Implementation of the drug price reforms in the Inflation Reduction Act continues as the Biden administration, health care advocacy groups, and elected officials share how the law is delivering long-sought relief to patients. At a Department of Health and Human Services (HHS) roundtable, HHS Secretary Xavier Becerra and health care advocacy groups discussed how they can better educate consumers on the new reforms for patients on Medicare. Becerra emphasized the critical role these groups play in educating patients about the provisions that have already taken effect — capping insulin copays at $35 a month, and, for the first time, making all vaccines free. Pennsylvania Lieutenant Governor Austin Davis shared remarks at Protect Our Care’s tour stop about how the reforms make essential medications more affordable: “This is an issue that affects real Pennsylvanians. It’s really important because the insulin and prescriptions are just outrageous right now. So, they need to have a break. I mean, myself alone, when I go for one medication, it’s $400. They cannot afford $400.” Finally, patients are seeing lower drug prices from the historic new law — and we’re eagerly awaiting the relief to continue as the other provisions are implemented in the future. — (HHS, WGAL)
2. Medicare Negotiations Are Crucial For Patients
The Inflation Reduction Act’s Medicare Drug Price Negotiation Program will allow Medicare to negotiate lower prices on expensive, widely-used medications and undoubtedly bring savings to millions of patients. “It means that, for the first time, there will be an ability to have a little bit of counterweight to the pharmaceutical industry,” Andrea Ducas, Vice President of health policy at the Center For American Progress, told Fortune. When lower negotiated drug prices arrive in 2026 they will be monumental for patients on Medicare including those taking cancer drugs, blood thinners, autoimmune disease treatments, and some diabetes drugs. Last year, Bristol Myers Squibb blood thinner Eliquis, one of the drugs selected for the first round of Medicare negotiations, made “$11.8 billion in revenue…about 25% of the company’s $46 billion in total revenue in 2022.” C. Joseph Ross Daval and Aaron S. Kesselheim, drug price experts at the Program on Regulation, Therapeutics and Law (PORTAL) at Brigham & Women’s Hospital and Harvard Medical School, penned an op-ed in the Washington Post that debunks the claims made in recent lawsuits by pharmaceutical corporations to stop Medicare negotiations. The drug industry is trying to “achieve what it could not through the legislative process — maintaining unreasonably high brand-name drug prices at the expense of the American public.” wrote Daval and Kesselheim. Medicare negotiation will deliver relief to patients who have been forced to pay high drug prices and we won’t back down in our fight to ensure the successful implementation of this historic reform. — (Fortune, Accountable.US, The Washington Post)
3. Big Pharma Puts Profits Over Patients
While Big Pharma loves to shed crocodile tears about drug price reforms hurting their revenue stream, it turns out that actually — they are doing more than fine. In fact, they are exceeding expectations on profit margins and doubling down on lobbying efforts. This week, Novartis raised its full-year earnings forecast for the third time. Keytruda, Merck’s blockbuster drug, has seen “significant revenue growth” since last quarter, with sales growing 17 percent to $6.3 billion. The Pharmaceutical Research and Manufacturers of America (PhRMA) spent over $20 million this year on lobbying, making the trade group one of the top spenders in the industry. It’s clear that Big Pharma executives are busy lining their pockets with piles of cash. All the while, patients are struggling to afford their medications. Nearly 40 percent of working-age adults reported skipping or delaying necessary health care or a prescription drug in the past year due to cost, according to a recent survey by the Commonwealth Fund. It’s time to prioritize the health and financial well-being of patients over profit margins. Lower drug prices for all patients now. — (Reuters, SeekingAlpha, Merck, CQ Roll Call, Commonwealth Fund)
BONUS PHOTO: Check out our long time P4AD patient advocates Sue, Lisa, Judy, and a shout-out to Pamela who met with their respective senators on Capitol Hill to share their experiences with high drug prices and what competition would represent to them! Way to go ladies!
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Quick note to readers: This was Audrey’s last week (in review) at P4AD! She’s been honored to be in your inbox for the last couple years. We’ll be excited to announce P4AD’s incoming communications and media director very soon and we’ll see you here next week as usual.
Welcome to the Week in Review.
