Welcome to the Week in Review.
Projected Savings From Out-Of-Pocket Cap
Asthma and chronic obstructive pulmonary disease (COPD) disproportionately affects Black, Latino, and Native American communities, as a result of key social determinants of health – such as air pollution, limited access to care, and economic inequities. For many living with asthma, annual prescription drug costs can average up to $1,830 per person, forcing patients to choose between adhering to their treatment plans and affording other basic life necessities. In general, 30 percent of Black people and 42 percent of Latinos in the U.S. report not taking prescribed medication due to cost – driving higher rates of hospitalization and mortality for these communities. There is encouraging news however for some patients on Medicare with asthma and COPD who could see relief in January when the annual $2,000 out-of-pocket cap goes into effect. A new analysis published in the Journal of General Internal Medicine estimates that 360,000 patients on Medicare with asthma and/or COPD could save more than $1,000 per year, with total out-of-pocket savings exceeding half a billion dollars annually, helping to ease the financial burden that contributes to medication nonadherence and worse health outcomes. — (Asthma and Allergy Foundation of America, KFF, Politico, Journal of General Internal Medicine)
Rising Prices Of Cancer Therapies
Big Pharma’s exorbitantly high launch prices and consistent price gouging of cancer medications have reached unsustainable levels at the expense of patients. A new study in Nature reveals the staggering scale of this issue: in 2023, the U.S. spent $99 billion on cancer therapies, with projections soaring to $180 billion by 2028. Why is that? This surge is driven by two alarming trends: new cancer therapies are coming to market at astronomical prices, often exceeding $100,000 per treatment, and existing drugs are seeing perpetual price hikes that outpace the rate of inflation. And the consequences are dire for patients. The study highlights that 50 percent of older adults skip filling prescriptions for cancer therapy when their out-of-pocket expenses exceed $2,000. However, for cancer patients on Medicare, in 2025, the $2,000 cap on out-of-pocket costs mandated in the IRA is projected to save patients an average of $7,590 annually, with some patients saving up to $19,296. The Inflation Reduction Act, alongside critical reforms to our patent system, offer hope for more affordable cancer treatments in the future. — (Nature, P4AD, patientspushforcompetition.org)
P4AD Advocates Celebrate Relief At HHS Roundtable
From lower insulin costs to free vaccines, patients on Medicare are seeing benefits that will only continue to grow as the law is fully implemented. This was the theme of a virtual roundtable this week which included patient advocates, Department of Health and Human Services (HHS) Secretary Xavier Becerra, and Centers for Medicare & Medicaid (CMS) Director Dr. Meena Seshamani. P4AD founder and cancer patient David Mitchell shared how the cap on out-of-pocket costs has already saved him more than $13,000 this year. “The IRA is delivering lower prices, lower out-of-pocket costs, steady or lower premiums and all the while maintaining a strong innovation pipeline,” shared David at the virtual roundtable. “It’s a big win for me and millions of other patients like me.” Lisa McRipley, a patient advocate who lives with multiple sclerosis (MS), expressed the relief she felt knowing that next year, the annual out-of-pocket cap will save her up to $6,000. Patient advocates played a critical role in the passage of the IRA in 2022 and remain on the frontlines of ensuring its successful implementation, and educating the public on the historic drug prices reforms.
ICYMI
CMS unveiled a preliminary list of 101 generic prescription drugs for which the agency expects to cap monthly prices at $2. The drug list, which is part of a voluntary model proposal, includes common drugs for cholesterol, high blood pressure, and other chronic conditions. Serving as a companion to the drug price reforms in the IRA, this initiative would stabilize prices of widely-used generic medicines, curb rationing, and increase medication adherence.
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Welcome to the Week in Review.
