Patients For Affordable Drugs Now Responds To Results Of The U.S. Presidential Elections
WASHINGTON, D.C. — Following the U.S. Presidential Election being called for Former President Donald Trump, David Mitchell, Founder of Patients For Affordable Drugs Now, issued the following statement:
“Patients For Affordable Drugs Now remains unwavering in our mission to lower drug prices for millions of Americans and we are ready to work with President-Elect Trump and the new Congress to make prescription drugs more affordable for those facing crushing costs.
“Even with the sweeping reforms ushered in under the Biden-Harris administration, one in three Americans still can’t afford their prescription drugs, and nine in ten agree that lowering drug prices should be a top priority for our elected leaders. On behalf of patients across all 50 states, we are committed to working with the Trump-Vance administration and the new Congress to expand on the gains made in recent years to lower drug prices and continue to deliver meaningful relief to patients.
“Previously, President-Elect Trump voiced support for allowing Medicare to negotiate lower prices and implementing the ‘Most Favored Nation’ model to prevent Americans from paying more than the average prices people in other countries pay for the same medications. We are hopeful that the new administration will return to these commitments or bring forward other approaches we can help enact to build upon the progress achieved in recent years.
“The Inflation Reduction Act was the most significant step forward in lowering prescription drug prices in two decades. On behalf of the patients we represent, we will vigorously defend the landmark drug pricing law against any attempts to roll back these hard-won reforms – whether through administrative action, legislation, or litigation.
“As a bipartisan organization, we know that lowering drug prices isn’t a Democratic or Republican issue – the pain of high drug prices is not limited to a single party. More than 80 percent of Americans support the principal reforms we champion. We will bring our voices to bear to keep what we have won. But we will support the new administration as it works to rein in the unchecked pricing power of drug companies, the practices of PBMs that put profits ahead of patients, and make prescription drugs affordable for every person in the U.S.”
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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.
Court Watch: US v. Pharma
Combined oral arguments brought by Bristol Myers Squibb (BMS), AstraZeneca, and Janssen Pharmaceuticals were heard by the Third Court of Appeals in Philadelphia in their efforts to halt the Medicare Negotiation Program. The arguments were considered by a three-judge panel that raised issues with the drug companies’ claim that they were being forced to participate in negotiations and that the program violated their First Amendment rights. This hearing marks the first appellate-level challenge to Medicare negotiations. In September, Patients For Affordable Drugs submitted an amicus brief in the consolidated case which highlights how lower negotiated prices will deliver transformative savings to patients. First-hand testimonies from patients like Lynn, who is forced to rely on financial assistance for her Imbruvica, and Aly, who spends nearly half of his monthly income on prescription drugs, including Eliquis, illustrate the devastating impact of high drug prices and the potentially life-changing impact of lower negotiated prices. While eight cases brought by Big Pharma and its allies have been ruled against the companies, we can’t rest on our laurels. As drugmakers continue to appeal, experts anticipate that one of the cases filed in various district courts may make its way to the Supreme Court. We are steadfast in our commitment to defending this historic program against challenges both inside and outside of the courts. — (Reuters, P4AD, Politico, P4AD, STAT)
Big Pharma Reaps Big Earnings
As we enter the last stretch of 2024, the pharmaceutical industry’s earnings underscore its continued financial strength despite their fear-mongering about the Inflation Reduction Act. Novartis — one of the drug manufacturers suing to stop Medicare negotiation — reported a striking $3.2 billion in earnings during the last quarter, an 111 percent increase from the same quarter last year. Pfizer, whose CEO Albert Bourla once described Medicare negotiations as “negotiation with a gun to your head,” outperformed analyst expectations with $4.47 billion in quarterly earnings. BMS also surpassed projections, reporting $1.21 billion in third-quarter earnings — in large part due to increased sales of Eliquis, its blockbuster blood thinner which was selected for the inaugural round of Medicare negotiation. While these companies relentlessly criticize the Inflation Reduction Act’s historic drug price reforms, their strong earnings reveal a thriving industry capable of succeeding under policies that better protect patients from sky-high drug costs. — (Accountable.US, Reuters, STAT, AP News, Washington Post,CNBC)
ICYMI
The Senate Judiciary Committee held a field hearing to examine the root causes of high drug prices and the financial burden on American seniors. During the hearing, lawmakers championed legislation that would reform our patent system and increase transparency into Pharmacy Benefit Managers (PBMs) – both critical levers to reining in spiraling drug costs. As we approach the lame-duck session, we are focused on advancing bipartisan bills to curb patent abuses and increase competition to lower prices for all patients.
