Busy week on the hill before recess! In a near-unanimous vote, the Senate Finance Committee advanced bipartisan reforms to increase transparency and accountability of Pharmacy Benefit Manager (PBM) practices. “The move adds to the flurry of activity in both chambers on PBMs, highlighting the interest in both parties in getting changes across the finish line,” Axios reported. In the Senate Judiciary Subcommittee on Intellectual Property, Senator Peter Welchshed light on Big Pharma’s abuse of the patent system. “When you have a patent system that can be abused by the patent holders, and they can go beyond the period of exclusivity, it’s brutal on the cost of health care for American employers, to taxpayers, and to private payers,” Welch explained. He used the example of Humira, which has brought AbbVie billions of dollars in profit during its reign as the world’s best-selling drug by obtaining 165 patents on the drug — barring any competition from coming to market. AbbVie’s Humira also illustrates how both patent abuses and PBMs play a role in preventing competition. When competitors finally come to market, PBMs often stand in the way of patients obtaining the more affordable options. PBMs “direct the prescription flow of patients,” Clear Health Costs summarized. “[PBM]s channel patients into higher-priced drugs and away from less expensive drugs. That’s how they get paid more.” Senators, let’s reform our rigged patent system and PBM practices – patients are waiting! — (Axios, WCAX, Clear Health Costs)
2. Debunking Pharma Doublespeak
Big Pharma will stop at nothing to preserve its bottom line and exploitative pricing power. New lawsuits from drug companies are “throwing the kitchen sink” in a desperate attempt to stop Medicare from negotiating lower prices for patients, terrified their profits will suffer under the new law. But pharma earning reports tell a different story. The five largest drug companies reported combined earnings of $81.9 billion in 2022, an increase of $8 billion from 2021, according to new analysis by Accountable.US. Given these billions of dollars in profit made last year, drug company’s claims about damage to their research and development (R&D) expenses sure seem pretty unconvincing. “The drug companies are putting their profits ahead of the affordability of drugs for millions of Americans on Medicare,” wrote Al Norman of Massachusetts. Thankfully, the Medicare negotiation program will rein in high drug pricesand increase access to innovative medicines by considering factors like a drug’s clinical benefit. “The Inflation Reduction Act might incentivize companies to focus more heavily on breakthrough therapies, instead of so-called me-too drugs,” Harvard Professor Ameet Sarpatwari told The New York Times. Big Pharma’s bogus lawsuits and lies about the new law don’t stand a chance – Medicare negotiation will bring relief to patients who have faced unjustified price hikes year after year. — (The New York Times, The Lancet, The Hill, The Fifty Plus Life, Common Dreams)
3. The Inflation Reduction Act: More Savings For Patients
Patients are already feeling relief from the Inflation Reduction Act and will continue to see savings from the soon-to-be implemented provisions. On the Senate floor, Majority Leader Chuck Schumer celebrated some of the historic reforms passed last year: “Because of the IRA, vaccines are free for Medicare beneficiaries, and a cap on out-of-pocket drug spending – no senior will pay more than $2,000 a year for drugs – is coming very soon.” A new study published in JAMA found that people on Medicare have filled more insulin prescriptions since the historic drug price law was passed in 2022. The study noted that the $35 monthly insulin copay cap “meaningfully reduced” the number of people on Medicare who were rationing insulin due to cost. For patients like Lawrence, who paid more than $100 per bottle of insulin before 2023, the insulin copay cap brings significant savings. Medicare negotiation is also expected to lower drug prices for patients and reduce the federal deficit by billions of dollars. The negotiation process is “turning the tables on drugmakers,” who set unjustly high drug prices, Leslie Walker discussed on the Tradeoffs podcast. At a town hall, Senator Elizabeth Warren explainedMedicare negotiation, which starts with just ten negotiated drugs for the first round, as the “crack in the wall” of Big Pharma monopoly power. This is just the beginning – we won’t stop until no walls exist between patients and their medications. — (Senate Democrats, Spectrum News 1, Augusta Free Press, Tradeoffs, The Berkshire Eagle)
