This Week in Prescription Drug Pricing: Big Pharma caught in contradiction, the growing impact of the Inflation Reduction Act, and the power of public pressure
Welcome to the Week in Review.
1. Big Pharma Caught In Contradiction
Big drug companies continue to drum up bold lies regarding the impact of the drug price reforms in the Inflation Reduction Act (IRA). This is despite the overwhelming evidence pointing towards the law as an important conduit for delivering financial relief to patients, while also maintaining critical levels of investment in innovation. Drug company executives, who are beholden to investors, recently stated that Medicare drug price negotiations were “encouraging” and would have “modest impact.” At the same time, several pharma companies have launched aggressive lawsuits attempting to dismantle Medicare negotiations, arguing that the program will deter investments and hurt revenue. In The Hill, P4AD’s Merith Basey calledout the hypocrisy of drug industry executives and allies who are talking out of both sides of their mouths: “We know that the impact of the IRA is not going to affect their bottom line in the way that they like to cry poor every time anyone tries to touch anything that gets in the way of their monopoly power.” Lower negotiated drug prices will not make a dent in Big Pharma’s huge profit margins, while delivering transformative relief to patients. “A few hundred dollars is a massive difference for one individual,” Merith continued. “Again, this is about ordinary people.” It’s evident that investments in drug development are not slowing down. So far this year, 21 biotech startups have received hundreds of millions of dollars in investments from venture capitalists. This juggling act displays Big Pharma’s lack of credibility and demonstrates their intention as clear as day: preserving monopoly pricing power at the expense of patients. — (Endpoints, Endpoints, The Hill, The Hill, Endpoints)
2. The Growing Impact Of The Inflation Reduction Act
Patients continue to reap the benefits of the groundbreaking drug price reforms in the Inflation Reduction Act. The number of vaccines administered to adults in the first nine months of 2023 exceeded pre-pandemic levels, largely thanks to the new vaccine provision introduced last year, which provides coverage without patient cost-sharing of certain recommended vaccines for people on Medicare Part D. “This underscores the importance of preventive health care and emphasizes the overall benefits of the Inflation Reduction Act in guaranteeing that Medicare patients receive accessible, affordable high-quality care,” the Department of Health and Human Services (HHS) spokesperson LaTanya Marble told Politico. The drug price reforms in the Inflation Reduction Act are directly addressing the urgent needs of patients living in the U.S. who pay on average nearly three times more for their medications than residents in other peer nations. — (Politico, Commonwealth Fund)
3. The Power of Public Pressure
Earlier this week, AstraZeneca and GlaxoSmithKline (GSK) responded to increased pressure and scrutiny from patients and lawmakers by announcing plans to cap out-of-pocket costs for some of their inhaler products at $35 a month. This move follows in the footsteps of Boehringer Ingelheim, which made a similar commitment earlier this month. The spotlight has been on the egregious price hikes of inhaler medications over the past year, prompting both the Senate Health, Education, Labor, and Pension (HELP) Committee and Federal Trade Commission (FTC) to call out the four major inhaler companies for patent abuse tactics that drive up prices and delay lower-cost competition. For example, AstraZeneca’s Breztri Aerosphere inhaler costs $645 in the U.S. compared to just $49 in the United Kingdom (U.K.) and GSK’s Advair HFA inhaler costs $319 in the U.S., while it is sold for only $26 in the U.K. These decisions by drugmakers to cap costs mark a significant milestone for some patients who rely on these medicines to manage conditions like asthma and chronic obstructive pulmonary disease. Jennifer, a patient advocate in Colorado, wrote to us about her experience with breathing complications, which led her to a prescription for an inhaler costing $495. “How could I pay for that regularly plus my mortgage, utilities, car insurance, gas to get to work, and the premium on my health insurance?” Her story is one of many shared experiences we’ve heard from patients who are forced to go without their inhaler medications due to cost. We urge Teva, the last of the four major inhaler companies, to immediately follow suit and reduce copay costs for patients. — (The Hill, Reuters, Common Dreams, CNN, FTC)
PRICE WATCH: Lenmeldy, a new life-saving gene therapy for the genetic disorder metachromatic leukodystrophy (MLD) will be the most expensive drug in the world at $4.25 million. Innovation is worthless if patients can’t afford it — we urgently need to address the high launch prices of transformative cell and gene therapies coming to market.
Have a great weekend!
Welcome to the Week in Review.