1. Enrolling In Medicare? The Inflation Reduction Act Will Bring Savings
The annual open enrollment period for people on Medicare kicked off this week – this time with added drug price savings built into the Inflation Reduction Act. Beginning in 2024, drug price reforms like the cap on out-of-pocket costs for patients on Medicare who fall into the “catastrophic” coverage tier are “going to help people who have very expensive medications for conditions like cancer, rheumatoid arthritis, and hepatitis,” said KFF’s Tricia Neuman. The cap will begin to phase in next year when people on Medicare will pay zero after they reach the catastrophic phase of Medicare Part D which should be at about $3,250-3,500 in spending. Senator Sheldon Whitehouse touted the provisions in the historic law and explained that the reforms are “lowering health care costs for seniors, and finally breaking the grip of Big Pharma, providing much-needed relief to Rhode Islanders on Medicare.” In a letter-to-the-editor, Diane J. Young cited Medicare negotiation as an important way to push back on the rising costs of prescription drugs in the U.S. For Bob in Nevada, lower drug prices through Medicare negotiation will save him money on his blood thinner medication, Xarelto — one of the most expensive medicines in Medicare Part D. Further in the coming years, patients living with cancer are going to see significantly lowered costs for their treatments because of Medicare negotiations and the $2,000 cap on out-of-pocket costs, explained Joshua Cohen in a column for Forbes. The savings will just keep coming – we’re excited for patients across the country to enroll in Medicare and feel the relief in their pocketbooks from the Inflation Reduction Act. — (KFF, The Newport Buzz, The Washington Post, Nevada Current, Forbes)
2. Patients Depend On Patent & Regulatory Reforms
While Congress is sorting out its end-of-year package bill (as well as the Speaker of the House), elected officials and drug price experts are pushing for passage of bipartisan bills to curb patent and regulatory abuses and increase competition to lower drug prices. Former Texas Rep. Joe Barton penned an op-ed that breaks down the tactics that Big Pharma employs to keep drug prices high, like “pay-for-delay” in which drug companies pay off generic makers to delay their drugs from coming to market. Earlier this month, the Mayo Clinic and LifePoint Health filed a lawsuit against Celgene over its multiple myeloma drug Revlimid — alleging that the drug company engaged in pay-for-delay deals to stall the sale of generic versions of the drug. “Whether the current legal landscape for pharmaceutical patents is good policy is a hotly debated topic,” wroteUPenn fellow Laura Delbow in an opinion piece. “Yet one thing is certain: Patents are a key reason why drug prices are so high.” We couldn’t agree more. Thankfully, there are bipartisan policies to rein in Big Pharma’s manipulation of our patent and regulatory systems. Senators, time to advance these bills. — (Irving Weekly, Fierce Healthcare, The Regulatory Review, Des Moines Register)
3. Addressing Launch Prices Of Gene Therapies
Revolutionary cell and gene therapies will transform the lives of patients and offer potentially curative benefits. But these therapies are coming to market at outrageously high launch prices that put profit over the needs of patients and our health care system. P4AD’s David Mitchell told Bloomberg that these treatments will be “miraculous,” but a pressing question looms for patients about how to reach a fair price. Patients like David may one day turn to second line treatments like gene therapy to treat their conditions and will depend on the price being within reach. We need to address the high launch prices that Big Pharma charges patients and taxpayers. Drugs don’t work if people can’t afford them. — (Bloomberg)
PRICE GOUGING ALERT: This week we learned Pfizer plans to set the U.S. price for its COVID-19 antiviral treatment Paxlovid at nearly $1,400. That’s more than double what the government currently pays and far more than what it costs to make. Outrageous.
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My name is Henry Kracker, an 84 year old from Mansfield, Ohio. I am a retired children’s services agency director, living with diabetes for about 35 years and ATTR amyloidosis since July 2021, a rare progressive disease characterized by abnormal buildup of amyloid deposits in the body’s organs and tissues.
I take a range of prescription drugs to manage my health, ranging from Eliquis, Jardiance, Hydralazine, Losartan, Atorvastatin, Torsemide, two kinds of insulin and a drug called Vyndamax for my ATTR. Vyndamax alone has a monthly list price of more than $20,000 and I am currently paying an average of $1,427 per month out-of-pocket ($17,124 annually). My Jardiance and Eliquis have list prices of $593.30 and $560.75 a month which add another $1,100 to my out-of-pocket costs. Add in my insurance premiums of $6,000 plus and I’ll have an annual out-of-pocket cost of $24,224 for 2023. This is near 25% of my annual income. A cost I realize I can afford more comfortably than most.
No patient should have to navigate this broken system – drug prices should be lower and fairer.
Fortunately enough, I can financially withstand my high medical costs, but there is nothing normal about paying thousands of dollars annually, for drugs that are meant to be life-saving or stabilizing. Even though I can afford my prescription drug prices at the moment, I believe that what I and many more people in different situations are being charged is completely outrageous. The tangible idea of affordable prescription drugs and lower drug prices is an idea about fairness. With profit levels well into the billions, something is very wrong here. The lack of concern these drug companies seem to have over this ongoing problem is alarming.