1. Medicare Negotiation: Popular Provisions That Will Bring Relief
In the latest attack on the Medicare negotiation law, this week Johnson & Johnson (J&J) joined the list of drug companies and trade groups filing bogus lawsuits. Clearly, J&J is scrambling to protect its bottom line, since its blockbuster blood thinner Xarelto may be selected for the first round of negotiation. But patients aren’t fooled! A poll released this week by Navigator Research reported that voters overwhelmingly support the drug price reforms in the Inflation Reduction Act, with 81 percent supporting the provision giving Medicare the power to negotiate for lower drug prices. The Center For American Progress (CAP) released a new analysis that highlights how Medicare negotiation will specifically help women, Black and Latino people, LGBTQI+ people, and disabled people. The report explains that Black and Latino people on Medicare are nearly two times more likely not to fill a prescription due to cost, and the Inflation Reduction Act will provide tangible relief. Patients aren’t the only ones benefiting from the Medicare negotiation program. At a press conference organized by Protect Our Care and Opportunity Wisconsin, Rep. Gwen Moore explained: “Not only does the Inflation Reduction Act provide affordable medications to people, but it actually reduces the deficit by billions, hundreds of billions of dollars.” With billions of dollars of savings at play, no wonder drug companies are pleading with the courts to preserve their bottom line. — (Navigator Research, Center For American Progress, Up North News)
2. Momentum Builds On PBM Reforms
As Senate Majority Leader Schumer works on a health package to lower drug prices, momentum continues to build for Pharmacy Benefit Manager (PBM) reform. The Senate Finance Committee announced a markup of PBM legislation next week on July 26. Senators Tom Carper and Chuck Grassley introduced new legislation, the PBM Oversight Act of 2023, that would empower the federal government to increase oversight over PBMs’ practices. In the House, the Education and Workforce Committee passed a bipartisan package last week that included reforms to increase PBM transparency. Clearly, reforming PBMs is a priority in both chambers and across the aisle! The Federal Trade Commission (FTC) held a unanimous vote this week walkingback its previous stance against PBM transparency. The writing is on the wall: PBMs can no longer hide behind trade secrets and proprietary data. It’s high time to shed light on the middlemen’s practices and it’s evident that bipartisan support for reforms has never been stronger. — (Axios, The Hill, Bloomberg Law)
3. Continuing The Push For Competition
Following lastweek’slaunch of the “Push For Competition To Lower Drug Prices,” P4ADNow is continuing to spread the word about the ways that Big Pharma abuses the system and why we urgently need the Senate to pass reforms. Through a social media campaign, P4ADNow is breaking down how drug corporations exploit the patent and regulatory systems with tactics like pay-for-delay deals, product hopping, and patent thickets to maintain their monopolies. Humira, the poster child for patent abuse, finally has competition after years of market exclusivity due to a combination of anti-competitive tactics. Humira’s competitors have the potential to drive lower drug prices to the market and provide relief to patients who’ve faced unjustified, high drug prices. “The introduction of seven alternatives to AbbVie Inc.‘s blockbuster drug Humira in July will be the most important test to date on whether market competition can bring down what patients pay for expensive biologics,”reported Bloomberg Law. While we wait to see how Humira biosimilars play out, we urgently call on the Senate to pass reforms that foster competition and crack down on abuse of the patent and regulatory systems to ensure they are serving patients first, instead of padding the pockets of Big Pharma. — (P4ADNow, NPR, Bloomberg Law)
BONUS: It’s been almost a year since the Inflation Reduction Act passed and despite Big Pharma fear mongering, drug companies seem to be doing just fine! This week, Novartis announced a $15 billion share buyback and J&J published its quarterly earnings, which increased 6.3% for a total of $25.5 billion in sales. What was that about not enough money for R&D? 👀
Have a great weekend!
Special Edition! All About The:
Welcome to the Week in Review.
