July is a big month for people who love pumps: The live-action comedy film Barbie comes out AND the Inflation Reduction Act’s $35 monthly insulin copay cap will extend to people on Medicare who use pumps!
Welcome To The Week In Review.
1. Momentum For Bipartisan Drug Price Reforms
Congress may have been in recess this week, but bipartisan momentum continued to grow with regard to looking into the practices of Pharmacy Benefit Managers (PBMs) and reforming our rigged patent system. Politico reported that on April 19th, the Senate Health, Education, Labor & Pensions (HELP) Committee will mark-up a yet to be seen bipartisan drug price bill that is related to PBMs and generic drugs. Further, Axiosreported that Senate Majority Leader Chuck Schumer holds prescription drug reform as a top priority and plans to bring a health care package to the Senate floor that could include the five bipartisan bills from the Senate Judiciary Committee that address key fixes to our rigged patent system and reforms to the practices of PBMs. Following the Senate Finance Committee PBM hearing last week, Raymond, a patient in Washington, wrote an opinion piece urging legislators to continue bipartisan collaboration on reforming the PBM industry: “As a patient adversely impacted by benefit managers, I can confidently say that these reforms must remain a federal priority for the 118th Congress.” Tahir Amin, co-founder of the Initiative for Medicines, Access, and Knowledge (I-MAK) shared how patent reform is essential in the fight to lower drug prices on the Public Health On Call Podcast: “I think the first step we have to do is get the agencies like the FDA and USPTO to get on board and change some of the rules that allow companies to build these thickets of patents — and I think that’s happening at the moment.” We’re looking forward to working with lawmakers across the aisle on these reforms as they come back from recess next week! — (Politico, Axios, The Daily Herald, Johns Hopkins Bloomberg School of Public Health)
2. “How Long Can We Go Through Our Savings To Pay For A Drug?”
Patients continuously face high drug prices that push the medicines they need out of reach. Kentucky patient Sue Lee wrote a letter about the blockbuster drug Humira, which she took to treat painful sores caused by her chronic plaque psoriasis. Once on Medicare, the drug cost her $4,000 out of pocket monthly and she was forced to stop taking Humira completely. Florida patient Sydney, 18, lives with Crohn’s disease and was also forced to stop taking Humira, which improved her health significantly, because of its high cost. Sydney’s mother, Holly, explained the hardship of paying for the expensive drug to the Washington Post: “How long can we go through our savings to pay for [a drug]?” Trudy, a respiratory therapist in Washington, told the Post how she witnessed seniors with chronic lung disease forgo their medications and inhalers for years because of high drug prices set by Big Pharma. In addition, patients who rely on EpiPens shared that they are currently paying in excess of $600 a year, an increase from the original $100 per year, for the life-saving drug. We clearly need meaningful policy solutions to fix our rigged system. Drug corporations won’t stop padding their bottom line — with no regard for patients’ health and financial security — unless we stop them. — (Lexington Herald-Leader, The Washington Post, Vox)
3. Popular Provisions In The Inflation Reduction Act
There’s no denying the popularity of the drug price provisions in the Inflation Reduction Act. A new survey reports that 83 percent of people over the age of 65 support the president’s budget proposal to expand on drug price reforms in the Inflation Reduction Act including Medicare negotiation. Lawmakers have been singing a similar tune about the savings in the new drug price law. Senator Jacky Rosen proudly reminded the Nevada Legislature about the success of the Inflation Reduction Act: “After years, years of obstruction, Medicare can finally negotiate lower drug costs for our seniors.” Senate Judiciary Committee Chairman Dick Durbin shared that 50,000 people in Illinois will see savings due to the $35 monthly insulin copay caps. Rep. Jared Golden wrote in an op-ed that the Inflation Reduction Act will “lower prescription drug prices for the more than 262,000 older Mainers enrolled in Medicare Part D,” and that, contrary to Big Pharma’s lies, “using the purchasing power of the government to negotiate lower drug prices for seniors is the right thing to do.” Senator Peter Welch also debunked Big Pharma myths about the new law: “All of the fear mongering — that it was going to ruin innovation — has been proven to be false. Keep in mind, these high drug prices are brutal whether you voted for Trump or you voted for Biden. All of us are hearing about that from our constituents.” Well said! Regardless of political background, patients know the Inflation Reduction Act will bring drug prices down while maintaining innovation we need. — (Morning Consult, Framingham Source, WFLA, KUNR, Fox Illinois, Bangor Daily News, Roll Call)
Have a great weekend, everyone!
