This Week in Prescription Drug Pricing: Facts VS Pharma Fear Mongering and Becerra’s National Latino Health Tour

Welcome to the Week in Review.

1. Facts VS Pharma Fear Mongering

• This year’s record investment in biotech companies directly contradicts the drug industry’s claims that the Inflation Reduction Act would stifle innovation and drug development. Data from HSBC shows the industry raised a staggering $6.8 billion from venture-capital investments in the first three months of 2024 — one of its best fundraising quarters since early 2022. Recent actions from one company in particular, Vertex Pharmaceuticals, exemplify the drug industry’s primary focus on padding their pockets. Vertex announced plans on Wednesday to buy Alpine Immune Sciences, a biotech company focused on immunology treatments, for a staggering $4.9 billion — one of the biggest acquisitions this year. Furthermore, Vertex CEO Reshma Kewalramani made headlines due to a massive compensation boost, which jumped 30 percent to $20.6 million in 2023. It’s evident that Vertex is flush with cash, in part due to the company’s cystic fibrosis treatment Trikafta, which carries an annual list price, upwards of $300,000, that pushes it far out of reach for patients in the U.S. and around the world. This weekend in Los Angeles, California, health advocacy groups will protest Vertex’s unconscionable actions and hold the company accountable for raking in obscene profits while patients struggle to afford their drugs. We see through their lies and will continue to call out Big Pharma’s greed and hypocrisy. — (STAT, Yahoo Finance, Quartz, Fierce Pharma)

2. Becerra’s National Latino Health Tour

• This week, Department of Health and Human Services (HHS) Secretary Xavier Becerra finished the last leg of his week-long National Latino Health Tour to discuss improving access to affordable health care for Latino communities. Secretary Becerra met with patients, community health leaders, and legislators across sixstates to spread the word about the historic Inflation Reduction Act. Ensuring that Latinos and communities of color are made aware of the benefits of the new drug price reforms is critical given that Latinos experience higher rates of certain health conditions, like hypertension and diabetes, and are nearly two times more likely to not fill a prescription due to cost compared with their white peers. “It’s a relief that people are going to be able to afford what is a life saving medication, especially in a very heavily Latino district like the 8th District,” shared Rep. Yadira Caraveo at a roundtable with Secretary Becerra in regards to the $35 monthly insulin copay cap. At a fire-side chat with Becerra in California, Rep. Pete Aguilar emphasized how the law’s provision eliminating cost sharing for vaccines is currently helping the 1.2 million Latinos in the state who are on Medicare and celebrated the anticipated savings for patients in coming years. We still have a long road ahead to make sure that everyone knows about the transformational benefits within the Inflation Reduction Act which are increasing access to the medications patients need. — (Philanthropy News Digest, KOB, ASPE, Florida Phoenix, CAP, Commerce City Sentinel Express, IE Community News, SAC Health)

BONUS: Chimeric antigen receptor T-cell therapy (CAR-T), a groundbreaking type of cancer immunotherapy, is currently priced upwards of $350,000 for patients in the U.S. Last month, Fiocruz, a research foundation, and Caring Cross, a nonprofit working to develop advanced medicines, announced local efforts in Brazil to produce CAR-T treatments. The cost? Likely one tenth of the U.S. price, at around $35,000 per dose. Given the many cell and gene therapies in the pipeline here in the United States, it’s imperative that we find a way to tackle launch prices so that people who need these revolutionary drugs can access them at prices they can afford. 

Welcome to the Week in Review.

1. Patient Advocate Introduces POTUS

• Kris Garcia, a husband, father of four, and a P4AD patient advocate from Colorado introduced the President at the White House on Wednesday during an event hosted by President Biden and Senator Sanders focused on their efforts to lower the out-of-pocket cost of inhalers. This is a topic deeply personal to Kris who lives with chronic asthma, multiple bleeding disorders, and severe allergies. To manage his health, Kris relies on several expensive medications, including inhalers, and shared that the treatments he needs just to stay alive cost $800 a month, even after insurance coverage. The financial strain of these essential medicines has forced him to work extra shifts and has led him to ration doses, or forgo some of his prescribed treatments altogether. However, pressure from advocates and lawmakers has led three of the four largest inhaler manufacturers to commit to capping the out-of-pocket cost of their inhalers at $35 a month. This news, coupled with some of the drug price reforms in the Inflation Reduction Act, represents a glimmer of hope for Kris and millions of patients like him who will soon, as Kris put it, “spend less time worrying about surviving”, and more time living their lives. — (ABC 27, P4AD, P4AD, The Hill, The Washington Post, CBS News, Common Dreams)

2. P4AD Launches New Tool to Defend Medicare Negotiations

• As part of our ongoing campaign, US v. Pharma; Fighting to Protect Medicare Negotiation, P4AD unveiled a new tool: FightPharma.org. The website serves as a dedicated platform for our campaign to counter Big Pharma’s legal efforts to stop the implementation of Medicare negotiation. Currently, pharmaceutical corporations and their allies have filed nine lawsuits and additional appeals in an attempt to halt the program. Fightpharma.org will be updated with information on the status of these lawsuits and will provide opportunities for patients and advocates to take action, ensuring that the courts hear the lived experiences of those harmed or hurting from high drug prices. Se habla español? Stay tuned for a Spanish site coming in the next couple of weeks! 