ICYMI, Senate Majority Leader Schumer sent a Dear Colleague letter indicating his intention to advance bipartisan bills to lower drug costs during the July work period. Then on Thursday, we launched the “Push For Competition To Lower Drug Prices,” calling on the Senate to immediately pass bipartisan drug price competition reforms. Here’s a recap:
Press Conference On The Hill 🎤
Senator Klobuchar, patients, AARP, Patients For Affordable Drugs Now (P4ADNow), and SPACEs in Action launched the “Push For Competition To Lower Drug Prices” with a pressconference on Capitol Hill. The event focused on the burden of high drug prices on patients and the need to pass legislation that cracks down on the drug industry’s anti-competitive practices. “Sky-high prices have kept prescription medications out of reach for far too many Americans. By passing legislation to address the anti-competitive tactics that big pharma uses to keep drug prices high, we will enable more competition and innovation in the pharmaceutical market and lower costs for patients,” said Senator Klobuchar, who has been a champion in the fight to lower drug prices. Jacqueline Garibay, 22-year-old student who lives with ankylosing spondylitis from Austin, Texas shared how Amgen has used shady actions to keep biologic drugs at high prices: “Big Pharma is abusing the system and taking advantage of patients by preventing competition for life-saving drugs to protect its bottom line – people like me have no choice but to pay whatever price the companies set,” she continued. “It’s time to put patients’ lives ahead of drug industry profits.”
Letter To The Senate From 35 Orgs 📝
The morning of the press conference, 35 organizations representing patients, consumers, seniors, churches, students, unions, and disease advocacy groups sent a letter to the Senate calling for passage of bipartisan bills that lower drug prices through increased competition. The letter, lead by P4ADNow and AARP, urges the Senate to pass reforms that crack down on the drug industry’s anti-competitive practices, such as “pay-for-delay” deals and product hopping, and close regulatory loopholes, like the abuse of the citizen petition process, to promote generic and biosimilar competition to lower drug prices for patients. The Senate has a real opportunity to advance reforms to “promote competition, accountability, and transparency that will lower drug prices for patients, payers, and taxpayers.” It’s time to get it done.
Advocacy Campaign Launched 🚀
As part of the kickoff, P4ADNow launched new digital ads and an advocacy hub all about promoting competition to lower drug prices. The advocacy hub includes a breakdown of the legislation, first hand stories of how Big Pharma’s abuses hurts patients, and tools to help advocates write letters urging their Senators to pass a package that includes bipartisan bills that promote generic and biosimilar competition to lower drug prices. Check out an example of a new digital ad running below:
BONUS: Speaking of Big Pharma patent abuse, did you see that John Green called out Johnson & Johnson for seeking secondary patents on tuberculosis drug bedaquiline to maintain its monopoly on the drug? This shady move denies millions of people access to the drug. Worth a watch (plus follow the conversation on #patientsoverpatents, which has been trending on Twitter)!
Have a great weekend!
Senators, Patients, AARP, P4ADNow, and SPACEs in Action Launch Push At Press Conference
WASHINGTON, D.C. — Senator Klobuchar, patients, AARP, Patients For Affordable Drugs Now (P4ADNow), and SPACEs in Action launched the “Push For Competition To Lower Drug Prices” with a press conference on Capitol Hill today. To kick off the push, 35 organizations representing patients, consumers, seniors, churches, students, unions and disease advocacy groups sent a letter to the Senate calling for immediate passage of bipartisan bills that crack down on the drug industry’s anti-competitive practices and close regulatory loopholes to promote generic and biosimilar competition to lower drug prices for patients.
“Right now, drug companies abuse our system through anti-competitive practices that extend monopolies beyond the time intended under law, leaving patients in this country paying more than three times what other wealthy nations pay for the exact same brand name drugs,” said David Mitchell, a patient with incurable blood cancer whose drugs carry a list price of more than $900,000 per year and founder of Patients For Affordable Drugs Now. “The Senate has the chance to pass a package of bipartisan bills that will reform and improve our patent and regulatory systems to encourage earlier market entry of more affordable generics and biosimilars. These are common sense, bipartisan solutions that will deliver real relief to patients through lower drug prices. We urge the Senate to act now.”
As part of the kickoff, today P4ADNow also launched new digital ads and an advocacy hub for people to urge their Senators to pass a package that includes bipartisan bills that promote generic and biosimilar competition to lower drug prices.
This press conference took place following Majority Leader Schumer’s Dear Colleague letter indicating his intention to advance bipartisan bills to lower drug costs during the July work period. The package includes reforms voted out of the Senate HELP, Judiciary, and Commerce Committees on a strong bipartisan basis earlier this year.