CMS Guidance On 2nd Round Of Medicare Negotiation
The next round of the Medicare drug price negotiations has been designed to be more patient-centered, according to the Centers for Medicare & Medicaid Services (CMS). The next 15 drugs selected for negotiation will be released by February 1, 2025, with negotiated prices taking effect in 2027. Key elements of the new guidance include:
Last year, P4AD patient advocates participated in CMS listening sessions to share their experiences with high drug prices. Their testimonies were a crucial counterweight to pharma representatives who infiltrated the sessions with industry talking points. Along with other stakeholders, P4AD submitted comments on draft guidance for the inaugural round of Medicare negotiation, contributing to the chorus of patient voices that influenced these positive changes. We applaud CMS for including patient perspectives in this critical process and ensuring that the program truly serves the needs of those who are most harmed by high drug prices. — (CMS, Fierce Healthcare)
Medicinas Vitales, No Lujos
The high cost of prescription drugs for Latino communities takes center stage in a new P4AD ad campaign developed by Espacio, a creative collective out of El Tiempo Latino. The campaign, entirely in Spanish, is titled “Medicinas Vitales, No Lujos,” (Essential Medicines, Not Luxuries) and underscores the urgent need for reforms to lower the price of critical medicines, such as inhalers and chemotherapy drugs, used to treat chronic illnesses that disproportionately affect Latinos. The ads also draw attention to lawsuits from the pharmaceutical industry and its allies aiming to undermine the historic Medicare negotiation program. Our recent report highlighted that Latinos are more likely to require prescription medications for chronic illnesses — such as diabetes, high blood pressure, and cancer — and as a result of high drug prices set by pharma, 42 percent of Latinos report not taking their medications as prescribed due to cost. These shocking disparities are the catalyst behind the ad campaign to mobilize Latino communities to share their experiences with high drug prices and demand reforms to ensure patients can access life-saving treatments at affordable prices. The campaign includes a series of videos and digital print ads. — (El Tiempo Latino, P4AD, El Tiempo Latino)
Big Pharma CEOs Rake In Cash
Big Pharma executives continue to line their pockets as one in three Americans report difficulty affording their medicines. According to a new STAT News analysis, in 2023, health care industry CEOs averaged $11 million in annual compensation, with the median pay hitting $4.1 million – a staggering 51 times the median American household income. Topping the list, Moderna CEO Stephane Bancel, whose company amassed its huge fortune from taxpayer-invested COVID-19 vaccines, pocketed a whopping $305 million last year, which included salary, bonuses, vested stock, and other perks. And ranking among the top ten highest-paid industry executives, Eli Lilly CEO David Ricks took home an executive pay package of $73.9 million. These outrageous executive payouts are undoubtedly boosted by taxpayers who fund early development of blockbuster drugs. It’s a vicious cycle: taxpayers fund early drug development, then American patients pay inflated prices for years, all the while Big Pharma executives rake in millions of dollars in compensation. — (KFF, STAT)
ICYMI
In a new video, P4AD’s Merith Basey illustrates how Big Pharma games the patent system to block competition and keep prices high, and how we can curb these abuses and lower drug costs. Watch here.
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Welcome to the Week in Review.
Price Hikes Harm Black & Latino Communities
On Thursday, Patients For Affordable Drugs released a new report – based on drug price data released in July – that exposes Big Pharma’s excessive price hikes this year and details how price increases disproportionately harm Black and Latino patients. This year, big drug companies raised prices on over 1,000 essential medicines, half of which outpaced the rate of inflation. Our analysis sheds light on five cancer medications with significant price hikes in July, four of which had already been hiked in January. These medications are used to treat certain kinds of cancers like multiple myeloma, breast cancer, and prostate cancer, which disproportionately affect Black and Latino patients. “Black and Latino families are more likely to suffer from chronic conditions and certain cancers … that do require those long-term, very expensive drugs,” P4AD’s Executive Director Merith Basey told NBC BLK for their coverage of the report. “A lot of that is also linked to racial disparities in health care that have been well documented due to systemic racism.” Nearly half of Latinos and one-third of Black Americans aged 65 or older report not taking their prescribed medications due to cost, underscoring the urgent need for comprehensive drug pricing reform to address exorbitant prices, curb patent abuses, and promote affordable access to life-saving medications for all communities. — (P4AD, Black Enterprise, Rolling Out, NBC BLK, ASPE)
Senate HELP Hearing With Novo Nordisk CEO
