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)
Have a great weekend!
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.”
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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.”
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Welcome to the Week in Review.
1. New Poll: Americans Oppose Big Pharma’s Assault On Medicare Negotiation
On Tuesday, P4ADNow released a new poll that confirms what we already know: Americans overwhelmingly – by more than a 5-to-1 margin – oppose the pharmaceutical industry’s lawsuits attempting to block Medicare from directly negotiating lower prescription drug prices. “The American people understand the lawsuits to block lower drug prices through Medicare negotiation are not about looking after the best interests of patients and consumers,” said P4AD’s David Mitchell. The poll found that drug companies’ argument that the Medicare negotiation law will lead to fewer cures is not believable to voters by a nearly 4-to-1 margin, and voters by a 6-to-1 margin say drug companies are opposing this law over profits, not because it violates the constitution. Moreover, respondents who viewed drug companies unfavorably jumped from half to two thirds upon hearing of the lawsuits and the arguments from both sides. “Efforts in Congress to undermine implementation of the Inflation Reduction Act fly in the face of the wishes of the overwhelming majority of voters,” David continued. “Elected officials who align themselves with this unpopular and greedy industry, against the will of voters, do so at their own political risk.” — (P4ADNow, Common Dreams)
2. Medicare Negotiation Restores Fairness
We may sound like a broken record, but it’s too important to understate: The Inflation Reduction Act’s provision that empowers Medicare to negotiate lower drug prices will bring savings to millions of patients. The drug industry’s arguments clearly don’t add up — patients have long awaited the relief this new program will bring, after facing huge financial burden from their life-saving medications. P4ADNow’s David Mitchell and patient advocate Steven Hadfield are among the many patients who will benefit from the Medicare negotiation, reported Jamie Smyth in a feature piece in Financial Times (see photo below). The new program balances out pharma’s unfettered pricing power and restores fairness, given that “U.S. consumers [are] footing the development costs of new pharmaceuticals,” wrote Rob Rudick in a Washington Post LTE. Voters have expressed overwhelming support for Medicare negotiation: A new Associated Press/NORC poll found that 76 percent of respondents, across party lines, supported the new law. Seven of the first 10 drugs eligible for negotiation are used to treat cardiovascular and metabolic diseases that affect millions of Americans, according to an analysis published in JAMA. We won’t let up in our fight to ensure that Medicare negotiates lower drug prices for patients who need this relief. — (Endpoints, AARP, Financial Times, The Washington Post, AP/NORC, Truthout, JAMA)
3. The Inflation Reduction Act: A Clear Win For Patients
Patients, advocates, and experts continue to push for reforms that strengthen our patent and regulatory systems and promote competition to lower drug prices. In an opinion piece, Matt Mackowiak called on Senator Bill Cassidy to “crack down on the anticompetitive practices of Big Pharma to help lower drug prices” and pass bipartisan bills that can address these patent abuses. Carrie Parvin of Alaska also wrote an LTE calling on Senators Lisa Murkowski and Dan Sullivan to support bipartisan legislation that would curb Big Pharma patent abuses and “help usher in more generics and biosimilars to market.” In a new study, the Initiative for Medicines, Access, And Knowledge (I-MAK) highlighted the drug industry’s abuse of our patent system to prolong monopoly pricing power and limit biosimilar competition. The study found that four of the leading biologic drugs that have had competition since 2019 — Humira, Avastin, Rituxan, and Lantus — reaped an astonishing combined $158 billion during their period of patent extension. Patients like Sue Lee have felt the impact of drug companies’ patent abuse that enables them to charge ridiculously high prices. Sue was forced to stop taking Humira entirely when she went on Medicare because her costs jumped due to years of annual price hikes by its maker, AbbVie. The Association for Accessible Medicines (AAM) released a report showing that in 2022, biosimilars and generic drugs saved patients, employers, and taxpayers $408 billion. Patients deserve access to medications they need at prices they can afford – time for the Senate to pass bipartisan legislation that begins to fix our broken patent and regulatory systems. — (The Hayride, Mat-Su Valley Frontiersman, I-MAK, KFF, Real Clear Health, Big Molecule Watch)
Have a great weekend!
My name is Doug Lusty and I was born and raised in Salt Lake City and am now a longtime resident of Kaysville, Utah. For more than half of my life, I spent my professional career as an auditor for the state.
Today, I am fully retired at 60 years of age. But retiring in 2018 was no easy choice. For many years, I struggled with gastrointestinal issues and was misdiagnosed for about 15 to 20 years of my life. The doctors always told me I had irritable bowel syndrome (IBS), but I knew that was simply not the case.
Finally, in 2010, an emergency room visit changed my life forever. I ended up in the hospital for a bowel obstruction, where for the first time in my life a doctor decided to perform an abdominal CT scan which led to a correct diagnosis of Crohn’s disease. I was immediately referred to a gastrointestinal specialist (GI) who to this day has been great to me and given me the healthcare that I’ve needed badly. As recommended by this GI specialist, I underwent colon/rectal surgery in October of 2010, where 3 ½ feet of my small intestine and ½ a foot of my colon were removed. Then in 2018, I was diagnosed with diabetes – which has been the more manageable condition thus far.
Over the span of 13 years since my surgery, I have been put on a range of four biologic drugs meant to treat my Crohn’s disease and help me adjust to my new normal. I spent five years taking Humira, a TNF suppressor medication designed to stop tumor necrosis factor-ɑ or TNF from attacking healthy cells, which had a good effect on me until my body developed antibodies to it. I then spent four years on Entyvio, which never worked quite as well as Humira. Then for about three months I took Renflexis, which failed me immediately. I then fought my insurance to cover the next medicine I was prescribed: Stelara, where the copay per each injection was $2,641.09 every eight weeks.
I felt it was impossible for me to cover this expense. I needed Stelara to control the inflammation in my guts, so this is where my fight for affordable medications started. Stelara was far too expensive for my insurance to cover it until I qualified for its copay assistance program I am on now, where I only pay $10 per injection. But in a few years, I will have to make the move from private insurance with copay assistance to Medicare, where Stelara costs will impact me again. Despite being on Stelara at an affordable price now, my new normal has changed my life dramatically – most of my day is now spent on several runs to the bathroom, many of which are painful, and my wife and I worrying about our financial stability.
My wife, Sandy, also has medical issues of her own. She is on numerous prescriptions. She is currently on Medicare and does not qualify for co-pay assistance plans like I do. Between Sandy and me, we are currently on five of the medicines that were announced eligible for Medicare to negotiate lower prices for. Sandy is on Entresto, Emgality, and Farxiga. I am on Stelara and Jardiance. Our total out of pocket costs for these five drugs are in the thousands of dollars.
High cost drugs are truly a challenge we must overturn. By making prescription drugs more affordable for patients, patients like me could feel a sense of relief we have missed for so long.