The following are quotes from the speakers at today’s press conference:
“Sky-high prices have kept prescription medications out of reach for far too many Americans. By passing legislation to address the anti-competitive tactics that big pharma uses to keep drug prices high, we will enable more competition and innovation in the pharmaceutical market and lower costs for patients,” said Senator Klobuchar. “I’ll keep working to ensure all Americans can get the life-saving medications they need at prices they can afford.”
“Americans can’t afford to pay more than 3 times what people in other countries pay for the same medicine,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy and Engagement Officer. “Generic drugs have proven to be one of the safest and most effective ways to ensure that millions of older Americans can afford the prescription drugs they need. Now is the time for Congress to increase competition and help lower drug prices.”
“Lowering drug prices will increase the quality of life for many people like me across this country. We are urgently calling on the Senate to immediately advance and pass the bipartisan bills to lower drug prices.” – Arthur Blair, Board Member, SPACES in Action
“Big Pharma is abusing the system and taking advantage of patients by preventing competition for life-saving drugs to protect its bottom line – people like me have no choice but to pay whatever price the companies set…It’s time to put patients’ lives ahead of drug industry profits.” – Jacqueline Garibay, 22-year-old ankylosing spondylitis patient from Austin, TX
A recording of the event can be viewed here, and photos are available upon request.
1. Celebrating Reforms: The Out-Of-Pocket Cap And Insulin Copay Cap
More good news on how the drug price reforms in the Inflation Reduction Act are helping and will continue to help patients. Yesterday, the Department of Health and Human Services (HHS) released data showing that nearly 19 million people on Medicare Part D will save, on average, $400 per year when the $2,000 out-of-pocket spending cap takes effect in 2025. At a roundtable earlier this week, HHS Secretary Xavier Becerra celebrated the historic drug price legislation and vowed to continue to advocate for strong implementation of the Inflation Reduction Act because “no American should ever have to choose between paying rent or for prescriptions.” Indiana State Rep. Earl Harris Jr. highlighted the benefit of the monthly insulin copay cap in a town hall, stating that “some 81,000 Hoosiers who get their insulin through Medicare will see lower costs due to the act’s $35 monthly cap on the drug.” Congressman Dan Kildee celebrated the recent expansion of the monthly insulin copay cap for people on Medicare Part B that went into effect this month, saying that “No senior should have to pay hundreds of dollars for medicine that costs big pharmaceutical companies just a few dollars to make.” We’re delighted that the drug price reforms deliver long-awaited relief to patients, and glad government officials are spreading the word. — (HHS, Spectrum News 12, Chicago Tribune, WNEM)
2. More Evidence For Increasing Competition
Momentum is growing to stop drug corporations from abusing patent and regulatory processes to prolong their monopolies on prescription drugs. In an op-ed, Senator Bill Cassidy described how drug corporations take advantage of loopholes and “game the regulatory system to delay competition and preserve their ability to charge higher prices.” His piece pointed to reforms that address tactics to delay competition, such as “ending the abuse of the citizen petition process.” In a recent interview, the Initiative for Medicines, Access, And Knowledge (I-MAK) called out AbbVie for the drug company’s extensive patent thickets for its blockbuster drug Humira as a prime example of abuse of the patent system to protect unfettered pricing power. After years of market exclusivity fueled by patent thickets, Humira finally has competition, with seven biosimilars coming to market at lower prices in the last week. Competition that can lower drug prices is an essential step to restoring fairness to the system. Congress, over to you to pass reforms that close loopholes in our regulatory system so generics and biosimilars can come to market sooner. — (STAT, Life Science Leader, Managed Healthcare Executive, Axios)
3. Arriving At A Fair Price For New Treatments
New innovative therapies and treatments are arriving to market — the question of how to price them fairly remains. A new study published this week in The BMJ found that less than half of new approved drugs in the U.S. and Europe offer improved clinical value over existing treatments. Authors of the study noted that when new treatments don’t offer added therapeutic value, that information should be “reflected in the price of the drugs.” Spot on! We need a comparative value analysis tool in the United States to arrive at fair prices for prescription drugs — otherwise, patients may be paying more for drugs that offer less clinical benefit. In the case of groundbreaking gene therapies coming to market, patients and taxpayers are facing exorbitantly high prices despite massive public funding in research and development (R&D). Fyodor Urnov, a genetics professor at UC Berkeley, told The Washington Post that his team regularly receives emails from parents of patients with rare genetic disease who “desperately need treatment but can’t afford it.” He continued to comment that “We haven’t really built a system that spreads the public health joy equitably.” Drugs don’t work if people can’t afford them. — (The BMJ, Endpoints, The Washington Post)
Have a great weekend!
