JustCare

Tag: PhARMA

  • One billionaire’s influence over lowering drug prices

    One billionaire’s influence over lowering drug prices

    Rose Adams writes for The American Prospect about one billionaire’s influence over lowering drug prices. John Arnold, a former senior executive at Enron–remember Enron, the company that effectively blew itself up?–has been dedicating a significant amount of his wealth towards initiatives that lower drug prices. The sad reality is that the hundred million he has invested over the last decade has barely moved the needle.

    Pharma and the pharmaceutical companies have been investing a hundred million dollars a year or more to make sure Congress does not lower drug prices. Some of that money goes to members of Congress, like Kyrsten Sinema, to stand firm against any legislation that would bring down drug prices. Some of that money goes to advertisements designed to mislead Americans about the consequences of lower drug prices.

    Lower drug prices could easily mean smarter research and innovation, rather than many invested to create new versions of the same old drugs–me-too drugs–so that pharmaceutical companies can charge more for them.

    Some Pharma money goes to patient advocacy groups to serve as Pharma shills and to disease groups to remain silent on the issue of drug price affordability. Disease groups rarely if ever advocate on behalf of their members who struggle to afford or, worse still, forgo life-saving drugs because of their cost. Biogen, for example, has managed to ensure that the Alzheimer’s Association is mum on the issue of Aduhelm’s $56,000 a year pricetag and its potentially serious side effects.

    What’s so troubling is that Pharma continues to have the upper hand in the debate over drug prices, even though lowering drug prices is Americans’ number one policy priority and citizens of every other deeloped country typically pay less than half of what Americans do for their drugs. Without fair drug prices, tens of thousands of Americans will continue to die each year because they cannot afford their life-saving medications.

    Arnold and his foundation, Arnold Ventures, fund many groups to fight the good fight. Yet, if we’re lucky, at best we will see in the Build Back Better Act lower drug prices for 60 drugs over the next several years. That’s what’s in the legislation the House just passed. And, it’s not clear yet whether only people with Medicare would benefit from these lower prices or working people would also benefit. For sure, the uninsured will not benefit.

    Looking on the bright side, negotiated drug prices for 60 drugs, even if only for some of the population–if the Senate passes this provision in Build Back Better–is a foot in the door to lower drug prices on all drugs for everyone. Looking on the dark side, everyone thought that Medicare’s enactment 56 years ago was a foot in the door to guaranteed health care for all.

    Here’s more from Just Care:

  • 2021: Medicare drug price negotiation appears a long shot

    2021: Medicare drug price negotiation appears a long shot

    It has been 32 years since Senator David Pryor, then Chair of the Senate Aging Committee made the case for government negotiation of drug prices because Americans were facing a “crisis of affordability.” Today, with drug prices at much higher levels and thousands dying every year for lack of access to affordable medicines, it seems that Congress is not much closer to stopping Pharma from gouging Americans. Even Medicare drug price negotiation appears a long shot.

    Jonathan Weisman reports for the New York Times on the history of Congressional action on prescription drug prices. Senator Wyden, who chairs the Senate Finance Committee, is pushing hard for lower drug prices. Like Senator Bernie Sanders, who chairs the Senate Budget Committee, Senator Wyden does not want to let the pharmaceutical industry win the fight.

    Negotiated drug prices will allow tens of thousands more people to fill their medications. It will expand their access to drugs. As it is, health insurers restrict people’s access to drugs through formularies. Lower prices should mean greater access.

    There’s nothing complicated about this issue, as some Democrats claim. Every other wealthy nation regulates drug prices. And, opening our borders to allow drug importation would be simple. That would bring prices down in a jiffy and is not materially different from importation of food and other products. There is, however, a strong likelihood that these Democrats who are right now in the pockets of Pharma would lose large campaign contributions from the pharmaceutical industry.

    Meanwhile, some in Congress are looking to require pharmaceutical companies to pay rebates to the government on any drugs whose prices rise faster than inflation. That would at least limit drug price increases significantly.

    And, there is movement on allowing Medicare to negotiate down prices of outpatient drugs, such as chemotherapy, when they go off-patent. There is also some consensus on putting an out-of-pocket cap on the Medicare Part D benefit. The small percentage of people with high drug expenses would be better able to afford their medicines. But, depending upon how it is paid for, it could lead to higher Part D premiums for everyone with Medicare, and Pharma could be the primary beneficiary.