1. Biden Promises to Expand The Inflation Reduction Act
Key Senators remain committed to advancing bipartisan bills aimed at cracking down on pharmacy benefit managers (PBMs) and their opaque tactics, which drive up costs for patients and taxpayers. Senate Finance Committee Chair Ron Wyden and Ranking Member Mike Crapo, joined by advocates, held a press conference yesterday to encourage legislative action that would hold the secretive middlemen accountable. PBMs negotiate discounts, or rebates, with drug companies in exchange for preferable placement on formularies. However, the specific terms of these rebate contracts, including the amount of the discounts and how they benefit patients, are not disclosed to the public. As a result, it’s unclear whether PBMs are using their power to ensure patients are getting the best drug at the best price. Prior to the press conference, the Senators penned a letter to Senate Majority Leader Chuck Schumer, Senate Minority Leader Mitch McConnell, and members of the Senate Finance Committee, reaffirming their commitment to increase transparency and accountability in the PBM industry during this Congress. It’s time to pass reforms to ensure PBMs prioritize serving patients and consumers over padding their bottom line. — (Senate Finance Committee, Axios, Fierce Healthcare, DCNewsNowVimeo, Center for American Progress, Senate Finance Committee)
2. Exposing Big Pharma Lies
Despite warnings from Big Pharma suggesting the drug price reforms in the Inflation Reduction Act would stifle research and development (R&D) efforts and impede profits, recent data presents a starkly different picture. Contrary to the narrative propagated by drug companies and their trade associations, the industry is investing in R&D at record levels. Top drug companies have spent $153 billion on R&D, and mergers and acquisitions areincreasing at a steady pace. Additionally, costly advertising slots for major TV entertainment events this year, like the Super Bowl and The Oscars, weredominated by drug industry behemoths Pfizer and AbbVie. A report from Protect Our Care showed that last year alone, 16 of the largest drug companies reported $684 billion in earnings, a shocking figure that reflects the absurdly high prices set by drug makers. It’s glaringly apparent that Big Pharma is swimming in profits, all while patients struggle to afford essential medications. — (Endpoints, STAT News, Wall Street Journal, Axios, Fierce Pharma, Protect Our Care, Accountable.US)
3. Medicare Negotiation Puts Patients Over Profit
Big Pharma is marshaling its vast resources toward stopping the implementation of Medicare negotiations, one of the most popular and transformative drug price reforms in the Inflation Reduction Act. Kelly Bagby, Vice President at AARP Foundation Litigation, succinctly explained the objectives behind the various lawsuits pharmaceutical corporations have filed: “They want to make sure their historical profitability is maintained, and not changed, while at the same time trying to delay everything.” To date, however, judges in three district courts have sided with the Biden administration, and last week, oral arguments were presented in four cases brought by big drug companies, during which, the judge expressedskepticism that anything other than maintaining their bottom line motivated their challenges to Medicare negotiation. “All of the momentum is clearly on the side of the government at this point, and not on the side of some of these other manufacturers,” Theresa Carnegie, a health care attorney with Mintz Levin, told CNBC. — (P4ADNow, The Washington Post, FiercePharma, Bloomberg Law, CNBC, Forbes, STAT News, CNBC)
BONUS: A new study from Bentley University shows that the National Institutes of Health (NIH) invested $11.7 billion on research leading to the approval of the first 10 drugs up for Medicare negotiation. Lower negotiated drug prices will help ensure patients and taxpayers get a better deal on these widely-used, high-cost medications. We deserve a fair return on the drugs taxpayers paid to invent!
Have a great weekend!
Welcome to the Week in Review.