Stay cool over the sweltering-hot holiday weekend! The forecast? High temps and lower drug prices. ☀️
Welcome to the Week in Review.
1. The Inflation Reduction Act: Cost Savings Continue
Three new additional policies that will benefit patients are taking effect under the Inflation Reduction Act. First, all insulin covered under Medicare now has a $35 monthly copay cap starting July 1. Second, additional people will qualify for extra savings on Medicare Part D costs through Medicare’s Extra Help Program. And third, recommended vaccines will be available at zero cost for people with Medicaid or CHIP prescription drug coverage starting October 1st. These new changes will deliver relief to patients in addition to the rest of the provisions in the new drug price law. Out-of-pocket drug spending for people on Medicare is expected to decline thanks to the $2,000 cap on out-of-pocket costs that takes effect in 2025, and in 2026 patients on negotiated drugs could see significant savings, according to a report by Centers for Medicare & Medicaid Services (CMS). Senator Debbie Stabenow emphasized the positive impact of Medicare negotiation with constituents in Michigan: “The US pays the highest in the world for prescriptions.” She continued, “reducing those costs can happen through negotiation, and the passage of The Inflation Reduction Act gave Medicare the power to negotiate prescription drug prices.” Josh Hishta of AARP wrote that Medicare negotiation is long “overdue” — adding that “big drug companies have been exploiting Americans through excessive drug pricing for years.” The new drug price law will rein in excessive drug prices that patients have been forced to pay and hold drug corporations accountable for their behavior. — (P4ADNOW, AARP, Oakland County Times, Daily Gate City)
2. Competition Means Savings
Generic and biosimilar competition can provide real relief for patients burdened with high drug prices. A new study published in Health Affairs found that the entry of biosimilar competition for anticancer medication Herceptin steadily lowered the price of both brand-name Herceptin and its five biosimilar competitors. The study’s authors found the average price of biosimilar competitors for Herceptin were 28 to 58 percent of the cost of brand-name Herceptin. Remarkable — this is even more evidence that competition is essential to lowering drug prices for patients. This is why we’re pushing for reforms that fix our rigged regulatory system so that competition can come to market sooner. — (Pharmacy Times)
3. Patients Need Access to Innovative Medicines
Scientific breakthroughs and innovation in medicines are advancing new treatments for patients. However, there is serious concern that the high price tags attached to these medications will put them out of reach for patients and make them unaffordable to the health care system. Many of these new treatments — like mRNA vaccines and CRISPR gene therapy — were propelled by years of taxpayer-funded research. “It will only be a golden age when research that is publicly funded is actually serving the public,” wrote Tahir Ahmin, executive director of the Initiative for Medicines, Access, and Knowledge (I-MAK). We agree, and are committed to stopping drug corporations from setting unjustified drug prices — especially when one in four Americans struggles with affording prescription drug costs. The latest example of new, high-priced treatments: A gene therapy used to treat patients living with hemophilia A, a rare, inherited bleeding disorder, was approved this week and carries a shocking list price of $2.9 million per treatment. We urgently need to find a way to address high launch prices for drugs coming to market and stop drug corporations from hiking the prices of older drugs. — (The New York Times, ABC)
BONUS READ: Protect Our Care’s new report sheds light on the big drug corporations that systematically game the patent system and spend millions on lobbying to protect their unfettered pricing power. Read more about why Medicare needs the power to negotiate lower drug prices here!
Have a great weekend!
Heard, chef! It’s thyme to lower drug prices for all people.
Welcome to the Week in Review.