Though it is still a work in progress, there is one step closer to affordable prescription drug prices for patients on Medicare, like me. Finding out that Eliquis and Jardiance are two of 10 drugs selected for drug price negotiations gives me some comfort, knowing that somewhere down the line, these two drugs will have lower list prices which will translate into savings from my out-of-pocket costs.
Lower prescription drug prices are needed now. It is time to stop Big Pharma from their corporate greed.
Welcome to the Week in Review.
1. Senators Celebrate Drug Price Reforms With Patients
This week, Senators met with constituents in their states — and the drug price reforms in the Inflation Reduction Act were top of mind. Senators TimKaine and TammyBaldwin discussed the benefits of lower negotiated prices for patients on Medicare and the $2,000 cap on out-of-pocket costs in their respective states. At a roundtable led by Senator Jacky Rosen and Centers For Medicare & Medicaid Services (CMS) Director Meena Seshamani, an outpour of Nevada residents in attendance praised the $35 monthly insulin copay cap as a huge relief to their drug costs. “I was an immediate beneficiary of the drop in insulin rates,” said David Berman, a retired attorney who lives with type 1 diabetes and participated in the roundtable discussion. “We were paying the $70 a month (per dose) and starting at the beginning of the year, $35 a month. That adds up.” In New Mexico, Senator Luján hosted a town hall with health care experts and local advocates who all touted the monthly insulin copay cap as a victory for patients on Medicare. “I am proud to have helped enable Medicare to negotiate the price of drugs,” Senator Baldwin remarked. “Negotiating drugs under Medicare will not only help our seniors but it will help drive down prices for those with private health insurance.” Couldn’t agree more – the Inflation Reduction Act provides the long-awaited relief millions of patients desperately need. — (WTVR, Richmond Times-Dispatch, Office of Senator Tammy Baldwin, The Freeman, Las Vegas Sun, Albuquerque Journal)
2. Medicare Negotiation: A Monumental Step For Patients
Health care experts and advocates continued to debunk Big Pharma’s weak claims about Medicare negotiation and highlighted the many ways the new program will help patients. P4AD’s Merith Basey sat down with MedCity News at the 2023 HLTH Conference to discuss how the Medicare negotiation program is highly favorable among people living in the U.S. “Recent polls have also shown that it doesn’t matter on which side of the aisle you sit. Over 80% of people in this country believe that Medicare should negotiate.” In a letter to the editor, Dr. Elmore Rigamer explained that U.S taxpayers fund a large share of basic research leading to new drugs. LA Times Columnist Michael Hiltzik penned a piece about how Big Pharma is “whining about having to negotiate with Medicare,” when clearly the industry isn’t strapped for cash: “As the Democratic staff of the House Oversight and Reform Committee reported in December 2021, the largest drug companies spent more on dividends and stock buybacks ($578 billion) than R&D ($522 billion) from 2016 through 2020,” Hiltzik explained. Drug corporations’ efforts to thwart negotiations won’t withstand. Patients have faced the high cost of prescription drugs for too long, and lower negotiated prices are on the way. — (AARP, MedCity News, The Advocate, The Los Angeles Times)
3. Momentum For Reforming Our Patent And Regulatory Systems
More momentum this week to restore fairness in our patent system and allow competition to lower drug prices for patients. The Center For American Progress (CAP) published a new report that highlights our rigged drug price system and recommends key bipartisan legislation to curb abuses of the patent system by drug companies. The report dives into the different patent abuse tactics — like product hopping, patent thickets, and sham citizen petitions — that Big Pharma takes on to preserve its monopoly pricing power. In an op-ed, Montana Rep. Mike Yakawich further echoed that there are currently bipartisan solutions in Congress to rein in Big Pharma’s aggressive patent abuses. Registered Nurse Jaclyn Clark penned an op-ed that explains how these “perverse and unfair practices” lead to the high prices that Mainers are paying at the pharmacy. Patients deserve access to medications they need at prices they can afford. We urge the Senate to pass bipartisan legislation to advance legislation that curb these abuses of our patent and regulatory system and promote competition to lower drug prices. — (Center For American Progress, Ravalli Republic, Portland Press Herald)
Have a great weekend!
Welcome to the Week in Review.