Marking another significant upset for Big Pharma and a critical victory for patients, Novartis faced a setback last week in its lawsuit to stop the implementation of the Medicare Negotiation Program. District Judge Zahid Quraishi rejected Novartis’ claim that the program violated the Takings Clause, compelled speech protections, and the Excessive Fines Clause, underscoring, yet again, the voluntary nature of the program. Novartis’ case was the final of four cases before Judge Quraishi, and he has now ruled in favor of the government and patients in all four. This case also marks the eighth lawsuit to be ruled against the pharmaceutical industry. Next week, oral arguments will be heard as Bristol Myers Squibb, AstraZeneca, and Janssen lay out their appeals before the Third Circuit Court of Appeals. “Behind every one of these legal challenges is a story of a patient rationing their medication or going into debt to afford life-saving drugs,” P4AD’s David Mitchell said in a statement this week. “The court’s decision last week moves us one step closer to a future where no one has to make these impossible choices.” — (Bloomberg Law, Washington Monthly)
First Patient Leaves Hospital After SCD Therapy
Kendric Cromer, a 12-year-old from Washington D.C., made headlines earlier this year when he became the first patient to receive an FDA-approved gene therapy for sickle cell disease (SCD). After nearly five months of treatment, involving intensive chemotherapy and the infusion of new modified blood cells, Kendrick left the hospital this week and is now on the road to living a life without SCD. This groundbreaking treatment offers transformative potential for children, like Kendrick, who suffer from the lifelong, painful blood condition affecting 100,000 people in the United States, most of whom are Black and Latino. However, while the promise of gene therapy is life-changing, the reality is that the newly approved SCD gene therapies, Lyfgenia by Bluebird Bio and Casgevy by Vertex Pharmaceuticals, come with staggering list prices of $3.1 million and $2.2 million per treatment, respectively. These high launch prices raise serious concerns about the financial strain on patients, insurers, hospitals, and our health care system overall. While the potential benefits of gene and cell therapies are profound, the current pricing models create barriers that limit access for many patients. As we celebrate the remarkable advancements in treatment, it is crucial to address the urgent need for a sustainable pricing structure that balances fair profits for manufacturers with accessibility and affordability for patients and the health care system as a whole. — (The New York Times, CDC, CNBC)
Legislators Tout IRA Savings
As we anticipate the drug price reforms in the Inflation Reduction Act taking effect in 2025, patients are already reaping substantial savings this year from the provisions already underway. At an event in New Hampshire, President Biden and Senator Sanders touted a new report by the Office of The Assistant Secretary for Planning and Evaluation (ASPE) that found that because of the Inflation Reduction Act, nearly 1.5 million patients on Medicare saved nearly $1 billion in out-of-pocket costs in just the first half of 2024. The report also revealed that the annual out-of-pocket cap is delivering crucial relief for patients burdened by high cancer drug costs, which comprised nine of ten of the highest-spending medications among those who reached the cap in 2024. In two months, when the out-of-pocket cap for patients on Medicare lowers to $2,000, nearly 19 million people are projected to save roughly $400 per year on prescription drug costs. As the drug price law continues to take effect, patients stand to see substantial savings on their prescription drugs, lower out-of-pocket costs, lower average premiums for patients, and a variety of plans to choose from — ensuring access to a wide range of treatments at more affordable prices. — (PBS, ASPE, HHS, KFF)
ICYMI
The pharmaceutical industry’s top trade association, The Pharmaceutical Research and Manufacturers of America (PhRMA), closed out last quarter spending $6.9 million in health care lobbying efforts ranking the group as the top spender on health care lobbying among all health trade association groups this year.