At a hearing this week, the Senate Health, Education, Labor, and Pension (HELP) Committee grilled Novo Nordisk CEO Lars Jørgensen on the outrageous U.S. list prices set by the company for widely-used GLP-1s; Ozempic and Wegovy. In the U.S., Ozempic and Wegovy carry monthly list prices of $969 and $1,394 respectively, which is significantly higher than in other countries including Germany where the drugs carry $59 and $92 monthly list prices respectively. When confronted with questions about the company’s pricing practices, Jørgensen shifted the blame onto pharmacy benefit managers (PBMs), claiming the middlemen demand high rebates for favorable coverage. However, Committee Chairman Bernie Sanders shared that top pharmacy benefit managers recently pledged to not limit coverage of Ozempic and Wegovy if Novo Nordisk chose to lower the price of these treatments. This was the second time Jørgensen had testified before the committee about the company’s monopolistic pricing practices. In May 2023, Jorgensen testified alongside CEOs from Eli Lilly and Sanofi about insulin pricing practices. Holding drug manufacturers as well as PBMs accountable for actions that drive up drug prices and limit access to breakthrough medicines must remain a top priority for Congress. Innovation is worthless if patients can’t access it due to high cost. — (Endpoints, Reuters, Senate HELP Committee)
Competition Delivers Long-Awaited Relief
Robust competition within the prescription drug market continues to be the primary factor driving down drug prices. P4AD’s Lisa Ann Trainor, featured this week in Tradeoffs and STAT News, illustrated how increased competition and affordable generic medicines have helped millions of patients like herself gain access to treatments they need. In 2018, after years of living with a chronic illness, Lisa finally found Vyvanse, a drug that for the first time, was able to effectively manage her attention-deficit/hyperactivity disorder (ADHD). But two years later due to a change in insurance coverage, Lisa was forced to pay nearly $1,000 out-of-pocket for her Vyvanse — a drug with no generic alternative at the time. Overnight, Lisa’s “life-changing treatment” was priced out of reach for nearly three years until last summer when the Food and Drug Administration (FDA) finally approved a generic version of Vyvanse that she could afford. Patients like Lisa are the bedrock of P4AD advocacy efforts to ensure generic versions of drugs become available sooner to drive down prices and bring essential medicines within reach. — (Tradeoffs, STAT, patientspushforcompetition.org)
ICYMI
On 60 Minutes last week, Federal Trade Commission (FTC) Chair Lina Khan highlighted Big Pharma’s exploitation of our patent and regulatory systems which blocks competition and extends its monopoly pricing power. Khan broke down pharma’s anti-competitive tactics to Lesly Stahl, succinctly explaining how they patent every aspect of asthma inhalers as an example, without making any change to the active ingredients in the formula. Watch here.
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Welcome to the Week in Review.
Spotlight On Costly GLP-1s
The astronomical prices for blockbuster GLP-1 medications Ozempic and Wegovy have ignited a fierce debate over patient access and affordability. With monthly list prices in the U.S. of $969 and $1,394 respectively, these drugs manufactured by Novo Nordisk have become poster children for the pharmaceutical industry’s contentious pricing practices. While these treatments carry outrageous prices, with roughly half of patients reporting difficulty affording them, Ozempic could in fact be manufactured for less than $5 per monthly injection, and Novo Nordisk would still make a profit on the drug. In addition, there are growing concerns around the financial burden being placed on our health care system and on taxpayers. Medicare spending on GLP-1s skyrocketed to $5.7 billion for Ozempic, Wegovy, and Mounjaro in 2022 , up from $57 million in 2018. Lawmakers have called on Novo Nordisk CEO Lars Fruergaard Jørgensen to testify before the Senate Health, Education, Labor & Pensions (HELP) Committee on September 24th to respond to concerns about these pricing practices. Ozempic may also be one of 15 additional drugs selected for the second round of Medicare drug price negotiation — which will be announced by February 1, 2025 — due to its high cost and lack of competition. — (NBC News, CNBC, KFF, KFF, Reuters, Senate HELP Committee)
P4AD Advocates Take Action
P4AD patient advocates from across the country took action this week to push for comprehensive patent reforms and spread the word about how the historic drug price law is lowering costs.P4AD patient advocates met with legislators from both sides of the aisle to urge them to pass bipartisan legislation aimed at curbing pharma’s abuse of our patent system. Flying in from Wisconsin, South Carolina, Massachusetts, Kentucky, and Colorado, the advocates shared their experiences with high drug prices with their representatives and explained how the passage of these bipartisan bills would ensure more timely entry of generic and biosimilar competition to lower drug prices. Judy Aiken, a retired nurse from Portland, Maine who lives with psoriatic arthritis and psoriasis, testified before the Senate Finance Committee at a hearing about the relief being delivered to patients through the Inflation Reduction Act. Judy shared how the out-of-pocket cap saved her nearly $6,000 in 2024 and that her Enbrel will see a 67 percent reduction in price in 2026 thanks to Medicare negotiation. Lisa McRipley, a patient advocate from Richmond, Texas who lives with multiple sclerosis and Jackie Trapp, a retired educator from Muskego, Wisconsin who lives with multiple myeloma, both participated in White House events this week and shared how the IRA has significantly reduced the financial burden of their prescription drugs. Lisa shared with President Biden how the out-of-pocket cap will save her $6,000 next year, and during a panel focused on Women and Aging, Jackie shared that her out-of-pocket costs are now capped at about $3,300, after years of spending up to $21,000 annually for her Revlimid medication alone.
