TL;DR of PhRMA’s statement on the House plan to lower drug prices? “We’re good with the high prices, thanks.” Welcome to the Week in Review.
1. Get On Board the Negotiation Train
The House has offered up a robust plan that would allow Medicare to negotiate prescription drug prices. It would lead to major savings for patients and taxpayers across America. — (AP)
2.Patients Over Party!
Trump tweeted that he likes House Speaker Nancy Pelosi’s drug pricing plan and called for getting it done “the bipartisan way.” Congress: Please do! — (STAT)
3. PhRMA and BIO LOL
PhRMA and BIO are threatening the end of days if taxpayers negotiate. MEMO: The profit margins of drug corporations are almost three times the average of the S&P 500. Plenty of room to lower drug prices and fund innovation there. — (HealthLeaders Media)
4. Product Hops Must Stop!
A patient and an academic gave this insidious Big Pharma tactic the what for at a House Congressional hearing. What’s it all mean? — (P4AD and Regulatory Focus)
5. International Pricing Index: Let’s Make a Deal
Everybody loves the International Pricing Index! (Except for pharma, but nobody likes them.) — (NPR)
WASHINGTON, D.C. — In response to today’s release of a bill by House leadership that would lower drug prices for Americans, Ben Wakana, Executive Director of Patients For Affordable Drugs Now, issued the following statement:
“Early details of H.R. 3 clearly deliver on the promise to break the monopoly pricing power of drug corporations by allowing Medicare to negotiate for lower prescription prices. Importantly, the legislation incorporates key bipartisan priorities like an International Pricing Index, caps on price increases, and an out-of-pocket limit for prescription drug spending. It will lower drug prices for all Americans covered by a government plan or private insurance. H.R. 3 is a bold step forward.”
BACKGROUND:
The plan includes the following key provisions that would:
End the ban on Medicare negotiating directly with drug companies to lower prescription drug prices and empower HHS to negotiate prices for the 250 most costly drugs each year.
Ensure that Americans –– regardless of insurance type –– have access to lower-priced drugs. A drug corporation would be required to offer the negotiated price to Medicare and private insurance plans. If a drug company overcharges Medicare or fails to offer the fair price to people, it will be subject to a penalty of 10 times the difference between the price charged and the maximum fair price for the drug.
Establish a maximum fair price based on an international pricing index. Americans will pay no more than 120 percent what other wealthy nations pay (Canada, United Kingdom, Germany, France, Australia, Japan) and negotiations could take that price lower.
Stop drug companies from increasing prices faster than the rate of inflation, and impose penalties on drug companies if prices rise above inflation. If a drug company has raised the price of a drug in Medicare Part B or D above the rate of inflation since 2016, it can either lower the price or be required to pay the entire price above inflation back to the Treasury.
Cap seniors’ out-of-pocket costs for prescription drugs at $2,000 per year.Currently, out-of-pocket costs for seniors on Medicare can be over $15,000 per year.
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1. Let. Medicare. Negotiate.
A leaked draft of a House plan to empower the U.S. government to negotiate drug prices injects enthusiasm into the drug pricing debate and overlaps with President Trump’s plan. — (New York Times/FiercePharma)
2. Momentum Grows for Senate Finance Bill
Republican lawmakers are voicing their support to the Senate’s bipartisan effort to lower drug prices by curtailing price hikes and lowering out-of-pocket costs in Medicare. — (Press Herald)
3. Speak Out
P4AD Digital Director Samantha Reid describes what it’s like to live with the financial uncertainty illness brings. High drug prices for drugs to treat Crohn’s disease certainly don’t help! — (Twitter)
4. On the Take
The first six months of 2019 saw $4 million in pharma campaign finance donations pour into lawmakers’ coffers. See who’s got their hand in the pill cash jar. — (KFF)
5. No, really. LOWER DRUG PRICES.
The latest polling again shows the public wants Congress to make lowering drug prices a top priority. — (KFF)
WASHINGTON, D.C. — David Mitchell, a cancer patient and the founder of Patients For Affordable Drugs Now, issued the following statement in response to a draft plan in the House of Representatives that would lower drug prices for Americans through negotiations with drug corporations.
“If reports are accurate, this plan would deliver significant relief for patients and taxpayers. The proposal would lower prescription drug prices for American patients while protecting access to medicine and increasing funding for innovation.
“Americans pay two to three times what people in other nations pay for prescription drugs. Why? Other countries negotiate — we don’t. This proposal will ensure that Americans experience lower drug prices whether covered by a government plan or private insurance. It will be a bold step forward.”
BACKGROUND:
According to reports, the plan includes the following key provisions that would:
End the ban on Medicare negotiating directly with drug companies to lower prescription drug prices and empower HHS to negotiate prices for the 250 most costly drugs each year.
