Latest News | Feb 2, 2024

The Week in Review in Prescription Drug Pricing

Welcome to the Week in Review.

1. “Fewer people will have to make these tough choices”

2. Legal Battle For Drug Pricing

3. Bipartisan Solutions To Increase Competition 

BONUS: The announcement by the Centers for Medicare and Medicaid Services regarding the focus on sickle cell disease (SCD) as the inaugural target of the Cell and Gene Therapy Access Model marks a significant step towards addressing the unmet needs of patients on Medicaid living with rare diseases and increasing the reach of potentially curative treatments in the future. The agency announced plans to negotiate with drugmakers over the prices of these gene therapies to ensure they’re accessible for the thousands of patients on Medicaid living with SCD. By facilitating access to potentially life-changing treatments and supporting outcomes-based agreements with manufacturers, this model has the potential to not only improve health outcomes for patients on Medicaid living with SCD but also alleviate financial burdens on communities facing systemic barriers to access essential medications.

Welcome to the Week in Review.

1. Fighting Against Lawsuits To Stop Negotiations

On Wednesday, January 31st, oral arguments will be heard in AstraZeneca’s legal challenge against Medicare’s ability to negotiate the price of the company’s diabetes and heart failure drug, Farxiga. Amidst this legal battle, Patients For Affordable Drugs Now (P4ADNow) has thus far signed onto seven amicus briefs led by Public Citizen and supported by AARP, Protect Our Care, Doctors for America, and Families USA to support the government’s opposition and explain the harm high drug prices have on people on Medicare. Meanwhile, by February 1st, the Centers for Medicare & Medicaid Services (CMS) are set to dispatch initial offers to the manufacturers of the first 10 drugs selected for negotiation. Drugmakers will then have 30 days to agree on the maximum fair price or provide a counteroffer. This next step marks a historic stride towards lower negotiated prices for millions of people on Medicare in 2026 and increased access to medications at prices they can afford.  — (O’Neill InstitutePublic CitizenALM BenefitsPro)

2. Big Pharma Greed: Wheeling and Dealing

New figures show that drug corporations are pulling in record profits and have been cashing out on billion-dollar biotech deals. Johnson & Johnson, manufacturer of three of the drugs selected for Medicare negotiation, announced $4.8 billion in Q4 earnings which is nearly double their earnings from the previous year, according to Accountable.US. Sanofi, one of the big three insulin makers that monopolize the industry, announced a multi-billion dollar acquisition of a biotech company, making it the sixth drugmaker buyout valued at $50 million or more this year. Despite all the huffing and puffing from drug industry CEOs about recent drug price reforms slowing down investment, Big Pharma is making huge returns on drug sales and new drug development is doing just fine! In fact, a report published by S&P Global Ratings projects that the global pharmaceutical industry will have “healthy revenue growth through 2027.” It’s clear that drug corporations put profit over the well-being of patients and we’ll continue to expose their shady behavior until everyone can access medications at prices they can afford.  — (Accountable.USBiopharma DiveS&P Global)

3. Push For Competition

Big drug companies exploit our patent and regulatory systems to extend their monopolies and keep prices high, at the expense of patients. Big Pharma wields anti-competitive tactics like patent thickets and pay-for-delay deals to extend their timed monopolies and block competition from the market. Right now, there is a critical window of opportunity to pass legislation to curb these patent abuses and bolster competition to lower drug prices for all patients. These competition bills have critical bipartisan support from influential legislators: “Some of the most liberal Democrats in Congress and the House GOP’s lead budget writer are backing a plan to keep drugmakers from gaming the patent system,” wrote Axios reporter Peter Sullivan. Patients urgently need legislators to pass these reforms to curb anti-competitive practices and strengthen market forces to drive down steadily increasing drug prices. — (Chicago TribuneReutersEndpointsAxios)

Welcome to the Week in Review.

1. Pushing for Transparency

In the health care policy arena, the focus centers around the passage of the Lower Costs, More Transparency Act (HR 5378). With bipartisan backing, this legislation seeks to increase transparency and affordability in healthcare pricing practices. One important provision of the bill requires the Food and Drug Administration (FDA) to streamline the approval process for generic drugs by mandating that the FDA explain to generic drug companies why their applications were not approved and therefore better enable them to address issues that might stand in the way of their future approval. If passed, this provision would not only help increase competition but is also projected to result in over $800 million in cost savings. Facilitating generic entry is a key step toward reshaping the pharmaceutical landscape to lower costs for patients. Ironically, current negotiations between the House and Senate underscore the lack of transparency in the dynamics themselves that are shaping healthcare policies for patients. (MoneyTalks News, STAT News)