1. A Big Win For Medicare Negotiation
It’s official — Medicare has started negotiations with all the makers of the first 10 drugs selected. P4ADNow’s Merith Basey celebrated this important step inthe movement towardsloweringprices for the millions of patients who take these essential and costly medications including cancer treatments, blood thinners, autoimmune disease treatments, and some diabetes drugs. According to the White House, “the 10 drugs selected for negotiation accounted for $3.4 billion in out-of-pocket costs for an estimated 9 million Medicare enrollees in 2022.” Lower negotiated drug prices will bring savings to millions of patients on Medicare when the negotiation program takes effect in 2026. It comes as no surprise that voters across party lines support implementation of the Medicare negotiation program and overwhelmingly — by more than a five-to-one margin — oppose the lawsuits trying to halt the negotiation process. We’ll keep fighting for successful implementation of Medicare negotiations to ensure patients and taxpayers get a better deal on these widely-used, high cost medications. — (P4ADNow, CMS, The New York Times, The White House, Times-News, Forbes)
2. Push For Competition To Lower Drug Prices
Patients have been financially burdened by expensive prescription drugs for far too long and urgently need generic and biosimilar competition to enter the market to lower prices. Compared to peer nations, the U.S. spends more than twice as much on prescription drugs per person, according to a recentstudy by the Commonwealth Fund. The authors of the study found that prescription drug prices are two to three times those in other nations, with branded drugs accounting for 80 percent of prescription drug spending. These essential medications are priced out of reach for patients, who are forced to risk putting their health in jeopardy by not taking their drugs as prescribed. A CDC report in 2021 estimated that of the “60% of adult Americans who took at least one prescription drug in the past year, 9.2 million (8%) did not take their medications as prescribed to save money.” This is not acceptable. A solution? Generics and biosimilars can drive down prices. A recent Department of Health and Human Services (HHS) report found that biosimilars have significantly lowered costs for patients on Medicare and assessed that they can be used more widely to increase savings. Thankfully, there is a real opportunity in Congress to pass bipartisan legislation that increases generic and biosimilar competition to lower drug prices for patients. Let’s get it done. — (Medical Economics, Commonwealth Fund, Public Citizen, CDC, HHS, Politico)
3. Patients Need Affordable Vaccines
Everyone deserves access to live-saving vaccines. Yet, even when research leading to the development of vaccines is primarily taxpayer funded, Big Pharma often swoops in once they are considered profitable, and is able to dictate their price. This week, two pioneering scientists — Katalin Karikó and Drew Weissman — whose decades-long research in mRNA technology lead to the development of the COVID-19 vaccines, were awarded the Nobel Prize in Physiology or Medicine. P4AD’s David Mitchell applauded the scientists, and highlighted that the taxpayer grants funded their pivotal research and saved millions of lives: “The foundational work by Karikó, Weissman with the support of [the National Institutes of Health] NIH enabled the mRNA technology to be ready for development in record time when COVID-19 attacked the world in 2020.” In 2022, drug companies planned to raise the price of their COVID-19 vaccine more than six times what the U.S. government initially paid. Classic Big Pharma putting profits before patients. In a powerful essay published by ProPublica, Anna Maria Barry-Jester detailed how drug company GSK delayed rollout of its tuberculosis (TB) vaccine, developed with government and non-profit funding, to pursue more lucrative business opportunties. Profiteering from pandemics and deadly disease is abominable. The U.S. government and taxpayers deserve better, especially after footing the bill for key research that has helped and improved countless lives. — (The New York Times, ProPublica)
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WASHINGTON, D.C. — The following statement was issued by Merith Basey, executive director of Patients For Affordable Drugs Now, following the announcement by the Centers for Medicare and Medicaid Services (CMS) that all of the drug companies making the 10 drugs selected for the first round of negotiations have agreed to enter negotiations with Medicare:
“On behalf of patients across the country, we are very pleased to see all of the drug companies manufacturing the ten selected drugs have agreed to enter negotiations with Medicare. This marks an important milestone in our movement – for the first time ever, Medicare will now officially be in the process of negotiating lower prices for essential and costly medications taken by millions of people in this country including cancer treatments, blood thinners, autoimmune disease treatments, and some diabetes drugs.
“People in the United States overwhelmingly support this law, and we look forward to continuing to work with the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS) to ensure the Inflation Reduction Act is implemented in the best interest of patients, despite opposition from drug companies.
“These first 10 drugs are just the beginning – we will continue pushing on all fronts to lower drug prices for everyone.”
###
Background:
The period of negotiation between the Medicare and drug companies will occur between October 1, 2023 and August 1, 2024. The negotiated “maximum fair prices” will be published no later than September 1, 2024.
Starting October 30, Centers for Medicare & Medicaid Services (CMS) will host a series of patient-focused Listening Sessions for all 10 drugs.
The prices of the following ten drugs are being negotiated by Medicare:
Eliquis
Jardiance
Xarelto
Januvia
Farxiga
Entresto
Enbrel
Imbruvica
Stelara
Fiasp/NovoLog
Welcome to the Week in Review.