    One sure thing. Polling shows that Americans–Republicans and Democrats alike–desperately want to see Congress regulate drug prices and make drugs affordable. It would help the Democrats in 2022, if they succeed at getting this done.

    Here’s more from Just Care:

  • US is a goldmine for pharmaceutical companies

    US is a goldmine for pharmaceutical companies

    Public Citizen released a report illustrating how the US is a goldmine for pharmaceutical companies. Pharmaceutical companies earn more from Americans who buy 20 best-selling prescription drugs than they do from everyone else in the world combined. No wonder that a new Politico-Harvard poll shows that drug price negotiation is Americans’ top policy priority for Congress right now.

    Public Citizen analyzed the financial filings of the pharmaceutical companies manufacturing 20 blockbuster drugs to arrive at its findings. It made clear that higher revenues in the US has nothing to do with the number of prescription drugs we take because we don’t take more drugs than people in other countries. It’s all about drug prices in the US.

    Public Citizen’s findings speak volumes as to why Pharma is so opposed to Medicare drug price negotiation.  We’re talking $158 billion in total revenue for just 20 drugs, nearly two-thirds (64 percent) of which comes from Americans. To date, Congress has expressly forbidden Medicare from negotiating drug prices, driving up drug costs.

    Pharmaceutical company profits would fall tens of billions of dollars a year if Americans paid prices comparable to people in other wealthy countries. That’s looking less and less likely as the Democrats try to pass legislation around drug prices. Perhaps, members will agree to some Medicare drug price negotiation and drug price increases capped at inflation but that’s not at all a done deal.

    In the meantime, Americans are forced to pay too high prices for our drugs relative to people in every other country or go without them. Pharmaceutical companies profit handsomely from their monopoly pricing power for brand-name drugs. Insurers and pharmacy benefit managers also make a lot of money off of high drug prices, but pharmaceutical companies earn more.

    Here’s more from Just Care:

  • Who benefits if Congress lowers drug prices and how much?

    Who benefits if Congress lowers drug prices and how much?

    Democrats in Congress are determined to bring down prices for at least some prescription drugs as part of the budget reconciliation bill. The question is how will it do so. Will members talk the talk but then appease big Pharma and not walk the walk? Those Democrats who want to ensure that their constituents are not dying for lack of needed medicines should be doing everything in their power to ensure lower drug prices for everyone in the US.

    Rachel Cohrs reports for Stat News that Democrats in Congress are focused on lowering drug prices for people with Medicare as part of the budget reconciliation bill. If that’s all they do, the legislation will likely hurt their chances of reelection. You can be sure that Pharma will invest in a mass marketing campaign telling everyone who does not have Medicare that it plans to raise prices on their drugs to make up for lost Medicare profits. Some economists believe Pharma would not succeed, as drug companies are already getting the highest prices they can get. Regardless of whether the economists are correct, it’s the public perception that matters.

    Crazy as it sounds, the Democrats do not have a simple plan to extend the benefits of Medicare drug price negotiation to everyone else in the country. The cleanest way to ensure everyone in America has affordable drugs would be to give everyone Medicare for the purpose of benefiting from its negotiated prices. But, too many conservative Democrats would object to that tactic, and it is not clear that it would fit into a budget reconciliation bill even if all the Democrats supported it. That said, a bill that does not allow everyone to benefit from negotiated drug prices indirectly or passively will result in people foregoing life-saving medicines and dying prematurely.

    H.R.3, which passed in the House in 2019, relied on international reference pricing–benchmarking drug prices to the average of what other wealthy countries pay–as a means for Medicare to lower the price of 250 drugs over 10 years. It permitted private insurers to piggyback off those rates but did not lower drug prices for the uninsured. Rumor has it that the Dems, this go round, are not relying on international reference pricing but rather “domestic reference pricing,” basing drug prices somehow on prices already available in the US.

    Of course, drug prices for the vast majority of people in the US are super high. So, unless Congress bases drug prices on the prices the Veterans Administration pays, domestic reference pricing will not reduce drug prices in a meaningful way.

    Congress could make drugs available to everyone at the Medicare-negotiated price through community health centers or Federally Qualified Health Centers (FQHCs). There are more than 14,000 of these government-administered primary health care clinics. With additional resources, these clinics could be an avenue for giving everyone access to affordable drugs.