1. Lawsuits Over Medicare Negotiation Program Trickle In
More evidence again this week that Big Pharma will stop at nothing to keep drug prices high for patients. Four long-expected lawsuits have been filed across the country in an effort to stop the implementation of Medicare’s new drug price negotiation program. Following the lawsuits filed by Merck and the U.S. Chamber of Commerce earlier this month, drug corporation Bristol Myers Squibb (BMS) and drug industry group PhRMA, alongside two other groups with ties to pharma, also filed suit against the federal government. BMS and Merck’s lawsuits share an allegation that the law violates the First and Fifth Amendments, even going as far as saying the program is “extortion.” But we see through the spin: Corporations like BMS and Merck have been extorting patients with unjustified drug prices for decades and, finally, negotiation addresses its unbalanced power! PhRMA and the Chamber’s suits mirror the others — with the addition of an unfounded claim that drug companies have no say in the process. In fact, the Centers for Medicare & Medicaid Services (CMS) is voluntarily soliciting comments from corporations throughout implementation, it is drug corporations who forced excessive prices that led to patients suffering due to lack of access, and only a narrow amount of drugs are subject to negotiation. Despite legal efforts to stall Medicare negotiation, drug corporations are no match against the power of patient advocacy. The drug price reforms are here to stay. (Fierce Pharma, The Washington Post, Axios, CNBC)
2. Zeroing In On PBM Reform
Pharmacy Benefit Manager (PBM) reform still remains top of mind on Capitol Hill. Senator Chuck Grassley spoke to STAT about the urgency of reforming the middlemen’s practices: “We’ve got to pass legislation. We can’t put up anymore with … middle people, between the companies and the consumer, without knowing what they’re doing, particularly when they’re raking in a lot of taxpayer money.” We agree! A year-long STAT investigation dove deep into the industry and shed light on the secret deals, fees, and kickbacks orchestrated by PBMs who are supposed to be operating in the best interests of patients. The report established that a number of major consulting firms, who are hired by employers to handle and advise on prescription drug coverage, also benefit by collecting fees from large PBMs for each prescription. STAT writes that these firms “often are getting paid more — a lot more — by the PBMs and health insurance carriers that they are supposed to scrutinize than by companies they are supposed to be looking out for.” Who pays the price for these expensive and opaque arrangements? Employees. As both chambers of Congress and the Federal Trade Commission zero in on the shady practices of PBMs, it’s clear that the time is ripe to peel back the curtain. (STAT, STAT)
3. Debunking Drug Industry Lies
Big Pharma doublespeak is rife this week. Eli Lilly announced a $2.4 billion purchase of biotech company DICE Therapeutics which has a small molecule inhibitor in Phase II trials. Yet it was only last week that Lilly’s CEO David Ricks touted a lie that the new drug price law is harming investment into small molecule drugs. It’s evident that drug corporations are not slowing down their investments, despite the fear tactics deployed from industry executives. In fact, Flagship Pioneering — the firm behind Moderna and Laronde — gave $50 million to a new startup “focused solely on small-molecule drugs.” While we constantly hear the refrain about the Inflation Reduction Act “harming” innovation, we know the truth: Big Pharma is dishing out lies to distract us from the enormous profits that they bring in at the expense of patients. (Endpoints, STAT, Arizona Daily Star)
4. Innovation Is Worthless If Patients Can’t Afford It
While cell and gene therapies may soon be able to cure some of the world’s most complex diseases, it is imperative that these new treatments are affordable for patients. First up: sickle cell gene therapy. Bluebird bio is racing to get approval for its one-time gene therapy for sickle cell disease, which is expected to be priced at between $2 million and $3 million per patient. Second: cystic fibrosis treatment. A new analysis showed that the price of cystic fibrosis treatment Trikafta, currently listed at $311,741 per year, is much higher than the value it delivers. “It is essential for therapies to be priced based on value,” echoed the team of scientists that led the study, noting that the high costs of therapies “are straining health care affordability” for patients. And lastly: the world’s most expensive drug. Hemgenix, a single-use gene therapy priced at $3.5 million per dose, was administered to a patient living with hemophilia B for the first time this week. Innovation is worthless if patients can’t afford it — that’s why we need to urgently address high launch prices for new life-changing drugs coming to market. — (Biopharma Dive, Cystic Fibrosis News Today, Pharmaceutical Technology)
Have a great weekend!