Drugs work best when people can’t afford them … APRIL FOOLS!?
Welcome To The Week In Review.
More Bipartisan Pressure On PBMs
The Senate Finance Committee held a hearing on Thursday about the impact pharmacy benefit managers (PBMs) have on patients and taxpayers. “I believe this is an industry that is going in the wrong direction, and that’s having a big impact on the prices Americans are paying at the pharmacy counter,” Chairman Ron Wyden shared in his statement at the hearing. Senators on both sides of the aisle agree. Ranking Member Mike Crapo said, “Policymakers also need more line of sight into the black box of drug pricing relationships and transactions, especially as we look to pursue productive reforms in the future.” Cracking down on PBMs is gaining momentum to be “a major bipartisan effort,” that “the PBM industry is likely to challenge vigorously.” In 2022, the PBM trade group Pharmaceutical Care and Management Association spent $8.7 million on federal lobbying and then launched a seven-figure ad campaign earlier this year to try to counter arguments that the middlemen rake in profits while driving up costs. While the PBM industry throws money to try to maintain the status quo, bipartisan support for reform has never been stronger. “These are issues Democrats and Republicans all over the country and in Congress agree must be addressed,” Rep. Buddy Carter, a former pharmacist, explained. “The PBM lobby is powerful and influential, but it is not untouchable. We know how to fix this mess.” — (Senate Committee on Finance, Endpoints, Open Secrets, MM+M, The Hill)
2. “Saving Money Due To The Inflation Reduction Act”
Patients continue to see savings thanks to the drug price reforms in the Inflation Reduction Act. People on Medicare living with HIV will save tens of thousands of dollars when the $2,000 out-of-pocket cap provision takes effect in 2025 — a welcome change, considering people on Medicare living with HIV have disproportionately high prescription costs, spending 14 times as much on Part D drugs than other people on Medicare in 2020. Elected officials and leaders continued to spread the word about the historic new drug price law this week. Senator Joe Manchin explainedhow the $35 monthly insulin copay caps are delivering “tremendous savings” for people on Medicare and emphasized that the soon to be implemented out-of-pocket cost caps and Medicare negotiation will bring much needed relief. Department of Health and Human Services (HHS) Secretary Xavier Becerra discussed the law’s provision to insulate people on Medicare from drug company price hikes and detailed how free vaccines are providing relief to people on Medicare. “If you’re on Medicare – zero cost now out of your pocket to get [vaccines],” said Secretary Becerra. Martha in Wisconsin is relieved that seniors like her no longer have to worry about affording the shingles vaccine — shots that cost $200 out of pocket per dose. After meeting with Senator Tammy Baldwin, Martha wrote in an op-ed: “Mere months after making these vaccines free for those on Medicare, I know that seniors are already saving money due to the Inflation Reduction Act.” — (KFF, The Journal, TMJ4, Up North News)
3. Big Pharma Keeps Gaming The Patent System
In the latest Big Pharma patent shenanigan, Johnson & Johnson (J&J) is attempting to exploit our patent system to maintain its monopoly on its psoriasis and irritable bowel disease drug Stelara by delaying biosimilar competition from entering the market. J&J is trying to leverage patents it inherited from Momenta Pharmaceuticals when it purchased the company in 2020 to stall Amgen’s biosimilar version of the drug from coming to market. If successful, the move would allow J&J to continue to charge patients any price it wants for Stelara (which is worth almost $18 million per day in revenue for J&J). “It just goes to show the various different plays that are going on in order to delay Amgen coming in,” said Tahir Amin, co-founder of the Initiative for Medicines, Access, & Knowledge (I-MAK). Manufacturers