1. Biden Promises to Expand The Inflation Reduction Act
In a week marked by significant developments in the fight to make medicine more affordable, Patients For Affordable Drugs Now (P4ADNow) applauded President Biden’s ongoing commitment to reducing drug prices for patients nationwide. The Biden Administration’s proposals to expand Medicare negotiation to 500 drugs over a decade and extend cost-saving measures to millions of people on private insurance, among other reforms, signals a potentially monumental step toward achieving affordable drugs for every American. Furthermore, President Biden’s State of the Union address underscored the historic achievements of the Inflation Reduction Act for patients and highlighted the proposals he had announced on the eve of the address. P4ADNow patient advocate, Steven Hadfield, emphasized the impact of the reforms, sharing his personal experience and the relief he has felt thanks to capped monthly insulin costs and expressed hope for further relief brought by Medicare negotiation. His presence as a guest of First Lady Jill Biden during the State of the Union exemplifies the urgency and importance of lowering drug prices for millions of Americans. P4ADNow continues to advocate for the implementation of the new drug price law and bipartisan bills in Congress that help address the challenges faced by patients like Steven. We know the momentum and public pressure to reduce drug prices are stronger than ever. – (P4ADNow, P4ADNow, STAT News, Pharma Phorum, P4AD, AARP, NPR, New York Times, Yahoo News, P4ADNow)
A quick selfie with P4AD patient advocate, Steven Hadfield, before he joined First Lady Jill Biden for the SOTU
2. Legal Battles Over Medicare Drug Price Negotiation Heat Up
On Thursday, a federal district judge in New Jersey heard oral arguments in four of several cases challenging Medicare’s authority to negotiate drug prices. In a courtroom exchange that captured attention, Judge Zahid Quraishi probed the industry’s arguments and questioned the purported financial burdens Medicare negotiation would have on drugmakers, injecting a note of skepticism by remarking, “A lot of people would say pharmaceutical companies could give up an arm. They have a lot of appendages.” This observation reinforced the judge’s scrutiny of the industry’s claims. Rachel Cohrs of STAT News highlighted the judge’s remarks that these big drug companies were “businesses with the goal of profit… These companies are not Mother Teresa developing drugs for free for the American public.” A P4AD patient advocate was also in the room representing patients and listening to the arguments, which came just days after a federal judge in Delaware issued a sweeping ruling against pharmaceutical giant AstraZeneca in a case brought by the drug company seeking to overturn Medicare negotiation. Last month, a federal district judge in Texas dismissed a similar lawsuit from the industry trade group Pharmaceutical Research and Manufacturers of America (PhRMA), and in September a District Judge in Ohio ruled against the U.S. Chamber of Commerce’s case. That’s three times that a judge has ruled against pharma and for patients of the United States, and as this headline from Fast Company puts it, “Big Pharma is losing its fight to avoid prescription-drug-price negotiations”. – (P4AD, STAT News, BioSpace, Endpoints News, Georgetown Law, Reuters, FastCompany)
3. Boehringer Ingelheim Caps Inhaler Costs Amid Public Pressure
In a move spurred by mounting public pressure and widespread demand for lower drug prices, Boehringer Ingelheim has announced plans to cap out-of-pocket costs for its inhaler products at $35 per month starting June 1. The decision comes amidst growing criticism, notably from Senator Bernie Sanders, who, in his role as chair of the Senate Committee on Health, Education, Labor, and Pensions (HELP) launched an investigation into efforts by pharmaceutical companies to manipulate the price of asthma inhalers. These big drug companies have heard widespread complaints from American patients and consumers about the inability to afford their inhalers, especially considering they are drastically cheaper in other countries. This move draws parallels to actions taken by insulin manufacturers, including Sanofi, Novo Nordisk, and Eli Lilly, all of whom lowered the price on some of their older insulins after years of criticism over pricing practices. These developments help underscore the power of grassroots advocacy in driving industry reforms. While welcomed by many patients, Boehringer Ingelheim’s action demonstrates the ongoing need for sustained efforts to guarantee access to essential medications for all patients. – (Reuters, STAT News, The Lancet, The Hill, FiercePharma, P4AD)
Welcome to the Week in Review.
