The First Humira Competitor Has Arrived In The U.S.
AbbVie’s blockbuster drug Humira faces biosimilar competition for the first time in the drug’s 20-year reign in the United States. Amjevita, manufactured by Amgen, is the first of many biosimilars that are likely to come to market this year to compete with Humira and will serve as a key test of whether biosimilars will drive down drug prices in a meaningful way for patients. AbbVie has been able to raise Humira’s annual price to more than $80,000 over the last 20 years by exploiting the patent system, applying for more than 300 patents related to Humira (a shady tactic known as “patent thicketing”), and suing competing biosimilars to delay their launches. “The result is that we have been paying roughly five times what they pay in the EU for Humira,” shared cancer patient and P4AD founder David Mitchell. “And patients in the US have suffered economic and physical harm as a result.” Sue Lee is one of those patients. She took Humira to treat painful sores caused by a chronic skin condition called psoriasis, but when she retired and went on Medicare, the drug suddenly cost her $8,000 per year – which she couldn’t afford. Without the medication, her sores “came back with a vengeance.” With additional Humira biosimilars slated to be on the market in 2023, patients like Sue hope that the price of the medication may finally be reined in. But that outcome is “a little complicated” to predict. “With biosimilars, there can be different rules, and doctors will likely need to see big savings to want to push you over to this new drug,” explained NPR pharmaceuticals correspondent Sydney Lupkin. “But there are expected to be several more Humira biosimilars this summer, and that could start to move the needle on price.” We sure hope so – patients have been waiting for this relief for far too long. — (Tradeoffs, The New York Times, Financial Times, NPR)
2. The Inflation Reduction Act? “I Think It’s Wonderful.”
The drug price reforms in the Inflation Reduction Act that went into place this year are bringing much-needed relief to patients across the United States. Debra Coleman, who lives in South Carolina, was unable to afford the $150 it would have cost her for the Shingrix vaccine before the law passed. “I don’t have that kind of extra money,” Debra said. Thanks to the Inflation Reduction Act, vaccines are now free for people on Medicare like Debra. The new law also caps insulin copays at $35 per month for people on Medicare – truly “life-changing” for Robert Brown from Wisconsin, whose insulin cost nearly $200 per month for the many years before the law was in place. Looking ahead, patients aren’t the only ones who will see relief from the Inflation Reduction Act – the new law likely saves the U.S. government significant funds. A new study published in The Journal of The American Medical Association (JAMA) Health Forum found that if the provision allowing Medicare to negotiate prices for costly drugs had existed as the study modeled it from 2018-2020, Medicare would have saved $26.5 billion, or 5% of all drug spending. Considering the average price Medicare paid for brand-name drugs more than doubled from 2009 to 2018, it’s safe to say the drug price reforms are a welcome change to a rigged system. “I think it’s wonderful. It’s the first thing that came across my mind when I was standing in line at (the pharmacy),” remarked Debra on the passage of the Inflation Reduction Act. “It was like balloons going up.” We agree, Debra. — (Greenville Business Magazine, WTMJ, NBC News, JAMA Network)
3. Big Pharma’s Big Lobbying
Big Pharma spent record amounts of money lobbying Congress and federal agencies in 2022 – yet the industry still suffered its biggest defeat with the Inflation Reduction Act becoming law. Open Secrets’ new analysis released this week shows that pharmaceutical and health product companies spent $372 million (more than any other industry) on lobbying. The Pharmaceutical Research & Manufacturers of America (PhRMA) spent $29.2 million on lobbying, making the trade group the top spender in the industry. Pfizer won the prize for biggest spender of any individual drug company, with $14.9 million on federal lobbying, and Biotechnology Innovation Organization (BIO) was the third largest industry spender at nearly $13.3 million. Big Pharma’s power is no joke. “There are currently 1,834 registered lobbyists working for pharmaceutical and health products, meaning the industry has more than three lobbyists for each member of the Congress.” Despite all this power and spending, patients took on Big Pharma and won in 2022. We’ve seen signs of turmoil within the industry ever since – this week, generics manufacturer Tevaquit top industry association PhRMA, making it the second company to leave in the last few months. Politico reported that Teva’s move “follows a rare defeat in a years-long battle against Democrats’ drug pricing measures that included allowing Medicare to negotiate drug prices.” Looks like Big Pharma’s big lobbying doesn’t stand up to the will of patients. – (Open Secrets, Politico, STAT)
HEADS UP: Following this week’s hearing, we’ll be watching for the Senate Judiciary Committee’s upcoming markup and vote on a package of bipartisan bills that take important steps to address abuses of our patent system that inhibit innovation, block competition, and allow drug corporations to raise prices without restraint.