of blockbuster drugs Keytruda and Humira have been manipulating the patent system in a similar fashion — blocking competition via patent thickets and forcing patients to pay unlimited, high prices. In light of these patent abuses and others, Reps. Jodey Arrington, Lloyd Doggett, Darrell Issa, Michael Burgess, and Ann Kuster sent a bipartisan letter to the U.S. Patent and Trade Office (USPTO) Director, Kathi Vidal, urging her to move forward with policies at the USPTO that would crack down on patent thickets and increase generic and biosimilar competition to lower drug prices. “Too often, Big Pharma’s masterful innovation is in creating new, manipulative ways to maintain monopoly power and charge monopoly prices,” shared Rep. Doggett. Rep. Arrington said: “I’m proud to lead this bipartisan effort to reform our patent system and increase competition so seniors and families have better access to affordable treatments.” We are grateful that members of Congress are advocating for patients — we must unrig our patent system and allow competition to lower drug prices. — (BioPharma Dive, Drug Discovery & Development, Representative Jodey Arrington)
BONUS: Another bill to hold Big Pharma accountable! Senators Catherine Cortez Masto and Amy Klobuchar introduced the Lower Drug Costs for Families Act, which would build on the Inflation Reduction Act by extending the inflationary rebate penalty to protect patients with private insurance as well as Medicare. ?
Have a great weekend, everyone!
What do the PrincetonTigers and patients fighting for lower drug prices have in common? They’re both underdogs that recently scored against powerful opponents. ?
Welcome To The Week In Review.
Much More Than A Ban On QALYS
On Friday, the House Committee on Energy and Commerce passedH.R. 485 out of committee on a party line vote with Republicans voting in favor of an amended version of the bill which aims to block the ability of government and the private sector to use comparative effectiveness research (CER) measures to assess the value of medications for patients. Ahead of the hearing, P4ADNow sent a letter to the committee, urging members to oppose the bill unless elements to preserve CER measures that value all lives equally were included in the final version. “At the end of the day, there is no single factor more important in arriving at an appropriate price for a new drug than the value of the drug to patients,” the letter, signed by P4ADNow’s David Mitchell, states. Ranking Member Frank Pallone said he couldn’t support the bill without “assurances that nothing in the legislation would go beyond banning the use of QALYs or could be used to delay or disrupt the implementation of the drug price negotiations in the Inflation Reduction Act.” We agree and urge members of the House to oppose the bill on the House floor unless changes to address Rep. Pallone’s concerns are made. As David states in the letter: “It is axiomatic that to stimulate and reward innovative new drug development, we should pay more for high value drugs and less for low value drugs.” We need comparative effectiveness research to do that. — (House Committee on Energy and Commerce, P4ADNow, Energy and Commerce Committee Democrats)
2. Pandemic Profiteering: Moderna CEO Fails To Justify Vaccine Price Hikes
The Senate Health, Education, Labor & Pensions (HELP) Committee asked Moderna CEO Stéphane Bancel to justify the company’s planned price hike of its COVID-19 mRNA vaccine at a hearing this week. Spoiler: He wasn’t able to. Senator Patty Murray laid it out clearly: Taxpayers invested $12 billion into the vaccine, which costs $3 to make, and now Moderna is planning to increase the price 400 percent to $130 per dose. Indiana Senator Mike Braun called the planned price increase “preposterous.” Let’s be clear: Taxpayers funded the majority of early-stage research and drug corporations like Moderna swooped in at the last minute when there was an opportunity to line CEO’s pockets with record profits. “As soon as Moderna started to receive billions