FTC Takes On PBM Industry
Yesterday, the Federal Trade Commission (FTC) filed a lawsuit against the big three pharmacy benefit managers (PBMs) — CVS Caremark, Cigna’s Express Scripts, and United Health’s Optum Rx — for engaging in anticompetitive practices that “artificially inflated” list prices of insulin and blocked patient access to life-saving treatments. Earlier this week, Express Scripts filed a lawsuit against the FTC for claims made in the agency’s “scathing report” on the opaque practices of PBMs. Released in July, the report underscored some of the shady practices of the highly consolidated PBM industry and exposed the middlemen’s outsized influence on patient access and affordability of essential medicines. During the aforementioned Senate Finance Committee hearing this week, members across the political spectrum, including Chairman Ron Wyden and Senator Lankford as well as several other members of the committee, called for reforming the middlemen’s practices. P4AD and legislators on both sides of the aisle agree that we urgently need to increase PBM transparency to help shed light on what is going on behind the curtain and to better ensure that savings are passing on to patients. — (Fierce Healthcare, Axios, The New York Times, Senate Finance Committee)
Court Watch: US v. Pharma
Yesterday, P4AD filed an amicus brief in the Third Circuit Court of Appeals in lawsuits brought by Bristol Myers Squibb (BMS), Janssen, and AstraZeneca. The brief incorporates the stories of several patients on Medicare who have struggled to afford their medications due to high cost and highlights how lower negotiated prices will make their drugs more affordable. It also counters pharma’s misleading claims about the Inflation Reduction Act, explaining how Medicare negotiation fosters innovation while expanding patient access to life-saving treatments. Additionally, the brief pushes back against industry-funded groups that falsely claim to represent patients, exposing their role in preserving pharma’s monopoly pricing. Earlier this week, the Department of Health and Human Services (HHS) filed an opposition brief in the cases brought by BMS and Janssen, underscoring the voluntary nature of Medicare negotiations. Oral arguments will be presented in all three cases on October 28th. Despite the drug industry’s seven failed attempts to block Medicare negotiations in court, patients remain vigilant, continuing to defend the law both in the courtroom and in public advocacy efforts. — (P4AD, Bloomberg Law, O’Neill Institute, FightPharma.org)
ICYMI
On Thursday, the Senate Judiciary Committee was scheduled to mark up two controversial bills, S. 2220 (PREVAIL Act) and S. 2140 (Patent Eligibility Restoration Act). If enacted, these bills would make it easier for drug companies to secure undeserved patents and take away a key mechanism to challenge invalid patents that should have never been granted — meaning that pharma could more readily quash competition and continue charging high prices. Last week, P4AD sent a letter to members of the Senate Judiciary Committee to urge them to vote no on these bills. The markup for these two bills has been rescheduled for next Thursday, September 26th. P4AD remains committed to stopping any industry attempts to exploit the patent system and extend monopoly pricing power.
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Welcome to the Week in Review.