Have a great weekend, everyone!
My name is Melissa Evans and I live in Wilkes Barre, Pennsylvania. Over the past two decades, the high prices of prescriptions have defined most decisions I make.
In 1998, when I was only 24 years old, I suffered a heart attack that changed my life. I could no longer work and struggled through the process of getting insurance through Medicare disability. During this time, I had no insurance and had to face the full list prices of my prescriptions –I had no way of affording any of the prescriptions that I needed. Still to this day, I don’t know how I survived those years without any medication for my health conditions.
I now live with a thyroid issue, skin cancer, asthma, heart conditions, hypoglycemia, and high blood pressure. To treat my diagnoses, my doctors have prescribed 20 medications. Each carries its own monthly copay and they can add up to $500 out of pocket in just one month, even though I now have Medicare coverage.
Half of the time, I can’t even fill my prescriptions because of the high copays. I’ve had to choose between filling my prescriptions, getting much-needed surgeries, and paying my bills. These decisions often seem impossible to make. If I don’t take my medications, I’m neglecting myself. But I still want to pay my bills on time and live a full life. I was previously pretty active, but my diagnoses and the high-priced prescriptions that come along with them have put my life on hold.
With such high drug prices, the new reforms passed by Congress through the Inflation Reduction Act will be a huge relief for me. I currently spend more than $2,000 in out-of-pocket costs by the middle of the year, even while rationing some of my prescriptions and going entirely without others. With the new Medicare out-of-pocket cap of $2,000 in 2025, I’ll see my annual costs reduced and be able to fill my prescriptions without worrying about going over the cap.
Also, one of the drugs I take, Linzess, will potentially be among the first eligible to be negotiated by Medicare, which could also lower my costs while saving the government money!
These reforms will truly be transformational for so many of the millions of patients struggling right now. I know so many other people in similar situations to me who ration their drugs and still worry every month about making ends meet. With consistent and lower costs at the pharmacy counter, the Inflation Reduction Act will make a world of difference for patients like us. This relief can’t come soon enough!
Welcome To The Week In Review.
“I’m Very Thankful For This.”
The drug price reforms in the Inflation Reduction Act are continuing to provide much-needed relief to patients. A new report by the Department of Health and Human Services (HHS) found that 1.5 million people on Medicare would have saved an average of $500 on insulin had the insulin copay cap been in place in 2020. “That’s more money in seniors’ pockets,” remarked President Joe Biden upon the release of the report. Senior William Koopman, who lives with type 2 diabetes and will see his insulin costs drop by more than half, shared, “I’m very thankful for this.” For Patricia in Orange County, Virginia, and Bill in Conneaut, Ohio, the Inflation Reduction Act has meant free access to the expensive shingles vaccine. “This vaccine will protect [Patricia] from an excruciatingly painful condition that affects more than 1 million Americans every year,” wrote Patricia’s Congresswoman Abigail Spanberger, who supported the legislation. Had the policy been in place in 2020, 3.6 million people on Medicare would have received free shingles shots. These reforms are just the tip of the iceberg for how the Inflation Reduction Act will continue to help patients. “As other parts of the IRA are implemented, 2023 promises to be a year of behind-the-scenes action to shape what consumers pay at the pharmacy counter in the future,” Tradeoffs podcast reported in an interview with STAT News’ Rachel Cohrs. — (HHS, The White House, AARP, Fox News, Star Beacon, KFF, Tradeoffs)
2. Look Out, Big Pharma: Senate Subpoenas On The Horizon