1. A Big Win For Medicare Negotiation
Marking an historic step in ensuring successful implementation of the Medicare negotiation program, a federal judge issued a court ruling yesterday that denied the Chamber of Commerce’s lawsuit to halt the negotiation process. P4ADNow’s David Mitchell celebrated the news following the announcement: “Today’s court ruling is an important victory for patients and all Americans, and demonstrates the weakness of the industry’s objections to Medicare negotiation to lower prescription drug prices under the Inflation Reduction Act.” This ruling comes just before the October 1 deadline for manufacturers of the first 10 eligible drugs selected for negotiation to sign an agreement with Medicare to participate in the process. For patients on Medicare, lower negotiated prices will mean lower out-of-pocket costs and increased use of these expensive drugs. As a reminder, these 10 drugs eligible for negotiation include cancer treatments, blood thinners, autoimmune disease treatments, and diabetes drugs. Considering that prescription drugs cost “2.56 times more” than in other countries, it’s clear why 80 percent of Americans support the new law allowing Medicare to negotiate lower drug prices. Mark, an AARP member from Rhode Island, knows the stress of trying to afford high cost medication all too well: “I am unable to afford the thousands of dollar co-pays for the rheumatoid arthritis drug Enbrel…I had to skip dosages.” With Enbrel on the list of the first 10 drugs to be negotiated, patients like Mark will get a better deal on this high priced medication and worry less about going without. We are eager for the negotiation process to begin in October – it’s time for Medicare, for the first time ever, to have a say in negotiating a fair price for these outrageously priced medications. — (CNBC, KFF, Commonweal, AARP)
2. Time To Stop Big Pharma Patent Abuses
Amidst a potential government shutdown, elected officials and drug price experts continue to advocate for reforms that address abuses of our patent and regulatory systems and encourage generic and biosimilar competition to be included in the omnibus package. In an interview with Salon, Senator Amy Klobuchar deftly explained the tactics that Big Pharma employs to preserve their monopolies like “pay-for-delay,” “product hopping,” and abuse of the citizen petition process. Thankfully, Senator Klobuchar is leading bipartisan legislation to curb these patent and regulatory abuses and encourage generic competition coming to market. Professor Sean Tu explained to STAT that years of patent abuses by Big Pharma has led to outrageous profit margins: “Humira made $21 billion last year. From what I understand, that is as much as McDonald’s.” Tu continued, “the fact that the moment a patent expires competition leads to dramatic price drops is a quintessential case of markets regulating themselves … and they shouldn’t be allowed to exploit loopholes to extend monopolies.” Drug companies game our patent and regulatory systems so they can pad their pockets with profit by setting outrageous prices. We need to pass bipartisan reforms to fix this injustice and lower drug prices for patients. — (Salon, The Blaze, STAT)
3. Sickle Cell Awareness & The Looming Question Of High Launch Prices
We’re on the cusp of remarkable, potentially curative cell and gene therapies coming to market, but the high price tags attached to these promising treatments draws concerns about how patients and the health care system will afford them. Treatments for sickle cell disease are on the horizon and patients are eager to access this new groundbreaking treatment. Approximately 100,000 people in the U.S. live with sickle cell disease, of which Black and Hispanic populations are disproportionately impacted. The two current gene therapies under FDA review are expected to be priced between $2 and $3 million dollars. The opportunity for patients who’ve faced a “lifetime of restricted activity and pain” to finally live a healthier lifestyle will be pushed further out-of-reach given this staggering price. We need to bring reforms to our system that address high-priced gene and cell therapies so that everyone can afford life-saving drugs. (CMS, Managed Healthcare Executive)
BONUS WATCH: Check out P4AD’s Bilingual Organizer & Program Assistant Jesse Aguirre celebrate National Hispanic Heritage Month in this new video! Worth a watch.
Have a great weekend!
WASHINGTON, D.C. — The following statement was issued today by David Mitchell, cancer patient and founder of Patients For Affordable Drugs Now, in response to the decision in the U.S. District Court for the Southern District of Ohio Western Division denying the Chamber of Commerce request for a temporary injunction to stop Medicare from negotiating lower prices for prescription drugs:
“Today’s court ruling is an important victory for patients and all Americans, and demonstrates the weakness of the industry’s objections to Medicare negotiation to lower prescription drug prices under the Inflation Reduction Act. This is the first decision in the eight challenges that have been filed against the new law, and it sends a strong signal that drug companies and their trade associations will not prevail. Rather, the will of Americans expressed through the Congress will carry the day when all the legal arguments have been heard.”
