4AD is urging action on the following bipartisan bills in the House: H.R. 6986 to address patent thickets; H.R. 9070, the Affordable Prescriptions for Patients Act; H.R. 1717, the Interagency Patent Coordination and Improvement Act; and, H.R. 5429, the Medication Affordability and Patent Integrity Act.

• P4AD is urging action on the following bipartisan bills in the Senate: S. 142, to ban pay-for-delay agreements; S. 148 and S. 1067, to reform the citizen petition process; and S. 79 to establish a task force between USPTO and FDA in order to improve communication in the implementation of each agency’s patent-related activities. 
  • Last week, a group of national organizations representing patients, seniors, and employers sent a letter to members of the House Judiciary Committee calling for urgent action on these bills. The letter was signed by Patients for Affordable Drugs Now, AARP, the Campaign for Sustainable Rx Pricing (CSRxP), the ERISA Industry Committee, the Purchaser Business Group on Health, and the National Multiple Sclerosis (MS) Society. 

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Patients for Affordable Drugs NOW, is the only national, bipartisan 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 does not accept funding from organizations that profit from the development or distribution of prescription drugs. To learn more visit PatientsForAffordableDrugsNOW.org.