Senate Democrats appear prepared to capitalize on their expanded majority this Congress by wielding their subpoena power to take on corporate corruption, including within the pharmaceutical industry. In December, Senate Majority Leader Schumer suggested that subpoenas will be key to the Democrats’ strategy this year. Sen. Bernie Sanders, who now chairs the Senate Health, Education, Labor and Pensions (HELP) Committee, indicated he has plans to subpoena pharmaceutical executives to come before Congress. “We are living in a country today where drug companies are making huge profits while people split their life-saving pills in half because they can’t afford them,” shared the senator. Sen. Ron Wyden, chair of the Senate Finance Committee, has indicated that he may subpoena drug corporation Amgen if they don’t respond to his repeated requests for the company’s compliance with the committee’s investigation into Amgen’s unusually low tax rates. We are glad to see these senators take on pharmaceutical corporation corruption and represent patients’ best interests. — (Bloomberg, Fierce Pharma)
3. New Congress, New Opportunities For Drug Price Reform
With a new Congress, comes renewed opportunities to fix our drug price system to ensure everyone has access to medications. In the Senate, Senators Grassley, Durbin, Tillis, and Coons introduced bipartisan legislation this week that would establish a task force between the United States Patent and Trademark Office (USPTO) and the Food and Drug Administration (FDA) to encourage collaboration and aid each agency in boosting competition to drive down the prices of prescription drugs and other goods. “Congress must lead the way in making the patent system more accountable to the public,” the Initiative for Medicines, Access & Knowledge (I-MAK)’s Tahir Amin and Priti Krishtel wrote in an op-ed. And, more good news for patients, key members of Congress on both sides of the aisle have doubled down on their commitment to crack down on pharmacy benefit managers (PBMs) this Congress. Chair of the House Committee on Oversight and Accountability James R. Comer plans to hold hearings that look into PBMs, and Senate Finance Chairman Ron Wyden is encouraged by the commitment from members of both parties to work on legislation that takes on the middlemen. The New York Timesthis week laid out a third area that Congress has yet to address: The groundbreaking gene therapies coming to market at astronomical prices. These therapies are powerful treatments, and potential cures, for some of the world’s most devastating diseases, but, “the situation simply isn’t sustainable,” said Ruth Lopert, a health economist at George Washington University. “If it comes all at once and the payments can’t be stretched out, it will have a crushing effect,” shared Dr. Steven Pearson, president of the Institute for Clinical and Economic Review. We are committed to continue to work with Congress and fight for reforms until all patients can afford the prescription drugs they need. – (Office of Senator Grassley, The Hill, Roll Call, Politico, The New York Times)
Have a great weekend, everyone!
Happy Lunar New Year! May the year of the rabbit bring you peace, longevity, prosperity, and lower drug prices ?
Welcome To The Week In Review.
Inflation Reduction Act Lowers Insulin Costs (And More) For People On Medicare
Americans are continuing to feel relief from the Inflation Reduction Act this week, starting with the $35 monthly insulin copay caps for people on Medicare. Steve Lubin, a retired intensive-care nurse from Philadelphia living with type 2 diabetes, is one of millions of people on Medicare who will see savings this year from the implementation of the new law. Last year, Steve’s out-of-pocket costs for his insulin totaled a shocking $1,582. In 2023, his copays will be capped monthly at $35 per prescription for a total end-of-year cost of $630. For thousands of patients, this is going to make a huge difference – between 2007 and 2020, people who received coverage through Medicare saw their out-of-pocket insulin costs quadruple and many were “rationing their insulin or couldn’t take it at all.” AARP’s Leigh Purvis put this new insulin copay cap into perspective in several TV interviews, explaining that this year, the Inflation Reduction Act will help 230,000 people on Medicare who use insulin in Florida, 140,000 in Ohio, and 60,000 in Wisconsin. Millions more throughout the country will feel relief as all of the drug price reforms in the Inflation Reduction Act go into effect over the next few years, including free vaccines for people on Medicare, curbs to drug company price gouging above the rate of inflation, a cap on Medicare Part D out-of-pocket costs, and finally direct Medicare negotiation for lower drug prices. Thanks to the Inflation Reduction Act, Purvis told Spectrum News, many people on Medicare “are going to be seeing lower drug prices and lower drug costs.” — (The New York Times, ABC Action News, Spectrum News, News8000)
