Welcome to the Week in Review.
Key Drug Price Reforms Reintroduced
Senators Bernie Sanders and Ron Wyden, Ranking Members of the Senate HELP and Senate Finance Committees, respectively, reintroduced a health package that includes key bipartisan reforms to lower drug prices by curbing some of the shady tactics used by pharma and pharmacy benefit managers to keep prices high for patients and taxpayers. These reforms were left out of the year-end package in 2024 due to last-minute political maneuvering, and their reintroduction provides a second chance to address manipulative tactics like patent thicketing on biologics, which block more affordable biosimilars from entering the market and keep prices high. In a statement, P4ADNow Executive Director Merith Basey called on Congress to “act swiftly to pass these measures and prove that [Congress’] priority is lowering costs for Americans – not caving to corporate interests.” Patients have been calling for these reforms for years, including Kaye Peterson, a P4AD patient advocate from Kentucky who lives with type 1 diabetes. In an LTE in The Lebanon Enterprise this week, Kaye highlighted the impact of patent thicketing on insulin prices and urged Congress to pass these reforms. With mounting pressure from patients and advocates alike, lawmakers must choose between protecting Pharma’s profits or delivering long-overdue relief to Americans struggling to afford their medications. – (The Hill, Politico, Congress.gov, The Guardian, Congress.gov, P4ADNow, The Lebanon Enterprise)
Pharma-Backed Bills Seek to Undermine Medicare Negotiation
Big Pharma is escalating its campaign to undermine the 2022 prescription drug law – and they’ve found allies in Congress. Last week, the EPIC Act was reintroduced in the House to unnecessarily extend the Medicare negotiation exemption period for small-molecule drugs from nine to 13 years. On Wednesday, Senator Thom Tillis introduced a companion bill in the Senate, further escalating efforts to undermine the historic Medicare negotiation program. Meanwhile, the Maintaining Investments in New Innovation (MINI) Act was also reintroduced in the House this week by Rep. Don Davis – another bill aimed at creating loopholes for pharma by extending the exemption for genetically targeted therapies to 13 years – even though the current nine years is more than enough time for drugmakers to recoup investments. Yesterday, P4AD sent a letter to every Senator, urging them to oppose the EPIC Act, ORPHAN Cures Act, and MINI Act – building on a similar letter sent to the full House last month. The 2022 prescription drug law already strikes a fair balance between encouraging innovation and lowering prices for patients. Lawmakers must decide whether they stand with patients or with Pharma’s profits. – (Congress.gov, Inside Health Policy, Congress.gov, Congress.gov, P4ADNow, P4ADNow)
Monitoring Potential Impact of New Tariffs
Newly announced tariffs on pharmaceutical imports from China are raising important concerns about potential drug price increases and supply shortages. While it is premature to assess the full impact on patients, in particular since the recent tariffs levied on Mexico and Canada were delayed yesterday, we’re closely monitoring the situation. Any measure that could drive up drug costs for patients is a serious concern. We’ll continue to track developments and advocate for solutions that protect patients from higher prices. – (Forbes, Bloomberg Law, NBC News)
Attorneys Recalled to Defend Medicare Negotiation
At least two attorneys involved in defending Medicare’s drug price negotiation program have been recalled to their positions – after being caught up in the widespread layoffs across the government. This is a promising sign that the administration is committed to upholding the 2022 prescription drug law. This follows the DOJ’s recent brief defending Medicare negotiations in the case brought by Novartis to undermine the program. Additionally, last Friday marked the deadline for drugmakers to agree to participate in the next round of negotiations. While only a handful of companies have publicly confirmed their participation, none have publicly refused – an encouraging sign that the program could continue to move forward as planned. We remain hopeful that all manufacturers will negotiate in good faith and that the second round of negotiations will deliver significant savings – in line with the 62% average list price reduction achieved in the first round of negotiations. – (STAT News, Bloomberg, Inside Health Policy, Endpoints News, Fierce Healthcare, Inside Health Policy, Endpoints News)
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Welcome to the Week in Review.