Novo Nordisk’s legal battle against the Medicare Negotiation Program has shifted gears, with the company now focusing on challenging elements of the program’s implementation rather than broad constitutional arguments that were rejected by a federal judge in July. Novo Nordisk’s appeal, filed this week in the Third Circuit, claims that the Centers for Medicare & Medicaid (CMS) overstepped its authority by grouping six of the company’s insulin products as a single item for negotiation — Fiasp, Fiasp FlexTouch, Fiasp PenFill, NovoLog, NovoLog FlexPen, and NovoLog PenFill. These products were grouped due to their fundamental similarity, with variations primarily in delivery methods rather than in their formulations. The Third Circuit Court of Appeals will also be hearing combined oral arguments from Bristol Myers Squibb (BMS), AstraZeneca, and Janssen later this month. P4AD filed an amicus brief in the BMS and Janssen case and has signed onto seven other amicus briefs — led by led by Public Citizen and supported by AARP, Protect Our Care, Doctors for America, and Families USA — to defend the historic drug price negotiation program. — (Fierce Pharma, Bloomberg Law, US Court of Appeals)
Bringing CAR-T Closer To Patients
Chimeric antigen receptor T-cell (CAR-T) therapy, a groundbreaking immunotherapy for treatment-resistant cancers, offers the potential for long-lasting remissions without the need for maintenance therapy. However, significant access barriers hinder its potential relief for many patients. New research published in Transplantation and Cellular Therapy found that a patient’s proximity to a treatment center played a significant role in determining whether they received CAR-T therapy. According to their research, patients living 2-4 hours away from the nearest CAR-T treatment center were nearly 40 percent less likely to receive treatment compared with those living within 30 minutes. The current U.S. model often involves patients traveling significant distances to access CAR-T therapy and typically forces patients to wait several weeks to receive their personally modified therapy from remote sites. Contrasting this approach, countries like Spain have adopted a decentralized production model which has led to lower costs in part through bringing treatment closer to patients. As groundbreaking cell and gene therapies enter the U.S. market with price tags in the millions, we must prioritize strategies to make these potentially life-saving innovations accessible and affordable for both individuals and health systems. — (National Library of Medicine, AJMC)
Medicare “Smoothing” OOP Costs
As we approach 2025, the drug pricing provisions in the Inflation Reduction Act (IRA) are set to bring about transformative changes in how older Americans manage the cost of their medication. Two key reforms are taking effect in January: a $2,000 annual cap on out-of-pocket drug expenses and the new Medicare Prescription Payment Plan. In its first year, the spending cap promises significant savings for over 3 million recipients who do not receive the program’s low-income subsidy, addressing a critical financial burden for those with costly medications. Complementing this, the Payment Plan allows patients on Medicare to spread out their cost sharing across monthly installments, helping people who live with a chronic illness manage their out-of-pocket expenses. As implementation of these reforms nears, the growing anticipation among patients underscores the IRA’s promise of more manageable health care experience for millions of Americans. This combination of lower out-of-pocket costs and flexible payment options reflects an understanding of the complex financial challenges faced by millions of Americans who are struggling to afford the drugs they need. — (CMS, AARP)
ICYMI
Novartis recently suffered a legal setback in its effort to block a generic version of heart failure drug Entresto from entering the U.S. market. Undeterred, the pharmaceutical giant is appealing the decision, aiming to protect its lucrative franchise. In 2023, Entresto generated over $6 billion in global sales for Novartis. This case highlights the lengths brand-name drug manufacturers will go to extend their market exclusivity and stop the introduction of affordable generic alternatives that would lower costs and benefit patients.
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.
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 adcampaign 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.
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.
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.
From Left: Jackie Trapp (WI), Sue Lee (KY), Karolina Chorvath (MA), Gail DeVore (CO), Janet Kerrigan (SC)
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.