2. State Efforts To Curb High Prescription Drug Costs
Following the passage of federal drug price reforms, state legislatures and administrations are pursuing state-level drug price reforms to further rein in prices for their constituents. In California, Attorney General Rob Bonta filed a lawsuit accusing Eli Lilly, Novo Nordisk, Sanofi, and three of the largest pharmacy benefit managers (PBMs) of violating the state’s Unfair Competition Law by increasing the price of insulin far beyond the cost of development and rate of inflation. Bonta characterizes the shady business relationship between PBMs, who negotiate prices on behalf of insurance companies, and pharmaceutical companies as “pure profit padding.” California is the sixth state to sue drug companies for insulin prices, joining Arkansas, Kansas, Kentucky, Minnesota, and Mississippi. In Virginia and New Mexico, lawmakers are championing bills to establish prescription drug affordability boards that will oversee drug prices in the state. And Indiana lawmakers introduced Senate Bill 8, which would limit PBM greed by requiring the middlemen to pass discounts and rebates back to patients. Thank you to all these state lawmakers for boldly kicking off the year advocating for patients and combating high drug prices! — (The New York Times, The Center Square, KKOB, WFYI)
3. Case Study: Biosimilar Competition Reduces Drug Prices
The Journal of Clinical Oncology published a new study that found that the entry of biosimilar drugs for anticancer medication Herceptin, significantly lowered the price of both brand-name Herceptin and its five biosimilar competitors. Herceptin was granted FDA approval in 1998 to treat HER2+ breast cancer; since then, its manufacturer, Genentech, raised the price to a peak of $89,706 in 2019. The first biosimilar finally came to market that same year. After three years and with the introduction of five biosimilars, Herceptin’s price fell almost 30 percent to $63,592 in 2022. Today, biosimilar treatments are 40 percent less than Herceptin with a price of $38,173. This is a fantastic case of the drug price system working as it should – biosimilars drive competition and lower drug prices for patients who need this life-sustaining medicine — (The American Journal Of Managed Care)
Bonus: On Thursday, our all-star Legislative Director Sarah Kaminer-Bourland spoke as part of a panel at a joint public listening session held by the U.S. Patent and Trade Office and the Food and Drug Administration, where she discussed needed reforms that the two agencies can take on together to fix the rigged patent system, identify actors perpetuating the lack of equity, and lower drug prices as a result. Go Sarah!
The first of the drug price reforms in the Inflation Reduction Act went into effect on January 1. For people on Medicare Part D, vaccines are now free and insulin copays are capped at $35 a month. For patients, these reforms are life-changing, “The new cost cap will make a big difference. I won’t have to watch what I use. I can buy groceries,” patient advocate and former nurse Justine Miner, who lives with type 2 diabetes, shared with the Wall Street Journal. Patient advocate Jackie Trapp knows firsthand how expensive essential vaccines can be, she paid more than $200 out of pocket for her shingles vaccine, “I’m so relieved that future patients like me won’t have to spend what I did just to protect themselves from diseases like shingles.” The reforms remain popular among the American people, with majorities across the political spectrum supporting the Inflation Reduction Act and, specifically, the insulin copay cap. This week, the Department of Health and Human Services (HHS) and Centers For Medicare and Medicaid Services (CMS) outlined their plan for implementing the Medicare drug price negotiation provision in the law. “Today’s announcement is a critical step towards unshackling Medicare and delivering on the promise of drug pricing fairness,” Senate Finance Chairman Ron Wyden said upon the release of the plan. We couldn’t agree more. — (P4ADNow, P4ADNow, The Wall Street Journal, Navigator Research, Fierce Healthcare, United States Senate Committee On Finance)
2. Perpetual Pandemic Profiteering