House Reintroduces The EPIC Act
Big Pharma is at it again. This week, the House reintroduced the EPIC Act (H.R. 1492), a pharma-backed bill that would extend the Medicare negotiation exemption period for small molecule drugs from nine years to 13 years, forcing patients and taxpayers to pay higher prices for longer. The truth is, this bill is nothing more than a giveaway to the pharmaceutical industry. The 2022 prescription drug law already strikes the right balance to ensure innovation we need at prices we can afford. The law allows Medicare to negotiate after drugs have been on the market for several years while still allowing drugmakers to set prices and raise them in early years. Lawmakers who truly stand with patients must reject this dangerous bill and any other attempts to weaken Medicare negotiation, as extending drugmakers’ monopoly pricing power would only hurt patients and taxpayers. — (Inside Health Policy, STAT, Congress.gov, P4ADNow)
P4AD Files Fourth Amicus Brief Defending Medicare Negotiations
This week, Patients For Affordable Drugs (P4AD) filed an amicus brief in the Third Circuit Court of Appeals, defending Medicare’s ability to negotiate lower drug prices against a lawsuit brought by Novartis. This marks the fourth patient-centered amicus brief filed as part of P4AD’s US v. Pharma campaign, pushing back on the industry’s baseless claims that Medicare negotiation will stifle innovation and limit patient access. The brief highlights the experience of Bob Parant, a P4AD patient advocate, who has been living with type 1 diabetes for more than 50 years and began taking Entresto after emergency triple bypass surgery. As a patient on Medicare who needed both Entresto and insulin, Bob wasn’t able to afford both medications until key reforms in the historic prescription drug law went into effect. Prior to the law taking effect, Bob was forced to switch to a cheaper insulin that he found to be less-effective while posing potential risk to his longterm health. Last week, the Department of Justice filed its brief defending Medicare negotiations in the Novartis case. This was the first government brief of the Trump administration and marked an important moment as questions loomed over whether the new administration would defend the program in the courts. Today’s deadline for drugmakers to agree to enter into negotiations for the next 15 drugs is another key test – both for the administration’s commitment to lower prices and for Pharma’s willingness to engage rather than obstruct. — (P4AD, IP Watchdog, Fightpharma.org, P4AD, Commonwealth Fund, STAT)
Push To Revive PBM Reforms
Pharmacy benefit managers (PBMs) are black boxes in the drug supply chain that operate in secrecy. On Wednesday, the House Energy and Commerce Health Subcommittee held a hearing on the role of PBMs in driving up prescription drug costs. Lawmakers on both sides of the aisle called out the shady middlemen for their anti-competitive practices, highlighting how the three largest PBMs control 80% of the prescription drug market and use their dominance to manipulate formularies – prioritizing high-cost drugs while blocking lower-cost generics and biosimilars. And patients are the ones left paying the price. Stacy in Michigan shared with P4AD that her PBM refused to cover her husband’s life-saving insulin, even after changing jobs for better insurance coverage. Stories like hers are all too common as PBMs restrict access, inflate prices, and profit at the expense of patients. Congress has a critical opportunity to revive long-overdue reforms to increase transparency within the PBM industry that were excluded from the year-end funding deal in December. Patients are counting on Congress to hold PBMs accountable. — (House Energy and Commerce Health Subcommittee, Axios, Modern Healthcare)
In Case You Missed It
According to an HHS Office of Inspector General report, Medicare spending on 10 diabetes drugs, including seven GLP-1 treatments, increased 364% over four years from $7.7 billion in 2019 to $35.8 billion in 2023. Rising spending on these high-cost treatments raises serious concerns about the financial strain on patients and our health care system.
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Welcome to the Week in Review.