1. Court Deals Major Blow to AstraZeneca
Yesterday, a federal judge in Delaware delivered a significant blow to AstraZeneca by ruling against the company in its effort to halt the negotiation of its diabetes drug, Farxiga, marking a pivotal moment in the ongoing battle to defend Medicare negotiations. Patients For Affordable Drugs’s Merith Basey hailed this ruling as a critical step forward in ensuring fair drug prices. “On behalf of patients across this country we are encouraged but not surprised that the court has rejected AstraZeneca’s self-serving arguments and essentially said the company didn’t have a leg to stand on,” she said. “This ruling sends a clear message that Big Pharma’s greed cannot continue to be prioritized over patients’ well-being and underscores the importance of Medicare negotiation to begin to rein in exorbitant drug prices.” Last year, AstraZeneca generated over $4 billion in revenue from Farxiga, a medication used to treat patients with type 2 diabetes, heart failure, as well as chronic kidney disease. CMS data shows that nearly 800,000 patients on Medicare Part D utilized Farxiga between May and June 2022. Patients like Karen in Colorado, who lives on a fixed income and faces a $600 bill for a three-month supply of Farxiga, will benefit from a lower negotiated price scheduled to take effect in 2026. This case was one of nine threatening Medicare negotiation and once again a judge has ruled against the drug industry and for the United States. This Thursday, March 7th, four lawsuits filed by Bristol Myers Squibb (BMS), Novo Nordisk, Novartis, and Johnson & Johnson (J&J) will present combined oral arguments to a federal judge in New Jersey. P4AD is unwavering in our commitment to fight the pharmaceutical industry’s attempts to use the U.S. legal system to undermine policies aimed at reducing drug costs and ensuring patients can access the medications they need at prices they can afford. – (Endpoints News, P4AD, BioSpace, CMS)
2. Legislators Oppose Efforts To Undermine The Inflation Reduction Act
On Thursday, the House Energy and Commerce Subcommittee on Health held a hearing on legislative proposals related to patients living with rare diseases. Several bills that were the focus of the hearing would, if implemented, undermine the drug provisions in the Inflation Reduction Act. P4ADNow’s founder, David Mitchell sent a comprehensive 21-page statement to the subcommittee ahead of the hearing debunking Big Pharma’s claims including that the Inflation Reduction Act would inhibit investment in small-molecule drug development and drugs that treat rare diseases. David, who is a patient with a rare, incurable cancer, underscored how the law actually provides key incentives for drug investment and strikes the right balance between affordability and access. During the hearing, several subcommittee members echoed David’s sentiments, expressing opposition to bills that would curtail Medicare’s negotiating authority. Rep. John Sarbanes summarized the hypocrisy of drug companies who often cry wolf about investment in research and development, citing David’s statement which revealed that “Johnson & Johnson reported an 11.8 percent increase in R&D spending in 2022, Merck reported an 11 percent increase in R&D spending, and Moderna reported a 65 percent increase in R&D spending and projected further increases in 2023.” Despite claims that the new drug price law would stifle innovation, real-world evidence suggests otherwise: Big Pharma’s primary goal is to safeguard profits from its blockbuster drugs. The opposition from other committee members including Rep. Frank Pallone, the Ranking Member of the full committee, underscores the strong opposition from many Members to undermine the Inflation Reduction Act. — (YouTube, P4ADNow, Politico, PORTAL Research)
3. The High Cost Of Insulin
A new study published in Diabetes Research and Clinical Practice highlights the escalating financial burden faced by people managing diabetes. Researchers found that from 2009 to 2018, total costs associated with diabetes care increased, with people living with type 1 diabetes experiencing the most substantial rise in out-of-pocket expenses. “Studies show that the more a patient pays out-of-pocket, the less likely they are to stick with their medication long term, which poses a serious risk to their health,” said lead author Evan Reynolds. Fortunately, the $35 monthly insulin copay cap for patients on Medicare in the Inflation Reduction Act has brought significant savings for patients. But, there’s more to be done to ensure everyone can access their insulin at prices they can afford. — (University of Michigan, KFF)
BONUS: A new report from Protect Our Care found that in 2023, 16 of the largest drug companies reported a whopping $684 billion in earnings — ”a figure that is higher than the gross domestic product (GDP) of 88 percent of the countries in the world.” Remind us again how drug companies are hurting from the new drug pricing reforms?
Welcome to the Week in Review.