    Even though the value of Medicare drug price negotiation is threatened if everyone does not benefit from negotiated drug prices, the Democrats are apparently struggling over whether to enable private health insurers to benefit from Medicare-negotiated prices and, if so, how? There could be challenges to getting that into the budget reconciliation bill since the case needs to be made that the reform affects the federal budget.

    Critics of a bill that brings down drug prices for everyone claim that it would be “market-wide price setting,” which it would be. That’s what we have now as well, only it’s Pharma that’s doing the price-setting. As a result, we have Pharma price-gouging in the US that doesn’t exist in any other wealthy nation.

    Another provision in the Democrats’ bill would limit the amount that drug prices could rise from one year to the next to the rate of inflation. Ideally, that policy would apply to all drugs sold in the US, not simply to Medicare-covered drugs. It’s not yet clear how Congress would hold the drug companies accountable if they failed to comply with that requirement.

    Here’s more from Just Care:

  • Government drug price-setting could save millions of lives and end diseases

    Government drug price-setting could save millions of lives and end diseases

    In an opinion piece for Stat, James Glassman, a former undersecretary of state for public diplomacy, overlooks the fact that proposals to base drug prices in the US on the prices other wealthy countries pay are the most likely way the US will have the money and interest to invest in research to end cancer and other deadly diseases. Glassman fails to consider that right now the pharmaceutical industry is price-gouging and targeting its research where it can maximize profits, not end diseases. Drugs don’t end diseases if people can’t afford them or if they are never developed.

    Right now, every other wealthy nation sets drug prices. And, though it is not technically legal, millions of Americans with means are able to take advantage of those prices through importation. The FDA has never prosecuted anyone for importing drugs for personal use. So long as the US does not set drug prices, Pharma will price-gouge and set the agenda as to where to invest in research.

    Moreover, our government’s failure to permit importation, let alone to import drug prices leads millions of Americans with limited assets to go without life-saving medicines. By not importing drug prices, Congress is permitting excessive pharmaceutical company profits at the cost of millions of American lives.

    Setting drug prices at a level comparable to other wealthy countries makes market sense. That’s the price Americans pay when they import drugs. It’s a reasonable and quick way to level the international playing field on drug prices. And, it would generate hundreds of billions a year in savings.

    If the US set prices at a level comparable to other wealthy countries or even to the Veterans Administration, it could help end cancer. Yes, Pharma innovates under the current system, as Glassman contends. But,  Pharma only develops new drugs—often new versions of drugs currently available—to support its bottom line, not the needs of people with health conditions that drug companies do not think they can profit from. If the drug companies don’t see big dollar signs, their research goes in other directions.

    Savings from US regulation of drug prices could be applied to a national drug innovation agenda that ensured research and development of drugs to treat untreated diseases, which might not be as profitable as drugs to treat other conditions, but that would save lives. Moreover, the US could direct development of medicines that cure diseases, an important differential, as Pharma tends to develop drugs that people take for a prolonged period, as another way to maximize profits.

    Here’s more from Just Care:

  • Biden administration aims to stop Pharma from preventing drug importation

    Biden administration aims to stop Pharma from preventing drug importation

    ABCNews.com reports on a Biden administration effort to ensure states can legally import drugs from abroad. You might have guessed that big Pharma is opposing drug importation by states. In this case, Pharma is trying to block Florida’s efforts to import drugs from Canada.

    The Biden administration is trying to dismiss a Pharma lawsuit against state drug importation. The administration argues that Pharma has no basis for filing a lawsuit to block state importation of drugs as the Biden administration has not approved importation to date. Interestingly, for once, the Republican governor of Florida, Ron DeSantis, is on the same side as the Biden administration.

    That said, DeSantis is quick to criticize the Food and Drug Administration for not approving state drug importation speedily. He’s a politician. And, he sees an opportunity to build political support around lower drug prices.

    Only Florida and New Mexico are currently seeking permission from the White House to import drugs from Canada. They believe it will save them and their residents tens of millions of dollars a year.

    Meanwhile, Pharma has only a couple of lame arguments against importation of drugs. Even though the US is able to import food safely and millions of Americans have already imported prescription drugs safely, it cries “safety” like the boy who cried “wolf.”  Of course, importation must be from verified pharmacies, but there are thousands of them around the globe.