2. Easing the Burden for People on Medicare

In a significant development for many people on Medicare, the 2022 Inflation Reduction Act cap on out-of-pocket expenses for Part D drugs has gone into effect. This year, many individuals on Part D plans and who only take brand-name drugs will pay no more than $3,300 out of pocket annually for their medications, eliminating the 5 percent coinsurance after reaching the catastrophic spending threshold. The cap is expected to bring relief to approximately 1.5 million people, leading to substantial savings for patients. By 2025, the cap will further decrease to $2,000. In a piece from the Wall Street Journal, Patients For Affordable Drugs patient advocate Judy Aiken, who faced over $9,000 in out-of-pocket costs last year for her medication, Enbrel, expressed relief, emphasizing the positive financial impact of the cap on her well-being. David Mitchell, founder and president of P4AD, highlighted the remarkable savings this change brings and the crucial protection it offers to people on Medicare. These savings come at the same time as a notable escalation in list prices for a range of widely prescribed medications, including those by pharmaceutical giants like Novo Nordisk and Eli Lilly. This is despite the outlier in some of the older and competing insulins which saw a January 1 price drop for some of their older competing insulins timed to avoid paying additional rebates and following years of patient advocacy to lower the price of insulin. (KFF, WSJ, P4ADNow, NPR, Forbes, WSJ, CNN)

BONUS: Public Citizen and AARP, both prominent advocates for lowering drug prices, have released reports this week. Public Citizen’s report emphasizes the pharmaceutical industry’s disingenuous opposition to drug pricing regulations, revealing that major drug manufacturers spent billions more on activities such as stock buybacks and executive compensation than on research and development. Meanwhile, AARP’s Rx Price Watch series provides a comprehensive analysis of prescription drug pricing trends, highlighting the staggering annual costs faced by Americans, particularly older adults, and the disproportionate impact on people on Medicare. These reports are important tools for the ongoing conversation on drug costs and the need for comprehensive reforms. (Public Citizen, AARP)

Welcome to the Week in Review.

1. Urgent Need for Drug Negotiations

2. New Bipartisan Legislation Targets Patent Thickets

3. Debunking Pharma’s Claims

BONUS: Senate Democrats, led by Sen. Bernie Sanders, are investigating soaring asthma inhaler costs. The probe addresses the stark U.S. price disparities, emphasizing concerns for patients who often face high costs and rationing. The inhalers sell for hundreds of dollars in the U.S. but much less abroad. (The Hill)

Welcome to the Year in Review.

Over the last 12 months, our community has been at the forefront of amplifying patient voices in the fight to lower drug prices, fighting back against pharma lies, and advocating for bills that will increase competition and reduce patent abuses. From launching the Push for Competition with AARP alongside key allies to supporting the continued fight to ensure the successful implementation of the drug price provisions in the Inflation Reduction Act, our daily efforts have centered on uplifting patient voices and holding those in power to account so everyone in the United States can get the prescription drugs they need at prices they can afford. Highlights from the year include: 

1. Patient Advocates Celebrating the Popular Drug Price Reforms

2. Push For Competition Launch And Building Momentum

3.  Spanish Language Program Expansion

4.  Reports Driving Change

Meanwhile, keeping pace with the ongoing developments, here’s a snapshot of the latest events in the world of prescription drug pricing.

1.  Capping the Cost of Insulin

2.  Importing Rx From Canada

Welcome to the Week in Review.

1. Pharma’s Legal Assault on the Inflation Reduction Act

2. AbbVie’s Tactics Highlight Need for Pharmaceutical Reforms

3.  Rising Healthcare Costs and the Push for Affordable Medications

Patients For Affordable Drugs will be closed through January 1st. Wishing you peaceful and restorative holidays and we look forward to sharing some exciting new updates in the New Year! 

Welcome to the Week in Review.

1. Taking Aim At Soaring Drug Prices

2.  Enforcing Fair Drug Pricing

3.  Setting the Stage For Senate Health Care Package

BONUS: Not all patient groups are what they seem! This new report from Public Citizen shows the power of Pharma dollars at work and how they leverage patient groups to do their bidding including during the fight to pass the drug price reforms in the Inflation Reduction Act. Their actions keep prices high for patients. From the report; “if a patient advocacy group expresses doubts about a drug-pricing bill, that may have a greater impact. If a local advocacy organization publishes an op-ed in the member’s local paper, that will no doubt get a member’s attention. If a new controversial drug to treat a disease gets the ringing endorsement of the patient group representing those inflicted with the disease, that could carry great weight”. Bottom line: If you’re in bed with pharma, you’re not doing enough on drug pricing. To understand the influence of Pharma on a patient group see P4AD’s The Hidden Hand and the 2023 Update Hiding in Plain Sight. (KFF Health News

Have a great weekend! 

As we approach the end of 2023, we wanted to highlight the historic drug price reforms in the Inflation Reduction Act delivering relief to millions of patients on Medicare.

Welcome to the Week in Review.

1.The Inflation Reduction Act Delivers Long-Sought Relief

 2.  Patent Abuse Watch

 3.  States Push For Lower Insulin Prices

BONUS: P4ADNow salutes  Senators Dick Durbin and Chuck Grassley for introducing bipartisan legislation to increase price transparency in direct to consumer advertisements on prescription drugs. Thank you Senators for prioritizing patients over the interests of Big Pharma!

Have a great weekend!