Let’s hear it for the underdog! If the Denver Nuggets can bring home their first NBA championship, patients can continue taking on Big Pharma to win lower drug prices for all patients. 🏀💊
Welcome to the Week in Review.
1. 🚨 New P4AD Cancer Drug Price Report 📰
This week, P4AD released a new report that highlights the burden of cancer drug prices on patients and details the positive impact of the Inflation Reduction Act that will bring relief to people living with cancer. “Cancer patients — the majority of whom are on Medicare — can face annual out-of-pocket costs of more than $16,500,” said P4AD’s David Mitchell. In partnership with NORC at the University of Chicago, P4ADexamined the impact of the $2,000 out-of-pocket cap, a provision in the drug price law that takes effect in 2025, and found that people with Medicare who get a brand-name cancer drug through Medicare Part D will save an average of $7,590 annually, with some saving as much as $19,296. This will make a huge difference for patients like Lynn Scarfuto, who takes oral chemotherapy drug Imbruvica to treat her leukemia. Imbruvica carries a monthly list price of over $17,000. “Thanks to the Inflation Reduction Act, cancer patients with traditional Medicare coverage will spend less on the prescription drugs they need,” said Dr. Danielle Carnival, Deputy Assistant to the President for the Cancer Moonshot program. “This report makes clear that as additional provisions get implemented – including the cap on annual out-of-pocket costs for prescription drugs – the President’s Investing in America agenda will give Americans with cancer much needed breathing room and peace of mind.” — (P4AD, The White House)
2. More Momentum For The Inflation Reduction Act
The Biden Administration and Members of Congress are taking steps to further extend the Inflation Reduction Act’s drug price reforms to lower prices for more patients. Last week, the administration announced 43 drugs with prices rising faster than the rate of inflation that may be subject to penalties under the Inflation Reduction Act. That’s no small feat! This would save money for both patients and taxpayers. This week, the administration released new tools to increase enrollment in Medicare’s Extra Help Program, the subsidy that helps low-income people on Medicare pay for prescription drugs. Taking effect in January 2024, these new efforts come in addition to the expansion of the Extra Help program, which was included in the historic drug price law, and will make more people eligible for the subsidy. On Capitol Hill, Representatives Ruben Gallego and Elissa Slotkin introduced the Lower Drug Costs for Families Act, which would build on the drug price law by extending the inflationary rebate penalty to protect patients with private insurance. Bravo! Thank you to these lawmakers for fighting for further reforms to reign in high drug prices. — (HHS, HHS, Office of Rep. Ruben Gallego, The Gander)
3. Bipartisan Movement In Senate Finance To Crack Down on PBMs
Senate Finance Committee Senators Wyden, Crapo, Menendez, Blackburn, Tester, and Marshall introduced bipartisan legislation this week: the Patients Before Middlemen Act would reform Pharmacy Benefit Managers’ (PBMs) practices by delinking the compensation to PBMs from the price of a drug. Democratic Chairman Ron Wyden explained that currently, PBMs often favor higher-priced drugs in their negotiations, which means “seniors are forced to pay more for their prescriptions.” Republican Ranking Member Mike Crapo laid out how the new bill would promote cost-savings for patients: “Delinking PBM compensation from sticker prices would take a critical first step in ensuring that all supply chain participants seek out the best deals available, driving down out-of-pocket spending and promoting cost-cutting competition.” This introduction proves that the committee is taking steps to deliver on its bipartisan legislative framework to address PBM tactics that drive up costs for patients and taxpayers. “It would be a real game changer,” P4AD’s David Mitchell tweeted. “No more would PBMs be paid based on the price of a drug in Medicare, but rather a service fee.” It’s exciting to see Senators from across the political spectrum aligned in this effort — let’s pass reforms to crack down on the middlemen’s secretive practices and advance reforms that protect patients! — (Senate Finance Committee)
BONUS WATCH: P4AD’s Merith Basey joined RJ Eskow on “The Zero Hour” to call out the bogus Merck lawsuit over Medicare negotiation and explain the impact of the drug price reforms in the Inflation Reduction Act. Check out the full interview here!