1. “The Inflation Reduction Act is a great, wonderful thing”
It’s been 18 months since the passage of the Inflation Reduction Act and we’re still buzzing about the drug price reforms that are helping millions of patients see cost savings. Patients For Affordable Drugs (P4AD)’s founder David Mitchell, who is also a patient living with multiple myeloma, shared with KFF that last year alone, he paid over $16,000 for 12 bottles of Pomalyst, one of several drugs he needs to keep his cancer at bay. Thanks to the provision that caps out-of-pocket spending for patients on Medicare who use brand-name drugs at about $3,500, David has seen savings of more than $13,000 this year. Lynn, a retired nurse, and P4AD patient advocate who relies on a patient assistance group to help cover her drug costs, explained that because of the new drug price law she’ll pay nothing this year for her costly leukemia drug Imbruvica because the foundation’s first monthly payment covered her entire responsibility. Lynn told KFF: “For Medicare patients, the Inflation Reduction Act is a great, wonderful thing.” A new analysis by the Center for American Progress (CAP) estimated cost savings for a month’s supply of the first 10 drugs being negotiated by Medicare, ranging from $30 for insulin product NovoLog FlexPen to over $6,500 for Imbruvica. Medicare negotiation will provide monumental relief to the nine million patients on Medicare who use these 10 drugs, and who face some of the highest drug prices in the world. A new survey from KFF shows that more than half of voters are increasinglyconcerned about being able to afford their prescription drug costs, underscoring the need for successful implementation of lower negotiated drug prices. Patient voices were instrumental in the passage of the historic drug price law and will continue to play a pivotal role in defending these hard-fought reforms. — (KFF, CAP, KFF, Axios, The Hill, Business Insider, P4ADNow)
2. High Cost Of Cell And Gene Therapies
The exorbitant launch prices of new cell and gene therapies entering the market are a major concern and burden to patients, and our health care system, and drive the question of who will bear responsibility for the cost. A recently approved therapy to treat advanced melanoma called Amtagvi was priced by Iovance at $515,000, which makes it the most expensive cell-based treatment in the United States. Unfortunately, this high price tag is just the tip of the iceberg in the emerging trend of specialized therapies hitting the market at astronomical prices. For Elizabeth, a professor whose four-year-old son, Eliot lives with Duchenne muscular dystrophy, a fatal neuromuscular disease, the innovation of a new gene therapy, Elevidys, was “science at its very best, close to a miracle.” Three weeks after a one-time infusion, Eliot went from experiencing extreme fatigue and limited mobility, to “marching upstairs and able to jump over and over.” Elevidys has the potential to treat this debilitating disease that affects thousands of patients, however, its $3.2 million price tag raises serious questions about the accessibility of this treatment for patients. We urgently need to address the high launch prices set by profit-hungry drug companies. Because as we know, drugs don’t work if people can’t afford them. — (Reuters, STAT, Axios, The New York Times)
BONUS: On March 7th from 10 a.m. – 2:30 p.m., combined oral arguments will be heard in New Jersey for all four lawsuits aimed at stopping Medicare negotiations —filed by Bristol Myers Squibb (BMS), Novo Nordisk, Novartis, and Johnson & Johnson (J&J). These four companies each have a drug up for negotiation: Eliquis (BMS), Entresto (Novartis), Novolog (Novo Nordisk), and Imbruvica (J&J). While Big Pharma fights tooth and nail to undermine the widely supported provision in the Inflation Reduction Act, we’re advocating alongside patients for the successful implementation of the law that will deliver long-sought relief from high prices.
Welcome to the Week in Review.
1. Medicare Negotiation Will Deliver Relief To Millions
Marking an important step in protecting Medicare’s ability to negotiate lower prices for millions of patients, a Texas federal judge dismissed the lawsuit from trade association Pharmaceutical Research and Manufacturers of America (PhRMA) in conjunction with the National Infusion Center Association and the Global Colon Cancer Association (NICA). This is one of nine lawsuits aimed at blocking the implementation of the Medicare negotiation program in order to keep drug prices high. The ruling is the thirdtime a judge has weighed in against the drug industry’s efforts to undermine the law. This recent decision sends a strong message and comes at a time of widespread disapproval of and turmoil within the pharmaceutical industry. Despite tens of millions of dollars in lobbying efforts against the Inflation Reduction Act, patients and advocates effectively championed the passage of the Law in 2022. Additionally, a growing number of drug companies have severed ties with the trade group amid disagreement about its strategic direction. In essence, these developments underscore a dynamic shift in the landscape, from a rift within the industry itself and growing momentum for reform from patients and advocates. — (Bloomberg, Georgetown University, Axios, P4AD Now, Politico, MM+M)
2. Drug Price Reforms Drive Big Cost Savings
Patients across the country are celebrating the relief they’re already seeing from the drug price reforms in the Inflation Reduction Act. Marianna in Minnesota wrote in a letter to the editor that the drug price law is a “legislative health care miracle” and detailed how the provisions to end cost-sharing for vaccines and the $35 monthly insulin copay cap have made a huge difference to seniors on Medicare like herself. Additionally this year, many patients who take brand-name drugs on Medicare Part D will now have their out-of-pocket drug costs capped at about $3,500. In 2025 the cap will drop to $2,000 for people on Medicare. Pam, a Michigan educator living with diabetes, reflected on her experience with high insulin prices in an op-ed: “I recently calculated that I spent $1,068 last year on insulin. And this high cost doesn’t even account for my other medical treatments and prescriptions.” Thanks to the $35 insulin copay cap for patients on Medicare, Pam will spend “Iess than half” of what she spent on her insulin in the previous year and finally have some more room to breathe when paying bills every month. We’re eagerly looking ahead for the rest of the drug price provisions to be implemented — the $2,000 cap on out-of-pocket costs in 2025, and in 2026, lower prices for the first 10 negotiated drugs. — (Post Bulletin, KFF, The Gander)
BONUS: Patients For Affordable Drugs Now (P4ADNow) beganrunning a series of TV ads this week to inform constituents in Congressman Don Davis’ district (D-NC1) that he has reneged on his campaign promise to “stand up to drug companies.” Instead, Davis has become the only Democrat in the House of Representatives to sponsor a bill that would undermine Medicare’s ability to negotiate lower drug prices, a wildly popular provision in the Inflation Reduction Act that is supported by more than 80 percent of voters. (Politico, Axios, YouTube, YouTube, NC Newsline, P4ADNow, YouTube, STAT News, P4ADNow)
Welcome to the Week in Review.