P4ADNow Six-Figure Ad Campaign
P4ADNow has launched a six figure ad campaign featuring patients urging legislators to pass a package of bipartisan bills to reform our patent system and lower drug prices. These ads are part of our “Push For Competition To Lower Drug Prices” to advance key legislation in both the House and Senate. The bills include:
The Senate has already unanimously passed an amended version of S.150, which would address patent thickets, signaling a growing appetite from legislators on both sides of the aisle to reform the patent system. Collectively, these Senate bills are estimated to save taxpayers $4.5 billion over the next 10 years. Building on this momentum and to continue pushing for additional bills, P4ADNow and other organizations are planning lobby days on The Hill over the coming weeks.
Big Pharma and its allies are simultaneously pushing harmful patent legislation, including S. 2220 (PREVAIL Act) and S. 2140 (Patent Eligibility Restoration Act). On Wednesday, we sent a letter to members of the Senate Judiciary Committee to urge them to vote NO on these bills which would hurt patients. We will continue in our efforts to protect patients and ensure that they are prioritized over industry profits. With growing bipartisan support and patient voices leading this effort, we’re closer than ever to achieving meaningful patent reform. — (Inside Health Policy)
Court Watch: US v. Pharma
Yesterday, P4AD filed an amicus brief in the Third Circuit Court of Appeals in lawsuits brought by Bristol Myers Squibb (BMS), Janssen, and AstraZeneca. The brief incorporates the stories of several patients on Medicare who have struggled to afford their medications due to high cost and highlights how lower negotiated prices will make their drugs more affordable. It also counters pharma’s misleading claims about the Inflation Reduction Act, explaining how Medicare negotiation fosters innovation while expanding patient access to life-saving treatments. Additionally, the brief pushes back against industry-funded groups that falsely claim to represent patients, exposing their role in preserving pharma’s monopoly pricing. Earlier this week, the Department of Health and Human Services (HHS) filed an opposition brief in the cases brought by BMS and Janssen, underscoring the voluntary nature of Medicare negotiations. Oral arguments will be presented in all three cases on October 28th. Despite the drug industry’s seven failed attempts to block Medicare negotiations in court, patients remain vigilant, continuing to defend the law both in the courtroom and in public advocacy efforts. — (P4AD, Bloomberg Law, O’Neill Institute, FightPharma.org)
Out-Of-Pocket Cap Delivers Savings
The Inflation Reduction Act’s annual cap on out-of-pocket costs has already delivered substantial cost savings for patients living with cancer. A University of Michigan study published in JAMA found that the average median cost savings for patients on Medicare Part D taking oral cancer medications, as a result of the out-of-pocket cap, is estimated to be more than $7,000 in 2024. Patients with cancer routinely face steep out-of-pocket costs, upwards of $10,000 a year for their medications. For almost a decade, Jackie Trapp paid over $15,000 annually for her cancer medication Revlimid, but this year because of the IRA her costs were capped at $3,300. The IRA is a victory for patients faced with expensive prescription drugs and we look forward to further savings for patients next year when the cap is further reduced to $2,000. — (MedicalXpress, JAMA, P4AD)
ICYMI
Reforms to lower drug prices continue to have broad bipartisan support from voters. New polling from Navigator Research reveals that 86 percent of Americans support expanding Medicare’s authority to negotiate for lower drug prices and 82 percent support capping the price of insulin at $35 a month, viewing these measures as an essential step towards delivering relief to American families.
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Welcome to the Week in Review.