DOJ Defends Medicare Negotiations
The Trump Department of Justice (DOJ) took the first step in defending Medicare negotiation in court. On Wednesday, the DOJ filed a brief in the Third Circuit Court of Appeals in the Novartis case, maintaining the government’s legal defense of the Medicare negotiation program – for now. Notably, this is the first DOJ brief under the Trump Administration, and it remains largely unchanged from previous filings, signaling that the government is standing with the program against Big Pharma’s multi-million dollar legal assault. This is an encouraging sign for the nine million patients on Medicare who are expected to save at least $1.5 billion out-of-pocket in the first year. However, this fight is far from over. Several industry-backed lawsuits still threaten the program, and with a critical February 28th deadline approaching for drugmakers to agree to negotiate in the next round, PhRMA’s pressure campaign is in full force. Patients fought hard for this law – and we will continue to hold the administration accountable to ensure it delivers the savings millions of Americans are counting on. — (Politico, O’Neill Institute, Inside Health Policy, STAT, Axios, FightPharma.org, P4AD)
Push For Competition Bills & Defending Medicare Negotiations
With a new Congress in session, there is a critical opportunity to continue to advance reforms that lower drug prices. Last Congress, P4AD championed a slate of bipartisan bills to curb anti-competitive practices by drug companies and pharmacy benefit managers (PBMs), including:
Millions of patients are counting on lawmakers to revive these reforms and pass them into law to rein in the skyrocketing cost of prescription drugs and reduce taxpayer spending. At the same time, Big Pharma and its allies are aggressively pushing legislation to undermine Medicare negotiations. The recently re-introduced Orphan CURES Act would expand the Medicare negotiation exemption beyond drugs with a single orphan disease designation to those with multiple indications, giving drugmakers more power to inflate prices. Meanwhile, the EPIC Act, which is expected to be re-introduced, would extend the negotiation exemption period for small-molecule drugs from nine to 13 years – keeping prices high for longer. Pharma is framing both bills as pro-innovation, but in reality, they are blatant attempts to protect monopoly pricing at the expense of patients. Lawmakers must reject these industry-backed measures and instead deliver the bold reforms that Americans overwhelmingly support. — (Congress.gov, CBO, Congress.gov, CBO, Congress.gov, P4ADNow, Congress.gov, STAT, P4ADNow)
Drugmakers Meet With President Trump — Patients Excluded
Big Pharma is cozying up to President Trump while patients are shut out. Yesterday, drug industry executives from PhRMA sat down with President Trump for a third time to push their agenda to weaken the 2022 prescription drug law and keep drug prices high. Meanwhile, patients who are most harmed by drug pricing policy have yet to be granted a seat at the table. Make no mistake: PhRMA’s so-called commitment to “innovation and affordability” is nothing more than a smokescreen for their all-out assault on the drug price provisions in the IRA which they’ve openly declared is their top priority, The drug industry has spent millions buying access to the administration, but patients won’t stop fighting to protect the reforms they fought for — and we’re watching to see whether Trump follows through on his promise to lower drug prices or caves to Big Pharma’s influence. — (Reuters, Fierce Healthcare, The Wall Street Journal, MedPage Today)
In Case You Missed It
At a White House event yesterday, following President Trump’s meeting with PhRMA executives, Pfizer CEO Albert Bourla was met with loud boos from the audience as he was introduced. One can safely assume this reaction underscores the deep frustration Americans feel toward Big Pharma’s greed, as drug companies continue to prioritize profits over patients while millions struggle to afford their medications.
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P4AD Report Debunks Drug Industry Myths About IRA
This week, P4AD released a report dismantling Big Pharma’s false claims about the 2022 prescription drug law, highlighting how the law is already lowering costs for patients and taxpayers. The report reveals PhRMA, the drug industry’s largest lobbying arm, spent more than $235,800 on social media ads over a four month period spreading misinformation about the law’s “unintended consequences” as it relates to patient costs, access, and future innovation. The report rebutted each of PhRMA’s claims with data and evidence – proving that the industry’s assertions are misleading at best and outright false at worst. At a press briefing on Wednesday, P4AD’s president and founder David Mitchell, and AARP’s prescription drug policy principal Leigh Purvis, debunked these claims, calling out the industry’s desperate attempt to regain its complete monopoly pricing power. They underscored how the law is delivering tangible savings to millions of Americans while ensuring fair profits for the industry and safeguarding future innovation. After decades of Big Pharma’s unchecked pricing power, the 2022 prescription drug law is reining in drug costs, and patients remain committed to defending this progress. — (P4AD, Youtube)
RFK Jr. Selected As HHS Secretary