of dollars from the federal government, Mr. Bancel literally became a billionaire overnight and is now worth over $4 billion,” Senate HELP Chairman Bernie Sanders highlighted at the hearing. “Pfizer-BioNTech and Moderna have received about $100 billion in revenue from COVID-19 vaccines in the first two years of sales — certainly a generous return on their own investments by any standards,” wrote Hussain S. Lalani, Sarosh Nagar, Jerry Avorn, and Aaron S. Kesselheim in the Boston Globe. Try as Bancel might, we won’t let Big Pharma take credit for life-saving vaccines developed on the back of taxpayers, nor will we stand for price gouging that hurts patients’ pockets. — (Senate HELP Committee, Senator Patty Murray, Roll Call, Washington Post, CNN, Boston Globe)
3. The Hill Fights For Future Reforms
Washington was busy this week working to shed light on the actions of members of the drug supply chain. Senators Tammy Baldwin and Mike Braun re-introduced the Fair Accountability and Innovative Research (FAIR) Drug Pricing Act, bipartisan legislation to require transparency for drug companies that increase drug prices. “This bill takes a step in the right direction by bringing much needed transparency and accountability to our broken drug price system, especially the challenge of unjustified price hikes and high launch prices,” P4ADNow’s Sarah Kaminer Bourland remarked. While answering questions for the Senate Finance Committee hearing on Wednesday, Secretary of Health and Human Services Xavier Becerra emphasized the Biden administration’s commitment to addressing pharmacy benefit managers (PBMs): “The administration is working on PBMs because we know that more and more, there is a growing concern that the middlemen in the process of getting drugs from manufacturer to patient are skimming off a good deal of the money that’s being generated.” Chairman Ron Wyden announced that the committee will hold a hearing on PBMs next week. And the Senate Commerce Committee passed the PBM Transparency Act of 2023 — another example of Congress continuing to scrutinize and crack down on PBMs. Keep up the good work, Congress! — (Senator Tammy Baldwin, Axios, Senate Committee on Finance, Fierce Healthcare)
Patients’ lucky charm this year? The drug price reforms in the Inflation Reduction Act. Less gold in Big Pharma’s coffers and more in the pockets of the people. ??
Welcome To The Week In Review.
Savings On The Way Thanks To The Inflation Reduction Act
The Inflation Reduction Act’s soon to be implemented provisions — such as the inflationary rebates, the $2,000 out-of-pocket cap, and Medicare negotiation — will bring much needed savings to people on Medicare. Patient advocate Ginny Boynton met with President Biden in Philadelphia last week and shared how the Inflation Reduction Act will lower her drug costs. Ginny lives with Lambert-Eaton myasthenic syndrome and her out-of-pocket costs will total close to $36,000 this year. But thanks to the Inflation Reduction Act, starting in 2025, Ginny and millions of people on Medicare will have their out-of-pocket costs capped at $2,000. Ahead of Biden’s speech announcing his 2024 budget, Ginny toldthepresident: “I’m on Medicare, so the Inflation Reduction Act is critical to me … I have a drug that costs $600,000 a year … and I can’t turn over in bed without it.” This week, the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS) issued guidance on the historic Medicare negotiation program that will begin with ten costly drugs in 2026. HHS also announced 27 prescription drugs had price hikes above the rate of inflation in the last quarter of 2022. People on Medicare who take these medications through Part B “could save between $2 and $390 per average dose for these drugs starting April 1,” reported CNBC. It’s clear that the Inflation Reduction Act will deliver savings to millions of patients like Ginny who’ve had to face high drug prices for far too long. — (P4ADNow, CNN, HHS, Reuters, HHS, CNBC)
2. ? Two More Insulin Manufacturers Bend To The Pressure of Advocates ?