Patients Push For Competition
On Friday, a group of organizations representing patients, seniors, and employers sent a letter to members of the House Judiciary Committee calling for urgent action on bipartisan legislation in Congress to lower drug prices. The letter urges committee leaders to advance bipartisan bills in the House aimed at reducing Big Pharma’s anti-competitive patent abuses that artificially extend monopolies and keep drug prices high. In addition to Patients for Affordable Drugs Now, the letter was signed by AARP, the Campaign for Sustainable Rx Pricing (CSRxP), the ERISA Industry Committee, the Purchaser Business Group on Health, and the National Multiple Sclerosis (MS) Society. The letter detailed abusive tactics such as patent thicketing, product hopping, and pay-for-delay schemes, emphasizing the need for action by the House Judiciary Committee to improve drug pricing competition before the end of the year. The Senate Judiciary Committee has already passed several bipartisan bills to boost competition in the prescription drug market, which are estimated to save taxpayers more than $4.5 billion over the next decade. To maintain momentum on this issue, this week, CSRxP, one of the letter’s signatories, launched a seven figure ad campaign to raise awareness of pharma’s anti-competitive tactics and urge lawmakers to take action. As Congress returns from recess, it’s crucial that legislators heed the demands of patients and consumers by advancing bipartisan bills to reform the patent system and reduce prescription drug costs. — (patientspushforcompetition.org, Axios)
P4AD Advocates In the News
P4AD advocates are continuing to spotlight the historic relief being delivered through the Inflation Reduction Act. On Tuesday, Jackie Trapp, a retired educator from Wisconsin living with multiple myeloma, participated in a virtual White House call and shared how Medicare’s out-of-pocket spending cap has reduced the financial burden of her prescription drugs. After nine years of paying between $15,000 to $21,000 annually for her cancer medication, Jackie told the President during the event that she was able to celebrate the New Year knowing that she wouldn’t have to pay more than $3,300 in January this year after she met the cap, and in 2025, her spending would be further reduced to $2,000 annually. Another patient advocate Judy Aiken was featured in her hometown newspaper, the Portland Press Herald, after introducing both President Biden and Vice President Harris at an event in August celebrating the new lower drug prices under Medicare negotiation. Judy shared how her out-of-pocket costs for her psoriasis and psoriatic arthritis medication Enbrel, which used to cost her over $9,000 a year, have been cut in half this year because of the out-of-pocket cap. The historic drug price law wouldn’t have crossed the finish line without the tireless advocacy of patients like Judy and Jackie, and as the reforms continue to take effect, P4AD will continue to amplify their voices, showcasing the real impact of this hard-fought victory on millions of Americans. — (Spectrum News, The White House, UPI, Courthouse News, Newsweek, Portland Press Herald)
ICYMI
Reforms to lower drug prices continue to have broad bipartisan support from voters. New polling from Navigator Research reveals that 86 percent of Americans support expanding Medicare’s authority to negotiate for lower drug prices and 82 percent support capping the price of insulin at $35 a month, viewing these measures as an essential step towards delivering relief to American families.
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Welcome to the Week in Review.
Historic Drug Prices Law Bring In Savings
The drug price reforms in the historic Inflation Reduction Act are already delivering relief to patients who depend on costly prescription drugs. And even more savings are expected as the law continues to be successfully implemented. A new report from AARP released on Wednesday found that approximately 1.1 million patients on Medicare are expected to reach the new $2,000 out-of-pocket cap between 2025 and 2029 and are estimated to see average savings of $1,100 a year. Further, more than 420,000 people will see annual savings exceeding $3,000 per year. Leigh Purvis, the in AARP’s Prescription Drug Policy Principal and author of the report, emphasized that the $2,000 cap on out-of-pocket costs will shield patients on Medicare who’ve historically had to pay 5 percent of their high-cost prescription drugs in the catastrophic phase, with no limit on the total, resulting in out-of-pocket costs often exceeding $10,000 per year. In addition this week, an analysis released by the Senate Finance Committee on the provision in the drug price law which penalizes drug companies for hiking prices faster than the rate of inflation has shown that it is yielding significant cost savings. The Committee highlighted that the drug companies responsible for price gouging 98 Medicare Part B drugs have been penalized under the inflation rebate program which took effect in January 2023, and as a result, has saved patients and taxpayers $3 billion. Before the passage of the Inflation Reduction Act, drug companies had unfettered power to dictate prices to Medicare, forcing patients to pay excessive amounts for their essential medicines. Now, with these curbs on pharma’s monopoly power firmly in place, patients and taxpayers are finally beginning to get a better deal. — (AARP, Reuters, Senate Finance Committee)
Eli Lilly’s Pump Fake
On Tuesday, Eli Lilly launched discounted versions of its weight loss drug Zepbound. The discounts however will apply only to low-dose vials of the drug sold exclusively through its direct-to-consumer online portal and will only be made available for patients without insurance. Eli Lilly’s claims in its press release that the decision is “expanding access and supply” received sharp criticism throughout the week for grossly misrepresenting who the plan would help. The discounted low-dose vials of Zepbound — previously available as injectable pens with a list price of $1,060 per month — will still remain wildly cost prohibitive at their discounted $399 list price for a monthly supply of 2.5 mg vials. Uncoincidentally, on the very same day that Eli Lilly made the discounted vials available, the company quietly increased the price of its autoinjector pen for patients with commercial insurance but without coverage for the treatment, hiking the monthly list price from $550 to $650. Drug corporations like Eli Lilly have arbitrarily hiked prices on insulins for decades and these limited price reductions are a reminder that leopards don’t change their spots. Innovation is worthless if patients can’t access the medicines they need at prices they can afford. — (STAT, Market Watch)
ICYMI
A major new poll of seven diverse states, commissioned by More Perfect Union Foundation, revealed widespread support for measures aimed at delivering relief to patients facing high prescription drug prices. 91 percent of respondents shared that they support the government taking further action to reduce the prices of cancer drugs and 90 percent of respondents support capping prices on inhalers, insulin, and other medical devices.