Robert F. Kennedy Jr. was confirmed yesterday as the Secretary of the Department of Health and Human Services (HHS), but after two Senate hearings last week, he offered little clarity on how he plans to lower prescription drug prices – raising concern for patients who urgently need access to affordable medications. With bipartisan interest in reducing skyrocketing drug costs and nine in 10 voters – on both sides of the aisle – demanding action, all eyes are on Secretary Kennedy. Will he champion reforms that put patients first or side with Big Pharma? — (Fierce Healthcare, P4ADNow, P4ADNow)
Rising Cost of Cell And Gene Therapies
New gene therapies are hitting the market with staggering price tags based on what the market can bear – not development costs. An investigation by ProPublica focused on one such treatment, Zolgensma, a $2.1 million gene therapy for children born with spinal muscular atrophy (SMA), which has become a prime example of how Big Pharma sets drug prices. Despite critical early grassroots fundraising and taxpayer-funded grants from the National Institute of Health (NIH), Zolgensma’s price was driven by Wall Street projections and a calculated pricing strategy. Novartis leveraged value-based pricing studies that floated prices as high as $5 million, helping to condition the market toward accepting an astronomical price tag. The final $2.1 million price was framed as a “compromise,” even though it had little to do with actual R&D costs and everything to do with maximizing profits for investors. This approach has set a dangerous precedent: new gene therapies can now leverage these prior launch prices as justification for setting even higher ones. Since Zolgensma’s debut, cell and gene therapies like Hemgenix ($3.5M) and Lenmeldy ($4.25M) have pushed the ceiling higher, straining public programs like Medicaid and Medicare. As P4AD’s David Mitchell told ProPublica, “every time the benchmark moves up, they think, ‘Well, we can get away with more.” Without reforms to rein in high launch prices, patients and taxpayers will continue to pay the price for Pharma’s unchecked greed. — (Drug Discovery Trends, ProPublica)
In Case You Missed It
Payouts to shareholders of major drug companies like Merck, Johnson & Johnson, and Pfizer more than tripled over the past two decades, according to a new study published in JAMA. Meanwhile, patients continue to struggle to afford their essential medicines as a result of Big Pharma’s anti-competitive tactics.
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Welcome to the Week in Review.
New Bills Attempt To Weaken The IRA
P4AD sent a letter to all members of the House of Representatives yesterday, opposing two bills that would weaken the Medicare Drug Price Negotiation Program – a critical lever that will lower drug prices for millions of Americans on Medicare. The letter makes it clear: the 2022 prescription drug law was designed to balance innovation with fairer pricing, ensuring drug companies can profit while preventing unnecessary price hikes that leave patients struggling to afford their medications. One bill, the ORPHAN Cures Act, would expand Medicare’s negotiation exemption beyond drugs approved for a single orphan disease to those with multiple indications—providing a loophole for drugmakers to extend unwarranted monopolies and inflate prices indefinitely. Orphan drugs with multiple indications already generate significant revenue from expanded patient populations, in both public and private markets, and don’t need additional exemptions to remain profitable. The second bill, the Ensuring Pathways to Innovative Cures (EPIC) Act, which is expected to be reintroduced, would extend the negotiation exemption for small molecule drugs from nine to thirteen years, forcing patients to pay higher prices for longer. This change is unnecessary, as the current law gives drugmakers ample time to recover R&D costs. Companies can still set launch prices and raise them in subsequent years – Medicare negotiation simply ensures they can’t keep hiking prices unchecked. These bills aren’t about innovation – they’re about protecting pharma’s profits and undermining the law at the expense of patients. Any members who are committed to lowering drug prices should oppose these harmful bills and reject industry-backed efforts to weaken the law. — (P4ADNow, KFF, STAT, BIO)
Price Hikes On 15 Drugs Selected For Medicare Negotiation
The drugmakers behind the 15 drugs selected for the second round of Medicare negotiation have spent years rapidly hiking prices. Cancer drugs on the list lead the pack: Pomalyst, a multiple myeloma treatment, has soared in price by 130% since its launch in 2013, while Ibrance, a breast cancer medication, has increased by 62% over the 10 years its been on the market. Novo Nordisk has hiked prices on expensive GLP-1 treatments Ozempic and Rybelsus every single year since 2021. Meanwhile, GlaxoSmithKline’s (GSK) inhaler Trelegy is up 24% since 2017 and Breo Ellipta has jumped 52% since 2013. Many of these drugs have also been shielded from competition by layers of patents, extending Pharma’s monopolies long past the dates they should have faced lower-cost alternatives. Austedo, a drug used to treat movement disorders like Huntington’s disease, has 28 active patents, while Ozempic and Trelegy each hold 20 active patents—ensuring prices stay high while patients foot the bill. — (NBC, AARP, Pharsight, Pharsight, Pharsight)
Americans Demand Health Care Affordability