Establish a maximum fair pricebased on an international pricing index. Americans will pay no more than 120 percent what other wealthy nations pay (Canada, United Kingdom, Germany, France, Australia, Japan), and negotiations could take that price lower.
Ensure that Americans –– regardless of insurance type –– have access to lower-priced drugs. A drug corporation would be required to offer the negotiated price to Medicare and non-Medicare insurance plans — this includes people who buy insurance through their employer, the VA, Healthcare.gov, etc. If a drug company overcharges Medicare or fails to offer the fair price to people, it will be subject to a penalty of 10 times the difference between the price charged and the maximum fair price for the drug.
Stop drug companies from increasing prices on all drugs faster than the rate of inflation, and impose penalties on drug companies if prices rise above inflation. If a drug company has raised the price of a drug in Medicare Part B or D above the rate of inflation since 2016, it can either lower the price or be required to pay the entire price above inflation back to the Treasury.
Cap seniors’ out-of-pocket costs for prescription drugs at $2,000 per year. Currently, out-of-pocket costs for seniors on Medicare can be over $15,000 per year.
Direct savings to new drug research and innovation at the NIH.
Medicare Part D provides coverage for 43 million Americans’ prescription drug needs. And spending has been on an untenable path.
Nearly 1 in 3 adults report not taking their medicines as prescribed because of the cost — (KFF)
Eighty six percent of Americans — majorities of Democrats, Republicans, and Independents — support allowing Medicare to negotiate for lower prescription drug prices. But under current law, Medicare is prohibited from negotiating directly with drug companies on behalf of taxpayers and Medicare beneficiaries. — (KFF)
Eighty percent of Americans say Congress’s top priority should be action to lower drug prices. — (Harvard/Politico)
Drug prices and Medicare drug spending are out of control. Americans pay twice as much for prescription drugs as other nations. — (The Atlantic)
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Pharma just took a DNA test. Turns out they’re 100% OVERPRICED.
1. “I have nothing. But I am alive, and I can still fight.”
Patient advocate Cynthia Stockton reflects on her experience with high drug prices as lawmakers weigh a measure that would help put an end to collusive pay-for-delay deals. — (The Sacramento Bee)
2. ? ← New Pharma Poll Numbers
According to Gallup’s annual review of U.S. public opinion, pharma is the lowest-rated industry in America. That’s a new low. — (Gallup)
3. PharmaCEOs Dish Dough
Drug company CEOs are opening their pockets and spending big bucks on a small targeted group of senators. — (STAT)
States have passed a record number of laws to rein in drug prices. Let’s keep the momentum going! — (USA Today)
Welcome to The Week in Review in Prescription Drug Pricing — Labor Day edition.
1. The $6 Million Claim
Pharma is siphoning hourly wages from the pockets of hard-working Americans. Read and watch: — (The New York Times & FX)
2. MS Mess
People living with multiple sclerosis face drug costs that quadrupled in a decade. — (Reuters)
3. Golden State Grapple
California patients are using their voices to tackle abusive pay-for-delay tactics and get the affordable drugs they need. — (@AGBecerra)
4. Congressional Cash Flow
Pharma is showering vulnerable Congressional members with cash to maintain influence as drug pricing scrutiny intensifies. — (USA Today)
5. No Info
The secrecy surrounding prescription drug prices has left prescribing doctors baffled. — (AP)
1. Slowing Down for the Speed Cameras
Under increasing scrutiny and pressure from patients and lawmakers alike, drug makers are still raising prices, just at slower rates than before. — (AP)
2. Clear as Day
Oregon wants drug price hikes OreGONE. A new transparency law means drug corporations don’t get to keep hikes in the dark any more. — (Biz Journals)
3. A choice no one should have to make
According to a new study, a significant number of working age adults with diabetes are rationing or skipping their medication due to sky-high costs.— (Huffington Post)
4. In His Own Words
P4AD’s David Mitchell shared his thoughts on the broken prescription drug market and the impact it has on patients. — (Washington Examiner)
5. Oh yeah?
A judge said HHS can’t make Big Pharma put its list prices in TV ads. HHS is pushing back. — (Reuters)
WASHINGTON, D.C. — Big Pharma has spent millions of dollars on a full-court press to stop the Trump administration from implementing an International Pricing Index for one reason: The plan will lower drug prices in America. Today, industry lobbyists will meet with administration officials to press their case that Americans should continue to pay twice what other countries pay for drugs.
“We have no doubt the drug corporations will dust off their favorite scare tactics — like ‘rationing medicine,’ ‘reducing access,’ and ‘socialism,’” said David Mitchell, a cancer patient and the founder of Patients For Affordable Drugs Now. “But the claims are outrageous, offensive, and wrong.”
Here are the facts:
FACT CHECK: PhRMA’s False Claims About the Medicare Part B demonstration
MYTH #1: The Part B demonstration will restrict access to lifesaving drugs. FACTS:
All protected classes of drugs in Medicare will be maintained.