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Welcome to the Week in Review.
Medicare Negotiation Promises Big Savings
Medicare’s first-ever lower negotiated drug prices will deliver substantial savings for patients and taxpayers when the lower costs take effect in 2026. Lower negotiated prices for just three of the first 10 drugs selected — Enbrel, Stelara, and Eliquis — will account for more than half of the $6 billion in taxpayer savings projected for the first year, according to the Brookings Institution. In a Centers for Medicare and Medicaid (CMS) press release, CMS illustrated a hypothetical example of a patient benefitting from Medicare negotiation: “a senior with Medicare who takes Stelara pays a 25% coinsurance on the drug which may amount to about $3,400 today for a 30-day supply. When the negotiated price goes into effect in 2026, that same 25% coinsurance would cost the beneficiary about $1,100 before the person reaches the catastrophic cap, after which the beneficiary will pay no more out of pocket on their prescription drugs. A beneficiary’s actual costs will depend on their plan’s benefit design.” The lower negotiated prices will offer more breathing room to the millions of patients on Medicare who pay three to eight times what residents in comparable countries pay for these same medications. The implementation of Medicare negotiation marks a pivotal shift in U.S. drug price policy, promising significant relief while maintaining critical innovation that patients need. P4AD will continue advocating to expand these efforts to ensure lower drug prices for all Americans. — (Brookings Institution, Centers For Medicare and Medicaid Services, Commonwealth Fund)
Keeping Our Foot On The Gas
Big Pharma’s monopoly pricing power stems in part from systematic abuses of our patent and regulatory systems, which they manipulate to maintain high prices and delay lower-cost competition from entering the market. Drug manufacturers employed tactics such as pay-for-delay agreements, patent thickets, and product hopping to extend their exclusivity periods on the first 10 negotiated drugs for years. A report from Accountable.US highlighted the blood thinner medication Xarelto as a “prime example” of abusing patent thickets to extend exclusivity periods. Johnson & Johnson, the drug’s manufacturer, filed 49 patents on Xarelto, resulting in over a decade of added market exclusivity and price hikes. Amgen, the manufacturer of the autoimmune disease drug Enbrel, has filed 57 patent applications since the drug came to market in 1990, with 72 percent of applications coming after initial approval by the Food and Drug Administration (FDA). These practices underscore the urgent need for legislative action to increase competition and lower drug prices for patients. Currently, there are bipartisan bills in Congress, which have already passed out of Senate committees and which aim to curb pharma’s abuses of the system. These bills are projected to save taxpayers $5 billion over ten years. Earlier this month, the Senate unanimously passed S. 150, the Affordable Prescriptions for Patients Act of 2023, which would address patent thicketing in the biologic market. As Congress returns from recess in September, we urge members in the House to take swift action to build off this momentum and finish the job. We will continue to push for further Senate action to pass the additional bipartisan bills which will enable competition and market forces to lower prices for millions of patients. — (Accountable.US, P4AD, patientspushforcompetition.org)
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