A new Gallup and Emory University poll found that more than half of Americans ranked improving access and lowering costs as one of their top three concerns – cutting across party lines and underscoring the mounting frustration over soaring prices. Big Pharma has rigged the system to put excessive profits over patients, driving up prices and leaving one in three Americans struggling to afford their medicines. With public demand for reform at an all-time high and nine out of 10 Americans in agreement that Congress needs to do more to lower drug costs, the question is no longer whether drug prices need to come down—it’s whether lawmakers will stand with patients or protect Pharma’s bottom line. — (Gallup/Emory University, Axios, KFF)
Big Pharma’s Big Earnings
Quarterly earning reports from 2024 are rolling in and unsurprisingly, Big Pharma has once again come out on top. Pfizer beat expectations and raked in $17.76 billion in fourth-quarter revenue, a 22% increase from the same period last year. Novo Nordisk reported revenue of $12.26 billion in the period, largely driven by skyrocketing sales of its pricey GLP-1 drug Wegovy. Meanwhile, GSK pulled in $10.4 billion in revenue, as it continues to charge more than $11,000 for its endometrial cancer treatment, Jemperli, among other medications. These earnings are a blunt reminder: Big Pharma is swimming in cash and can afford to lower prices. Instead, they continue to hike drug costs while lobbying to block reforms—putting profits over patients at every turn. — (CNBC, The Washington Post, Fierce Pharma, The Washington Post)
In Case You Missed It
Ranking Members of the House Committee on Energy and Commerce, the House Education and Workforce Committee, and the House Ways and Means Committee wrote a letter to the Government Accountability Office requesting that they monitor the Medicare Drug Price Negotiation Program to ensure the new Trump administration upholds its promise to lower prescription drug prices and drive down taxpayer spending.
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Welcome to the Week in Review.
Trump Administration Continues Medicare Negotiation
In a promising sign for patients, the Centers for Medicare and Medicaid Services (CMS) confirmed that the Medicare Drug Price Negotiation Program remains on track, marking a critical moment for the new administration and for patients. P4AD welcomed the announcement, and in a statement released on Wednesday, founder and president David Mitchell reiterated that this was a positive step forward, but that the real test will be in the execution. Patients need negotiations that deliver price cuts similar or better than those secured in the first round – where list prices were reduced by more than 60 percent on average. P4AD is fiercely committed to protecting the historic negotiation program and ensuring its successful implementation. — (CMS, P4AD, AARP)
US v. Pharma: Patient-Led Petition Delivery
Standing outside the headquarters of The Pharmaceutical Research and Manufacturers of America (PhRMA), the powerful lobbying arm of the pharmaceutical industry, P4AD and allied organizations delivered a clear message to drug company CEOs: Drop your lawsuits and let Medicare negotiate lower prices for patients. Backed by more than 202,000 petition signatures, patients demanded an end to Big Pharma’s legal assault on the program as they urged the CEO of PhRMA, among others, to uphold the law and not interfere with the popular program supported by more than 80% of Americans on both sides of the aisle. At the demonstration, Judy Aiken, a P4AD patient advocate, who paid over $9,000 for Enbrel in 2023, shared how Medicare negotiation will provide long-overdue relief when the new lowered prices come into effect next year. As drug companies and their allies continue to threaten the 2022 prescription drug law in court, patients aren’t backing down. — (Inside Health Policy, P4AD, P4AD)
HHS Secretary Confirmation Hearings
During heated, back-to-back confirmation hearings, Health and Human Services (HHS) Secretary nominee Robert F. Kennedy Jr. provided limited details on how he plans to lower drug prices for patients — a pressing issuefor a majority of American families. If confirmed as HHS Secretary, he would shape the future of programs and policies to make prescriptions more affordable — including the historic Medicare Negotiation Program. When asked about the program, RFK Jr. vaguely committed to continuing the initiative but offered no clarity about his plans or vision for implementation. His positions could determine whether it delivers real savings or is weakened to protect Big Pharma’s profits. Additionally, when facing questions about legislation that nearly passed during the 118th Congress and would have targeted pharmacy benefit managers, RFK Jr. replied that he had not read the specific bill. In closing remarks, Senator Bernie Sanders called out the lack of clear answers from RFK Jr. on why Americans pay some of the highest prices in the world. Nine in ten Americans want more to be done to lower drug prices – but whether RFK Jr. will stand with patients or protect Pharma’s profits is becoming increasingly uncertain despite his apparent dislike of the industry. — (STAT, Politico, West Health, P4AD)
In Case You Missed It
Senators Dick Durbin and Chuck Grassley re-introduced the Drug-price Transparency for Consumers (DTC) Act, a bipartisan bill, endorsed by P4AD, that would require drug manufacturers to disclose prices on advertisements for prescription drugs.