HHS: “We propose no changes to the Medicare benefit, just more discounts from drug companies.”
Bloomberg: “The aim is to drive down the cost of those medications by 30 percent.”
There is no evidence the Part B demonstration would harm patient accessto drugs unless drug corporations choose to withhold drugs from patients.
HHS: The proposal is to “lower drug prices—without any restrictions on patient access.”
The Part B demonstration does nothing to slow the FDA approval process or change U.S. incentives for new drug approval.
Multinational drug corporations will still want early access to the largest market and higher prices in the U.S.
It would not change “regulatory incentives such as accelerated approval and priority review mechanisms” which Forbes points out play a key role in early approval in the U.S.
Americans ration drugs today based on price.
NPR: “Insulin’s high cost leads to lethal rationing.”
CDC: “Among adults with diagnosed diabetes who were prescribed medication in the past 12 months, 13.2% did not take their medication as prescribed, and 24.4% asked their doctor for a lower-cost medication.”
Vox: “It means that our system, even if we don’t like to admit it, has to pick and choose who gets access to lifesaving drugs.”
MYTH #2: The Part B demonstration will establish drug prices that are impossibly low — stifling innovation, damaging drug companies and hurting our health system. FACTS:
Americans would still pay Pharma more for drugs than other developed countries.
The New York Times: “A government study that said Medicare was paying 80 percent more than other advanced industrial countries for some of the most costly physician-administered medicines.”
Secretary Azar: “Over the next five years under this model, we will go from paying 180 percent of what other countries pay for these drugs to 126 percent of what they pay.”
Lowering prices in Part B will have little to no impact on innovation.
National Academy of Sciences: “NIH funding contributed to published research associated with every one of the 210 new drugs approved by the Food and Drug Administration from 2010–2016. “
HHS: “The possible savings American patients would receive over five years represents less than 1 percent of pharmaceutical R&D spending during that time; and the pharmaceutical industry has offered no evidence of that amount having a meaningful impact on innovation.”
Drug companies can easily make that up by reducing advertising and marketing spending.
Washington Post: “Nine out of 10 big pharmaceutical companies spend more on marketing than on research.”
JAMA: “From 1997 through 2016…DTC prescription drug advertising increased from $1.3 billion to $6 billion with a shift toward advertising high-cost biologics and cancer immunotherapies.”
MYTH #3: The demonstration will result in worse care for patients. The government should not replace a market-based system with government price setting. FACTS:
We do not have a market-based system in the United States. Our system is completely based on laws and regulations.
Avik Roy, Foundation for Research on Equal Opportunity: “Medicare Part B does not represent a “free market” for prescription drugs. Instead, the program uses government-administered reimbursement rates to pay for drugs. The structure of this system is far removed from how a true market would work.” Peter Bach, MD, Director of Memorial Sloan Kettering’s Center for Health Policy and Outcomes: “There is no free market for prescription drugs in the U.S. The U.S. system of drug pricing is completely built on a foundation of government imposed laws and regulations that grant monopolies and market power to large players.”
JAMA: “High drug prices are the result of the approach the United States has taken to granting government-protected monopolies to drug manufacturers, combined with coverage requirements imposed on government-funded drug benefits.”
The 16 countries used for reference by and large have betterhealth outcomes and longer life expectancy than the U.S., while spending about half as much per capita for health expenditures.
Central Intelligence Agency: Of the 16 other developed economies in the IPI, Americans have shorter life expectancies than 13 of them: Austria, Belgium, Canada, Finland, France, Germany, Greece, Ireland, Italy, Japan, Spain, Sweden, and the United Kingdom.
World Bank: Of the 16 other developed economies in the IPI, Americans spend more on health care as a percentage of GDP thanall of them: Austria, Belgium, Canada, Czech Republic, Finland, France, Germany, Greece, Ireland, Italy, Japan, Portugal, Slovakia, Spain, Sweden, and the United Kingdom.
The current system is broken.
CNN: “Americans pay anywhere from two to six times more than the rest of the world for brand name prescription drugs.”
Wall Street Journal: “Compared with the U.S., drug prices are far lower in many overseas countries…Critics have long held that the [U.S.] percentage-based ‘add-on’ fee creates incentives for doctors to use higher-priced drugs.”
MYTH #4: Americans do not support the Part B proposed changes. FACTS:
According to a GOP pollster, Americans overwhelmingly support the International Pricing Index to lower drug prices.
Voters support the HHS proposal to lower drug prices by a 71-point margin (80 percent support vs. 9 percent oppose).
Majorities from both parties agree that Democrats and Republicans in Congress should support the proposal.
Notably, 8 in 10 voters believe the proposal will result in better care or have no impact on the care they receive.