1. Panel Discussion On Bipartisan Push For Competition
Senators Peter Welch and Amy Klobuchar were joined by patient advocates and health care experts for a panel discussion on Big Pharma’s use of patent thickets to extend market exclusivity and the new bipartisan legislation introduced by the Senators to make it easier for generic and biosimilar drugs to enter the market, increasing competition and lowering prescription drug prices. Jacqueline Garibay, a Patients For Affordable Drugs (P4AD) advocate and college student who lives with ankylosing spondylitis (AS), shared how drug makers used anti-competitive tactics to keep biologic drugs, like Enbrel and Humira, priced out of reach. “By using abusive tactics to prevent market competition for life-saving drugs, big drug companies are forcing people like me to pay astronomical prices that we can’t afford. P4AD’s Merith Basey explained to the panel how Big Pharma takes advantage of loopholes in our patent system and “artificially prolong their monopoly periods to keep prices high at the expense of patients.” Bipartisan legislation led by Senators Welch, Klobuchar, and Braun, as well as bipartisan legislation in the House, would tackle the systemic burden of patent thickets head on. Passage of these bills would be a step closer to restoring fairness to the U.S. patent system and pave a pathway for increased competition to deliver long-sought relief to patients. — (YouTube, Welch, Congress.gov)
2. Senate HELP Committee Examines High Drug Prices
At a hearing this week, the Senate Health, Education, Labor & Pensions (HELP) Committee asked the CEO’s from Merck, Bristol Myers Squibb (BMS), and Johnson & Johnson (J&J) to justify the higher drug prices they charge in the U.S. compared to other peer countries. A report released by the Senate HELP Committee prior to the hearing outlined the drug companies’ inflated U.S. prices, their spending on lobbying, and efforts to delay competition. One of the drugs under review by the committee was Stelara, an expensive biologic drug manufactured by J&J. P4AD patient advocate Jacquie Persson, who is 35 and living with Crohn’s disease, knows the impact of the high price tag of Stelara all too well. Stelara, which costs $25,000 per month, has tripled in price since market entry. If Jacquie had to access Stelara without insurance coverage, she would be forced to forgo the medication because of its cost and suffer painful flare-ups. Merck’s CEO, Robert Davis, had to answer questions about the company’s patent abuses that drive up prices for people like Steven Hadfield, a 71-year-old patient advocate who takes Merck’s expensive biologic Januvia to manage his type 2 diabetes. These are just two of countless stories of patients on these drugs who face financial hardship and medical uncertainty due to the exorbitant costs driven by pharmaceutical companies’ unfair pricing strategies and patent practices. The second panel featured Tahir Ahmin, Director of the Initiative For Medicines, Access, & Knowledge (I-MAK), Peter Maybarduk, Director of Public Citizen, and Dr. Darius Lakdawalla, Director of Research at the University of Southern California. Peter kicked off the panel by sharing a story from Lois, a Texas patient who critically needs diabetes drug Januvia to control their blood sugar, but is forced to go without because of its price. Lois’s story is one of over 34,000 stories that have been shared with P4AD from patients who have struggled to afford their essential medicines. — (New York Times, Commonwealth Fund, Senate HELP Committee, P4AD, P4AD)
BONUS: This past Sunday’s New York Times featured a story from Mark Miller about the profound impact of the Inflation Reduction Act on prescription drug costs for millions of seniors. The piece focused on P4AD founder and cancer patient, David Mitchell, whose story illustrates how individuals like him are for the first time paying less out-of-pocket as a result of the new drug price law.