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Welcome to the Week in Review.
US v. Pharma
Patients For Affordable Drugs filed a patient-focused amicus brief in the Second Circuit Court of Appeals, opposing Boehringer Ingelheim’s lawsuit to block Medicare negotiation. The amicus brief, P4AD’s third as part of our US v. Pharma campaign, highlights the transformative relief that lower negotiated prices will deliver to millions of patients and dismantles Big Pharma’s claims that the widely-supported program will stifle future innovation and limit patient access to essential medicines. It also recounts how drug industry lobbying resulted in a two-decades-long prohibition on Medicare’s negotiation authority, leaving patients to bear the burden of exorbitantly high prices dictated by the industry. Patient stories are central to the argument against Boehringer’s claims, including Oluyomi Amoye who shared his difficulty affording Jardiance, which is used to treat his type 2 diabetes, and one of the first 10 drugs selected for negotiation. As ten lawsuits have threatened this hard-fought victory, patients continue to defend lower drug prices in the courtroom and beyond. — (P4AD, Fierce Pharma, KFF, Action Network)
Trump Administration’s First Drug Pricing Action
On his first day in office, President Trump rescinded President Biden’s Executive Order that directed the Centers for Medicare and Medicaid Innovation (CMMI) to develop and test innovative payment and delivery models to reduce drug costs and promote access to drug therapies. These models include the voluntary Medicare $2 Drug List Model to standardize cost-sharing for over a hundred generic drugs at $2 per month, and the Cell and Gene Therapy (CGT) Access Model to help Medicaid patients, starting with those living with sickle cell disease, afford cutting-edge treatments. While the move doesn’t immediately end the models, it raises serious concerns about their future. Experts have called the decision “perplexing,” noting it signals a troubling start for an administration that has pledged to address high drug costs. In a conversation with Inside Health Policy, P4AD President and Founder David Mitchell emphasized the importance of these models as creative solutions consistent with bipartisan goals, urging the administration to move forward with bold initiatives to deliver meaningful relief to patients. P4AD remains committed to working with lawmakers across the political spectrum to advance reforms that make medications affordable for all. — (Politico, Pink Sheet, NBC, Inside Health Policy)
$2k OOP Cap Brings Transformative Relief
Just weeks into the new year, patients are already sharing how the $2,000 annual cap on out-of-pocket costs for people on Medicare is transforming their lives. The cap, which came into effect this month, will provide long-awaited financial relief for 11.3 million Americans struggling with high prescription drug costs. P4AD patient advocate Judy Aiken shared with NPR how she expects to save $7,000 this year on her psoriatic arthritis medication Enbrel – meaning she can consistently take her prescribed medications and finally address much-needed home repairs. Pamela of Rockford, MI, shared with P4AD that she will save $6,000 after years of paying the maximum out-of-pocket costs. “This year I can finally begin to pay down some debt rather than incurring more.” Maureen of Bridgewater, NJ, said she’s already met the cap, saving $4,000 this year. These stories represent just a fraction of the 420,000 patients on Medicare who are projected to save more than $3,000 this year thanks to this critical provision in the 2022 prescription drug law. — (Commonwealth Fund, NPR, AARP)
In Case You Missed It
This week on Capitol Hill, David Mitchell shared his story as a patient living with multiple myeloma, an incurable blood cancer. David highlighted the staggering costs of his treatments, which carry an annual list price of $1 million. Holding up a bottle of his Pomalyst – one of the drugs selected in the second round of Medicare negotiation – David emphasized the urgent need for the successful implementation of the Medicare Negotiation Program. In 2023, Pomalyst cost David over $16,000 for a year’s supply.