In another win for patients and advocates, this week, Novo Nordisk and Sanofi announced plans to cut prices on some insulin products starting January of 2024. This news comes on the tail of Eli Lilly’s insulin price cuts earlier this month, and the Inflation Reduction Act’s monthly $35 insulin copay caps for people on Medicare that started in January (and which could bring savings to more than 600,000 people on Medicare). Stacie Dusetzina, health policy professor at Vanderbilt University Medical Center, remarked that the drug companies “have little to lose by making this change” — for patients, on the other hand, lowering insulin prices could mean life or death. Diabetes disproportionately affects African American women, who are 80 percent more likely to be diagnosed with the condition and are more at risk of developing diabetes at an older age when their income decreases. “We need affordable insulin now. Too many lives depend on it,” wrote Linda Goler Blount, president and CEO of the Black Women’s Health Imperative. We couldn’t agree more — patient advocates have fought hard for years to bring lower insulin prices. As a result, all three drugmakers — who together make up roughly 90 percent of the U.S. insulin market — finally buckled to public pressure. This overdue step will bring relief to many patients. All people deserve access to their medicines. — (P4AD, P4AD, AARP, NBC News, The Afro, Common Dreams, NBC News)
3. Patients Can’t Afford Prescriptions — And PBMs Aren’t Helping
Over one third of Americans say that cost has prevented them from filling a prescription they need, according to a survey published this week. Results showed a sharp discrepancy between men and women, with 43 percent of women saying they have skipped filling their prescriptions due to cost compared to 30 percent of men. One of the reasons patients face such high costs? Pharmacy Benefit Managers (PBMs). PBMs are supposed to negotiate lower drug prices on behalf of patients, but right now it appears that the middlemen pocket their undisclosed rebates from drug manufacturers as profit and leave patients suffering. “PBMs are largely unregulated – and no one really knows what kind of savings are being negotiated on patients’ behalf,” wrote Beverly Goodell, executive director of the Lupus Foundation of New England. We are glad Congressis taking on the issue, and we will keep fighting for PBM reform — along with other drug price reforms — until cost is no longer a barrier to accessing medications patients need. — (The Hill, Portland Tribune, Commonwealth Magazine, Citrus County Chronicle)
Have a great weekend, everyone!
“I’m On Medicare, So The Inflation Reduction Act Is Critical To Me”
WASHINGTON, D.C. — Ginny Boynton, a retired lawyer and advocate with Patients For Affordable Drugs Now, met with President Biden last week to share how the Inflation Reduction Act will lower her drug costs. The White House released a new video yesterday that highlights Ginny and President Biden’s conversation just ahead of the president’s speech where he rolled out his 2024 budget that seeks to build upon the new drug price reforms in the Inflation Reduction Act.
“I’m on Medicare, so the Inflation Reduction Act is critical to me,” Ginny, a mother of two who lives with Lambert-Eaton myasthenic syndrome, told the president in Philadelphia last week. “I have a drug that costs $600,000 a year and another that’s $700 a month – and I can’t turn over in bed without it.”
Ginny’s out-of-pocket costs will total close to $36,000 this year. But thanks to the Inflation Reduction Act, starting in 2025, Ginny and millions of people on Medicare will have their out-of-pocket costs capped at $2,000. The new law also allows Medicare to negotiate the price of some of the most expensive drugs, caps Medicare insulin copays at $35 a month, and curbs drug company price gouging which will lower prices and stop Big Pharma’s monopoly pricing power.
Thank you to the mother of the disability rights movement, Judy Heumann, for a lifetime of relentless activism. May we all “make a fuss” in her memory.
Welcome To The Week In Review.