This week Moderna CEO Stéphane Bancel said the pharmaceutical company is considering quadrupling the price of its COVID mRNA vaccine as it moves to the commercial market. The huge jump in price to a range of $110 to $130 per dose from the current $26 per dose the company charges the U.S government, mirrors the increase Pfizer plans to make on its mRNA vaccine. This is just more pandemic profiteering on the backs of patients causing incoming Senate HELP Committee Chairman Bernie Sanders to pen a letter to Bancel calling the price increases “unacceptable corporate greed” and highlighting that the vaccine was funded by U.S. taxpayers: “You propose to make the vaccine unaffordable for the residents of this country who made the production of the vaccine possible. That is not acceptable.” — (Axios, Office of Senator Bernie Sanders)
3. Humira Hope For Patients
AbbVie has been gaming the U.S. patent system for years to maintain monopoly pricing power for its blockbuster drug Humira, which treats several debilitating diseases, including psoriatic arthritis, Crohn’s disease, and ulcerative colitis. The company blocked any biosimilars from coming to market in the U.S. by building up a patent thicket of more than 130 patents, preventing competition and allowing AbbVie to increase the price time and time again to its current astronomical price tag of $81,590 a year. But change is coming — more than half a dozen biosimilar versions of Humira are expected to become available throughout 2023. Patients like Samantha Reid have been waiting for this moment for a long time. “Cost should never be a factor in whether or not people are in pain or suffering or not able to live their lives,” Reid, who has lived with Crohn’s disease since age 18, told the Chicago Tribune. But “it is, and the reason it is, is because companies like AbbVie charge so much for these medications.” P4AD’s David Mitchell added, “AbbVie, and how it has handled Humira, is the poster child for abuse of our patent system.” The next few years “will be a big test of how well can biosimilars perform to lower prices in this country,” Mitchell added. In Europe, where biosimilars for Humira have been on the market since 2018, the drug costs far less. It’s long past time for Humira to get some competition to drive down prices for patients who need this medication. — (Chicago Tribune)
Have a great weekend, everyone!
What. A. Year. Here’s a look back at this momentous moment in drug pricing.
Welcome To The Week In Review.
History Was Made: A New Era For Drug Prices Beginsrs Of Congress Call Out Big Pharma For Covid Vaccine Price Gouging
After the culmination of a decades-long fight, history was made when Congresspassed and President Bidensigned into law the Inflation Reduction Act, which will lower prescription drug prices and cap out-of-pocket costs for at least 50 million Americans on Medicare. “With this legislation, we have changed the trajectory of drug pricing policy in the United States,” saidP4ADNowfounderDavid Mitchell. “We have finally begun to break the power of multinational drug corporations to dictate prices of brand-name drugs to the American people.” This success was hard won by patients, consumers, seniors, unions, small businesses, employers, physicians, nurses, and disease advocacy and human rights organizations whosentletters, ranads, videos, pressconferences, webinars, and tele-town halls. As patients begin to realize savings from this new law in 2023, we will continue to work to lower drug prices for everyone in the U.S. who needs access to affordable medicines.
2. Patient Advocates: The Backbone Of The Win
There is no doubt that patient advocates across the country, especially those who shared their personal experiences of the burden of high drug prices, made passage of the Inflation Reduction Act a reality. Patients were front and center in articles, radioandTVinterviews, podcasts, op-eds, letters, ads, and much more – explaininghowthedrugpricereforms willchangetheirlives for the better andimploringlawmakerstoact. Notably, patients introduced President Biden at the White House and at events on the road, urging passage and celebrating the new drug law and the ways it will benefit patients. “Insulin cost is inhumane,” patient advocate Bob Parant, a Medicare beneficiary who lives with type 1 diabetes, shared ahead of introducing the president (see photo below). “But thanks to President Biden and Democrats in Congress, the reforms in the Inflation Reduction Act will save me, and millions others, hundreds, and in some cases, thousands of dollars a year…The Inflation Reduction Act will allow me to do things I cherish – be able to travel to see my grandkids and also worry less about depleting my retirement savings.” We’re so grateful to our ever-growing community of over 400,000 patients and allies – we could not have done this without you.