Photo by Rod Lamkey, freelance reporter, for The Associated Press Center
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Next 15 Drugs Selected for Medicare Negotiations
Marking another historic step for patients, the Centers for Medicare & Medicaid Services (CMS) announced the next 15 drugs selected for Medicare negotiation. The selected medications were used by 5.3 million people on Medicare between November 2023 and October 2024 and accounted for $41 billion in Medicare spending within that period. In January this year, 12 of the 15 drugs selected for negotiation saw new list price increases, 11 of which were higher than the rate of inflation. Given the successful negotiations for the first 10 drugs, which saw an average list price reduction of more than 62%, lower negotiated prices for these additional 15 drugs will mean substantial relief to millions more patients. A lower negotiated price for Ofev, one of the selected drugs, could ensure Carole from Michigan can consistently take her treatment for chronic lung disease for which is unaffordable at $14,000 per month. A lower negotiated price for the inhaler Breo Ellipta would mean Teresa from North Carolina could finally treat her asthma with the only inhaler on that market that works for her. We remain steadfast in our commitment to supporting the successful implementation of the Medicare negotiation program, ensuring patients and taxpayers get a better deal on their life-sustaining medicines. — (P4AD, NBC News, HHS, AARP, BioPharma Dive)
Teva Joins Big Pharma’s Assault On Medicare Negotiation
Teva Pharmaceuticals has filed the 10th lawsuit representing Big Pharma and its allies aimed at blocking the drug price negotiation program. The lawsuit came just one day before Austedo and Austedo XR, Teva’s treatments for movement disorders, were officially selected for the next round of Medicare negotiations. These drugs cost patients up to $14,642 per month and generated $435 million in revenue for Teva in just three months last year. Teva’s legal argument – that Medicare shouldn’t negotiate prices for two drugs with the same active ingredient – is a new and desperate attempt to undermine negotiations. After seeing their earlier legal challenges repeatedly rejected by federal courts, the pharmaceutical industry is testing fresh claims to see if any will stick. This latest tactic is part of a broader, coordinated campaign to protect exorbitant profits at all costs, even as Americans struggle with high drug prices. Now that the next drugs up for negotiation have been announced, more lawsuits are expected. P4AD will continue to fight back, defending Medicare negotiation through amicus briefs filed in the courts, with campaigns like “US vs. Pharma,” and by mobilizing patients to protect these critical reforms. – (Bloomberg Law, FightPharma.org, Austedo, Teva Pharmaceuticals, HHS)
FTC Report Exposes PBM Price Gouging Scheme
The Federal Trade Commission’s (FTC) latest report shines a spotlight on the greed of pharmacy benefit managers (PBMs), revealing how CVS Caremark, Express Scripts, and OptumRx raked in $7.4 billion in revenue by inflating the prices of 51 lifesaving drugs between 2017 and 2022. The Big Three PBMs marked up specialty generics used to treat cancer, HIV, and heart disease, by hundreds – and in some cases thousands of dollars – at the expense of patients. For example, a month’s supply of Tadalafil, a pulmonary hypertension treatment, was acquired by pharmacies for $27 and marked up to $2,106, an increase of over 7,700%, and Tecfidera, a multiple sclerosis drug, was acquired for $177 and hiked to $3,930, a markup of more than 2,100%. The report, which expands on the FTC’s initial probe from July 2024, confirms what patients have long suspected: PBMs exploit their shadowy role in the drug supply chain to hike prices and pocket enormous profits, leaving patients to foot the bill. The findings underscore the urgent need for Congress to pass meaningful reforms to bring transparency and accountability to the PBM industry. — (FTC, Fierce Healthcare, Axios)
Debunking Pharma Misinformation About IRA
The Federal Trade Commission’s (FTC) latest report shines a spotlight on the greed of pharmacy benefit managers (PBMs), revealing how CVS Caremark, Express Scripts, and OptumRx raked in $7.4 billion in revenue by inflating the prices of 51 lifesaving drugs between 2017 and 2022. The Big Three PBMs marked up specialty generics used to treat cancer, HIV, and heart disease, by hundreds – and in some cases thousands of dollars – at the expense of patients. For example, a month’s supply of Tadalafil, a pulmonary hypertension treatment, was acquired by pharmacies for $27 and marked up to $2,106, an increase of over 7,700%, and Tecfidera, a multiple sclerosis drug, was acquired for $177 and hiked to $3,930, a markup of more than 2,100%. The report, which expands on the FTC’s initial probe from July 2024, confirms what patients have long suspected: PBMs exploit their shadowy role in the drug supply chain to hike prices and pocket enormous profits, leaving patients to foot the bill. The findings underscore the urgent need for Congress to pass meaningful reforms to bring transparency and accountability to the PBM industry. — (FTC, Fierce Healthcare, Axios)
ICYMI
As the Biden-Harris administration comes to an end, never-before-seen photos were recently published in People, of P4AD’s Judy Aiken sharing her experience with the high cost of prescription drugs with President Biden and how the relief being delivered through the historic drug pricing law is truly life-changing.
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