Biden’s Budget: A Vision To Expand Drug Price Reforms
President Biden’s newly released 2024 budget seeks to build upon the new drug price reforms in the Inflation Reduction Act. In an effort to lower drug prices for patients and save the government money, the plan proposes expanding the number of drugs Medicare can negotiate and would make drugs eligible for negotiation even sooner after approval. It would also extend the inflationary rebates to the private sector to limit drug price increases to the rate of inflation for people on private insurance and extend the monthly $35 out-of-pocket cap for people on insulin who have commercial insurance. The Inflation Reduction Act “will save Medicare hundreds of billions over the decades to come,” and will save “seniors up to thousands of dollars a year,” President Biden explained in an op-ed. “Lowering drug prices while extending Medicare’s solvency sure makes a lot more sense than cutting benefits.” The Inflation Reduction Act is already providing savings to patients like Roy, Robin, and Jennifer whose insulin copays are now capped at $35 a month. And thanks to the law’s $2,000 out-of-pocket cap, starting in 2025, people on Medicare living with cardiovascular disease could save a median of $855 per year. President Biden’s vision to expand reforms to lower drug prices responds to the needs of millions of people in the U.S. from across the political spectrum struggling to make ends meet due to high drug prices. Thank you, Mr. President. — (CNN, The New York Times, HHS, HHS, The Detroit News, AARP, Healio)
2. Preserving Value Analysis For Patients
This week, P4ADNow urged members of the House Energy and Commerce Subcommittee on Health to vote against H.R. 485, the Protecting Health Care for All Patients Act of 2023, in its current form. The original bill, which aimed to ban the use of quality-adjusted life years (QALYs), a metric of value analysis we do not support, instead contained overly-broad language that could jeopardize the use of value analysis as a tool in determining a fair price for a drug. “As a patient with an incurable cancer whose drugs carry a combined list price of more than $900,000 per year, I know firsthand the importance of a drug price system that fairly prices drugs based on their value to patients,” said P4ADNow’s David Mitchell. In addition to undermining the government’s authority to rein in unjustified prices on ineffective drugs, the bill as originally written could jeopardize the hard-won drug price reforms in the Inflation Reduction Act, which are already lowering costs for patients. The subcommittee advanced an amended version of the bill Wednesday and Ranking Member Frank Pallone said he will continue to work with Chairwoman Cathy McMorris Rodgers to ensure the legislation does not harm the implementation of the drug price reforms in the Inflation Reduction Act. We urge members of the full committee to oppose H.R. 485 until it preserves critical value analysis tools to analyze and incorporate value into drug pricing. — (P4ADNow, Politico, House Committee on Energy & Commerce Democrats)
3. Patients Still Need Reforms
While the Inflation Reduction Act includes historic drug price reforms to lower costs for people on Medicare, there are still plenty of changes to our system to fight for in order to deliver lower drug prices for all patients. First, while the new law caps insulin copays at $35 a month for people on Medicare, we still need to ensure that everyone can afford insulin. Addressing insulin prices is an issue of equity, as Black patients are disproportionately affected by diabetes and are more likely to struggle affording insulin. Second, we must fix our rigged patent system so that patients can afford the medications they need. “What we’ve been seeing lately is that companies are filing for dozens or even hundreds of patents to extend their monopoly period in order to keep their revenues, and that’s blocking competition from the market,” Priti Krishtel, co-founder of the Initiative for Medicines, Access, and Knowledge (I-MAK), told the Hill. Two physicians penned an op-ed this week sharing the direct impact patent abuse has on patients and calling for reforms “to ensure the U.S. patent system enables, rather than restricts, the development of truly effective and affordable medications.” They continued: “When patients must choose between their physical and financial well-being, harm is unavoidable.” Third, we need to find a way to address fair launch prices for new drugs coming to market. Big Pharma will keep releasing new drugs for more than $20,000 a month and continue to hike prices on older drugs on the market, unless we reform the system to stop the industry. We will keep fighting to stop the insulin cartel, restore the patent system to its original intent, and fix the system to address high launch prices. — (NBC News, The Hill, The Baltimore Sun, The Wall Street Journal)
Bonus: AbbVie CEO Rick Gonzalez’s 2022 pay package was a staggering $26.3 million, undoubtedly boosted by patients who paid for the company’s high-priced drugs like Humira. Another case of Big Pharma executives making huge profits at the expense of patients.