Democrats outperformed expectations in the 2022 midterm election – and a keypart of their successful campaigns for Congress was spotlighting the fulfilled promise of lower drug prices from the reforms passed into law in the Inflation Reduction Act. The drug price reforms are verypopularwithvoters – and backing this popular bill helped usher in wins for frontline candidates like Senators CortezMasto and Warnock and Reps. Wild, Pappas, Horsford, Craig, and Phillips. Constituents also took notice when members of Congress opposed the bill and worked to do the bidding of Big Pharma. When Senators Lee, Lankford, Lummis, and Rubiointroduced the so-called Protect Drug Innovation Act, which aims to reverse the life-changing drug price reforms, patientsspokeupanddenouncedthem. And Democrats who didn’t back the reforms had some serious setbacks as well. Reps. Peters, Schrader, Rice, and Murphy attempted to block and then weakened the drug price provisions in the House. The result? Rep. Schrader lost his primary to a Democrat who called out his pharma-friendly policies and Reps. Rice and Murphy chose not to seek re-election. Rep. Peters, the only one still in Congress, lost his bid to lead the New Democrat Coalition, in part due to his pharma friendly policies. The results of this year’s elections are clear: Americans support lower drug prices and those who stand in the way do so at their own political risk.
4. Big Pharma Continued Hiking Drug Prices In 2022
In a year when inflation reached historic heights and the pandemic lingered on, Big Pharma kept hiking drug prices to profit at the expense of patients. The industry started off the year by increasing prices on 554 drugs in early January, then hiked the price of 188 more drugs later that month, for a total of 742 hikes. The pharmaceutical industry raised prices again in July, bringing the total number of price hikes for the first seven months of the year to 1,186 — exceeding the number for the same periods of time in 2020 and 2021. P4AD released a report that details how the drug companies behind Eliquis and Xarelto, two blood thinners used by millions of patients, have raised their prices in lockstep over the past decade to avoid competition and extract increasing profits from patients and taxpayers. (And later in the year, Senator Klobuchar and Rep. Porter wrote a lettercalling on the FTC and DOJ to investigate the lockstep price hikes on the blood thinners Eliquis and Xarelto and whether they constitute a violation of antitrust laws). Big Pharma also brought new drugs to market at record-setting prices – Amylyx Pharmaceuticals set an annual price of new amyotrophic lateral sclerosis (ALS) drug Relyvrio (which lacks evidence it is effective for patients) at $158,000; Provention Bio set the price at nearly $200,000 for a 14 day course of a new treatment that may delay the onset of type 1 diabetes for an average of 2 years; and CSL Behring’s new breakthrough treatment, Hemgenix, for hemophilia is now the most expensive drug in the world with a whopping price tag of $3.5 million per dose. New innovation is worthless for those who can’t pay unjustifiably high prices – drugs don’t work if people can’t afford them!
5. Big Pharma Lost, Despite Spending Record Amounts On Lies
The drug industry spentrecord amounts of money to try to stop the Inflation Reduction Act from passing – yet the industry still suffered its biggest loss in decades. Pharmaceutical Research and Manufacturers of America (PhRMA) and closely allied groups spent at least $57 million on ads in the year leading up to the law’s passage. On lobbying, PhRMA spent over $29 million and allied industry association BIO spent over $13 million. These lobbyists and ads spread Big Pharma lies to scare patients and lawmakers about the drug price reforms in the Inflation Reduction Act. The Washington Post, KHN, and Kaiser Health News and Politifactdebunked these claims and set the record straight on Medicare negotiation and government spending. In August, P4ADNow sent a letterto Democrats in Congress countering the drug lobby PhRMA’s letter to Capitol Hill that was rife with drug industry lies meant to intimidate members of Congress as they sprinted toward a vote on the legislation. In the end, patients took on Big Pharma power and won. We’ve seen signs of turmoil within the industry ever since – BIO’s CEO resigned soon after the passage of the landmark legislation, one of PhRMA’s top lobbyists left the trade group the same month the new drug price law was passed, and in December, AbbVie left several industry trade groups including PhRMA and BIO. As STAT summarized: “PhRMA, once a titanic lobbying powerhouse, lost its edge.”
One more thing: Here at P4AD, we were thrilled to welcome Merith Basey as our new executive director! Her arrival came at a key moment when sweeping reforms to the U.S. drug price system became law and advocates are turning to other key policies to ensure patients and all of us here in the United States can afford the drugs we need. Check out thesevideos to get to know her better!