Welcome to the Week in Review.
1. “Fewer people will have to make these tough choices”
As part of the sweeping reforms to lower prescription drug costs for millions of patients, the Centers For Medicare and Medicaid Services (CMS) sent initial price offers to drug manufacturers for the first 10 drugs selected for negotiation. Executive Director of Patients For Affordable Drugs Now (P4ADNow), Merith Basey issued a statement, marking the moment as a historic milestone for patients who face exorbitant drug prices: “We’ve listened to stories of people rationing insulin or other life-sustaining medications just to make ends meet. By advancing this process of direct negotiation with drug companies, CMS is helping ensure that fewer people will have to make these tough choices.” Lower negotiated drug prices will deliver relief to patients who regularly pay some of the highest prices for drugs in the world. In fact, on the same day that CMS sent its initial price offers to drug makers, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) issued a report that found that in 2022, prices in the United States (U.S). across all drugs (brands and generics) were nearly three times as high as prices in peer nations and brand drugs were at least 3.22 times as high. Thankfully, Medicare’s new negotiation authority ensures that the program will rein in high drug prices and increase access to innovative medications for people on Medicare by considering factors like a drug’s clinical benefit compared to its therapeutic alternatives as well as current unmet needs. — (P4ADNow,ASPE, Axios)
2. Legal Battle For Drug Pricing
AstraZeneca’s legal challenge against Medicare’s drug price negotiation program, amid oral arguments, faced scrutiny from the Judge, shedding light on the ongoing struggle to lower drug prices for people on Medicare. The lawsuit, part of a broader, coordinated effort by big drug companies, aims to undermine Medicare’s newfound authority to negotiate lower drug prices, as established by the Inflation Reduction Act. AstraZeneca’s contention seeks to safeguard its control over pricing for its diabetes and heart failure drug, Farxiga, which raked in $4.4 billion in revenue for the company in 2022 alone. However, the Judge’s skepticism toward AstraZeneca’s arguments underscores the questionable tactics employed by pharmaceutical giants to prioritize profits over patient access. If these lawsuits were to succeed and overturn the Inflation Reduction Act’s provisions for Medicare drug price negotiation, millions of Americans would continue to be forced to shell out for high-priced medications they need to survive and taxpayers would miss out on the potential savings of close to $100 billion over ten years. Patients For Affordable Drugs (P4AD) strongly opposes these self-serving maneuvers, advocating for policies that ensure lower drug prices for people on Medicare. In a statement, P4AD’s Executive Director, Merith Basey underscored that “Medicare was never intended to serve as a blank check for Big Pharma’s insatiable greed.” And that P4AD remains steadfast in its commitment to “thwart the pharmaceutical industry’s attempts to exploit the US legal system, ensuring essential policies aimed at reducing drug costs and guaranteeing patient access to affordable medications.” — (Georgetown Law, STAT News, Bloomberg Law, P4AD)
3.Bipartisan Solutions To Increase Competition
Big Pharma’s abuse of our patent and regulatory systems grants drug companies unlimited pricing power and drives up costs for patients and taxpayers. A prime example this week: asthma inhalers. Senator Tammy Baldwin penned a letter to the makers of asthma inhalers demanding them to remove improperly listed patents — a tactic used by big drug companies to delay competition and force patients to pay high prices. Asthma inhalers can fetch prices exceeding $600 in the U.S. — yet in other countries, these essential medications are being sold for a fraction of that list price. Novo Nordisk’s recent announcement to stop U.S. sales of Levemir insulin (vials and pens) is another example pulled from the Big Pharma patent abuse playbook. Drugmakers who engage in this tactic called “product hopping” remove viable products from the market, limiting treatment options for patients, and then replacing them with newer versions that are more expensive. Robin Feldman, a University of California law professor, described the scheme to USA Today as “a shell game in which the consumer always loses.” Lawmakers have an opportunity to advance bipartisan solutions that tackle these barriers to increased competition and lower drug prices to patients. Congress, over to you! — (The Washington Post, USA Today,The Daily Herald)
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.