3. Lowering Drug Costs For Women

• Women experience disproportionately higher rates of certain health conditions and also encounter higher health care costs relative to men. This financial burden is further exacerbated for women of color and women who have low incomes. A recent analysis from the Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) illuminates how the Inflation Reduction Act is delivering much-needed relief to some of the nearly 30 million women who have Medicare Part D coverage. According to the findings, in 2020, approximately 733,000 women on Medicare would have experienced considerable relief had the $35 monthly insulin copay cap been in effect. Additionally, in 2021, around two million women would have benefited from the provision eliminating cost-sharing for vaccines. Looking ahead, the analysis predicts that the $2,000 out-of-pocket cap, effective in 2025, along with other provisions in the drug price law, will reduce women’s Medicare out-of-pocket expenses by an average of 28 percent, saving them around $128 per year on average. These significant insights were highlighted at an event hosted by HHS this Tuesday, attended by P4AD and numerous allies, all eager to celebrate the transformative impact of the Inflation Reduction Act on patients grappling with exorbitant drug prices, particularly those who have been historically disenfranchised. — (Managed Healthcare Executive, Center For American Progress, ASPE, Mirage News, P4AD)

PHARMA FACT CHECK: The Centers for Medicare and Medicaid Services (CMS) remains in negotiation with manufacturers of the initial 10 drugs selected for negotiations, having rejected their latest counter offers. Contrary to the assertions of Big Pharma and its allies that Medicare negotiation constitutes “price-setting,” recent actions by both drug companies and CMS, involving offers and counteroffers, debunk this narrative and underscore a genuine negotiation process.

Welcome to the Week in Review.

1. Curbing Drug Price Hikes

• On Tuesday, the Department of Health & Human Services (HHS) announced a list of 41 drugs available through Medicare Part B will have a lower coinsurance rate from April 1 – June 30, 2024, should drug companies raise prices faster than the rate of inflation. This measure, established through the Inflation Reduction Act, aims to hold drug companies accountable for excessive drug price hikes by requiring them to pay rebates to Medicare. During this period, some of the 763,700 people on Medicare who take one or more of these 41 essential medicines could save between $1 and $3,575 per average dose. According to an analysis by AARP, retail prices for 943 commonly used drugs increased faster than the inflation rate every year from 2006 until 2020. Until the passage of the Inflation Reduction Act, drug companies had been able to raise prices at will year after year. This initiative cracks down on aggressive drug price gouging and stands to generate substantial savings for patients and taxpayers. — (HHS, Healthcare Finance News, Patients For Affordable Drugs Now, AARP) 

2. Cracking Down On Inhaler Patents 

• Despite announcements from major inhaler companies to cap out-of-pocket costs and reduce the list prices of some of their products, inhaler manufacturer, Teva, has yet to follow suit. This week, the Federal Trade Commission (FTC) filed an amicus brief in Teva’s lawsuit against a competitor, contending that Teva “improperly listed” patents on its asthma inhaler ProAir HFA. Teva used these patents to prevent Amneal Pharmaceuticals from obtaining approval for a generic version of Teva’s inhaler, therefore stalling an affordable alternative for patients. In November 2023, Teva and other drug companies were challenged by the FTC to remove improperly listed patents on their products. — (Reuters, VeryWell Health, Fierce Pharma, FTC)

3. Big Pharma’s Big Bag

• Even though big drug companies claim that the Inflation Reduction Act would dramatically impact pharma research and development, these corporations continue to allocate billions toward CEO compensation. It was recently revealed that CEOs from some of the largest pharmaceutical corporations have seen substantial pay increases in 2023 including Eli Lilly’s CEO David Ricks whose compensation rose 24 percent to $26.6 million and Johnson & Johnson’s CEO Joaquin Duato who has received a staggering $28.4 million. Additionally, the industry has also seen a surge in biotech acquisitions and record-high mergers, exemplified by Novo Nordisk and AbbVie announcing multimillion-dollar deals just this week. Despite patients already benefiting from the law’s drug price reforms, with further cost savings anticipated as other provisions phase-in, it’s evident that the pharmaceutical industry is prioritizing profit maximization over patients’ well-being, driven solely by greed and a relentless pursuit of maintaining exorbitant prices. — (Public Citizen, Fierce Pharma, The Wall Street Journal, Reuters, Pharmaceutical Technology, Patients For Affordable Drugs) 

BONUS: According to a new study published in JAMA, blockbuster diabetes, heart disease, and weight loss drug, Ozempic, could be manufactured for less than $5 monthly, and still be profitable, despite carrying a monthly list price of nearly $1,000. We urgently need legislative action to rein in these exorbitant prices. Drugs don’t work if people can’t afford them. 

Follow our social channels for an exciting announcement next week in our ongoing fight against Big Pharma and efforts to defend the hard-fought reforms already lowering drug prices!

Have a great weekend!

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 called out 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, DCNewsNow Vimeo, 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 are increasing at a steady pace. Additionally, costly advertising slots for major TV entertainment events this year, like the Super Bowl and The Oscars, were dominated 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 expressed skepticism 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 increasingly concerned 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.