Have a great weekend, everyone!
January 2023: Millions Of Patients Will Pay Less For Medication Thanks To Inflation Reduction Act
This Month, Insulin Copays Are Capped At $35 And All Adult Vaccines Are Free Under Medicare Part D
WASHINGTON, D.C. — January 1, 2023, marked a milestone for drug price reforms in the United States. Thanks to the Inflation Reduction Act, for the first time ever, all patients who receive their insulin through Medicare Part D (including most forms of insulin delivered via syringes and pens) now have their copays capped to $35 per month, and all beneficiaries now face $0 out of pocket for all vaccines covered by the drug program.
“2023 marks a momentous year for patients – millions of people in the U.S. will begin to feel the impacts of the historic drug price reforms in the Inflation Reduction Act, both on their health and well being as well as in their wallets,” said Merith Basey, executive director of Patients For Affordable Drugs Now. “While we’re delighted to begin the year knowing that millions of people on Medicare Part D will now have their insulin copays limited to $35 a month and will have access to free vaccines, we acknowledge that there is so much more to be done. This is just the beginning.”
The insulin copay cap includes most forms of insulin delivered via syringes and pens (insulin delivered via pumps will be capped in July 2023). About 2.7 million Medicare beneficiaries will experience savings from the January insulin copay cap, and savings are projected to average around $850 a year per beneficiary.
“I live with high blood pressure as well as insulin-dependent diabetes,” said Patricia McKenzie, a Medicare beneficiary who lives in Lithonia, GA, and receives her Humalog insulin through Part D. “I live on a fixed income, so I have to plan carefully in order to afford my prescriptions. The new $35 copay cap for my insulin will ensure I can afford my insulin for as long as I need it.”
Steven Hadfield lives with a rare blood cancer as well as type 2 diabetes and takes Lantus insulin. “My Lantus insulin carries a monthly list price of $283, which only adds to the large financial burden of my other drugs,” Steven of Charlotte, NC, who gets his insulin through the Part D drug program, shared. “Over the past year, I’ve gone without my Lantus at times because of its cost. Now, it will only cost me $35 which will bring me more consistency and, for the first time, lower my drug costs.”
For the millions of Medicare beneficiaries who receive vaccines each year, access to free vaccines will bring relief. Expensive vaccines such as Shingrix, which treats shingles, had cost about $200 out of pocket for Medicare beneficiaries, but are now free. And Medicare beneficiaries will continue to receive COVID-19 vaccines and boosters for free.
“When I got my two shingles vaccines, they cost over $200 out of pocket, even with Medicare,” said patient advocate Jackie Trapp of Muskego, WI, who lives with multiple myeloma, an incurable blood cancer. “Now that vaccines are free for Medicare beneficiaries, I’m so relieved that future patients like me won’t have to spend what I did just to protect themselves from diseases like shingles.”
All of the drug price reforms in the Inflation Reduction Act will continue to be implemented in the coming months and years. In addition to capping insulin copays and making vaccines free, drug companies will finally be penalized for raising prices above the rate of inflation in 2023. Over the next three years, Medicare will also begin to negotiate lower drug prices directly with drug companies; and starting in 2025, Medicare Part D beneficiaries will have their out-of-pocket prescription costs capped starting at $2,000 a year.
For more information on the implementation of the drug price reforms in the Inflation Reduction Act, visit medicarenegotiation.org.
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After patients scored a huge goal against Big Pharma with passage of drug price reforms in the Inflation Reduction Act, things are looking Messi within the industry ⚽??
Welcome To The Week In Review.
Members Of Congress Call Out Big Pharma For Covid Vaccine Price Gouging
Earlier this week, Sen. Elizabeth Warren and current Rep. and Senator-elect Peter Welch sent a letter to Pfizer CEO Albert Bourla condemning his plans to increase the price of its COVID vaccine by nearly four times. The U.S. government currently pays $30 per dose of the vaccine – this astronomical price increase will bring that number to up to $130 per dose. Sen. Warren and Rep. Welch pressed Bourla to respond by Jan. 9 to nine questions the members posed about the price hikes and the impact on Pfizer’s bottom line and patients alike. “Pfizer has made past assurances that market pricing for a COVID-19 vaccine would be ‘unethical’ and would amount to ‘taking advantage of a situation,'” Sen. Warren and Rep. Welch wrote. “But that is exactly what the company is doing, and the impact of this price increase will fall hardest on the uninsured and underinsured.” Taxpayer dollars funded research leading to the development of mRNA COVID vaccines, and now taxpayers will be forced to pay again through out-of-pocket costs and higher premiums. Meanwhile, Pfizer could walk away with an additional $2.5 – $3 billion in revenue if the company follows through with these vaccine price hikes. Thank you Senator Warren and Senator-elect Welch for calling out this pandemic profiteering and standing with Americans. — (Office of Senator Elizabeth Warren, The Hill)
2. Case Study: Death Sentence For Hepatitis C Patients In Prisons
STAT’s Nicholas Florko released an 8-part investigation that looks closely at state prisons’ failure to test or treat incarcerated people for hepatitis C (HCV). Florko explains that while once-daily HCV pills are highly effective (95 percent of those who take the treatment are in fact cured), the treatments are very expensive and thus out of reach for many. Given that the drugs are so unaffordable, prisons are left to choose between paying tens of thousands of dollars to cover the HCV treatment for incarcerated people in their care or deny patients access and instead only cover their ongoing medical needs due to the condition. The result of this inhumane choice? “1,013 people died of hepatitis C-related complications in states’ custody in the six years after the first cure, a Gilead antiviral drug called Sovaldi, hit the market in late 2013.” Dubbed the “1,000 dollar pill,” Gilead has raked in billions from the hepatitis C treatments which originated in an Emory University lab with taxpayer funds. The corporation shamelessly continues to defend its prices as “fair and responsible.” This investigation – which included 100 interviews, 225 public record requests, and thousands of pages of legal filings – spotlights the inhumanity of our drug pricing system and how it disproportionately impacts society’s most vulnerable. Hundreds of lives lost because patients in prison didn’t have access to lifesaving medication? Unacceptable. — (STAT)
3. Spotlight On AbbVie
AbbVie made headlines this week – one for its repeated abuse of the patent system to keep Humira prices high and another for a controversial move to leave major industry trade groups in D.C. As a reminder, the price of AbbVie’s blockbuster drug Humira has swelled over the years as the company has extended the drug’s monopoly status in the U.S. by building a thicket of patents to prevent cheaper biosimilars from coming to market — a truly unethical scheme. After two decades of Humira monopoly, biosimilars for Humira are slated to come to market next year, an outcome that should increase competition and drive down price. But in 2016, ahead of the upcoming competition, AbbVie whipped up a new formulation of Humira (a slight tweak from the original), and in 2018, completed a product hop, moving patients from the original formulation to a new one. At that point, many of the biosimilars for the original formulation had already been approved by the FDA. When those biosimilars come to market next year, they will not apply to the new formulation of Humira, allowing AbbVie to maintain a portion of the market share. AbbVie’s shenanigans are a prime example of why we so desperately need to reform our patent system and speed generics and biosimilars to market. AbbVie opposes federal legislative changes that impede on its ability to dominate the market and price its drugs as high as it wants. Perhaps that plays a part in the company’s recent decision to leave several industry trade groups, like PhRMA and Bio, which are responsible for lobbying for the interests of brand-name drug companies. We can’t help but notice that the decision follows PhRMA and BIO’s failure to stop the passage of the historic drug price reforms in the Inflation Reduction Act that, for the first time, allow Medicare to negotiate for lower drug prices and curb drug company price gouging. We see you, AbbVie. ? — (Quartz, Politico)
One more thing: A reminder that the next two drug price provisions of the Inflation Reduction Act will go into effect next month. Starting January 1, Medicare beneficiaries will get their vaccines for free and patients on Medicare Part D will have their insulin copays capped at $35 monthly. We couldn’t be more excited for all the Inflation Reduction Act drug price reforms to be implemented. Patients like Brenda and Meg need relief from high drug prices.