    Here’s more from Just Care:

  • Several states plan to import drugs from Canada

    Several states plan to import drugs from Canada

    With drug prices in the US now substantially more than twice as much as in other countries, Donald Trump issued an executive order in his final days as president allowing states to import many drugs from Canada under certain conditions. Now, Phil Galewitz reports for Kaiser Health News that several states are planning to seek approval from the US Department of Health and Human Services (HHS) to get drugs at lower cost from our northern neighbor. Will the Biden administration provide approval?

    A new RAND report finds that in the 17 years between 2000 and 2017, drug prices in the US rose 76 percent. They are likely to continue to increase. Today, we pay on average more than two and a half times what other wealthy countries pay for brand-name and generic prescription drugs.

    Interestingly, we pay about 3.44 times more than other countries for brand-name drugs, but 84 percent of what other countries pay for generic drugs. We pay on average about 1.7 times what Mexicans pay for their brand-name drugs and 7.7 times what Turks pay for their brand-name drugs.

    During his presidential campaign, President Joe Biden supported the policy of drug importation from Canada as one way to help Americans afford their medications. Of course, Pharma opposes importation, claiming patient safety issues. But, its arguments around safety hold little weight. People have been importing drugs safely from Canada for years. Moreover, forcing people to go without needed medicines because they are unaffordable creates grave patient safety issues.

    Pharma has sued to stop the Trump policy from taking effect. The federal government must respond shortly. We will have a good sense of whether President Biden still supports importation from Canada, based on the federal government’s response to the lawsuit.

    Florida, Colorado, Vermont, New Hampshire and Maine have decided to take importation into their own hands. Some are contracting with private businesses to deliver them drugs from abroad. Florida’s plan is to get lower-cost drugs for state programs, such as Medicaid. It thinks it could save as much as $150 million in year one.

    Colorado is looking to contract with a private company to obtain drugs from Canada for its residents that would be available at their local pharmacies. And, health insurers in Colorado would be able to make the drugs available on their formularies. Colorado policy experts believe that importing drugs from Canada would more than cut the price of many drugs in half for Colorado residents.

    For its part, the Canadian government seems willing to cooperate with the states. However, it will only cooperate when it has a healthy supply of a drug. While that could be an issue with generic drugs, it does not appear to be an issue with brand-name drugs. Trump’s executive order does not allow importation of insulin or injectables.

    The Secretary of HHS must approve a state’s importation policy and find it safe. President Biden’s HHS nominee, Xavier Becerra supported a law allowing importation from Canada as a member of the House of Representatives back in 2003. That was a while ago; it’s not clear how HHS will respond in 2021.

    Again, safety should not be an issue. Many drugs sold in the US are safely imported from abroad already.

    Importation is not a solution to out-of-control drug prices in the US. It will only help a small portion of the population. But, making it legal to import drugs should help reset the market price for drugs in this country. It should make it harder for Pharma to challenge regulation of drug prices to levels at which people can legally import them.

    Here’s more from Just Care:

  • Trump might actually lower drug prices for people with Medicare

    Trump might actually lower drug prices for people with Medicare

    In one of his parting acts as president, Donald Trump appears to be trying to lower drug prices for people with Medicare or to wreak vengeance against Pharma for not announcing test results for their COVID-19 vaccines before the election. The Trump administration is working to speed up the process for pricing drugs for people with Medicare in line with what other wealthy countries pay. Many are dubious that Trump’s plan will work, but, for once, he has the right idea, freeing people with Medicare from the high cost of drugs.

    Trump’s move looks like revenge against the pharmaceutical industry for waiting until after the election to announce a COVID- 19 vaccine. Regardless, if it were to take effect, it would lower Medicare drug spending significantly. And, the pharmaceutical industry is not happy.

    Trump is essentially fast-tracking an executive order he issued in September calling for international reference pricing–pricing drugs at a similar level to peer nations–for some drugs available to people with Medicare. His administration is likely planning to issue an “interim final rule,” which sounds like an oxymoron. But, it would skip the interim rule-making phase and go directly to a final rule.

    Many experts believe that pharmaceutical companies will bring lawsuits to stop the rule from taking effect. If they rely on the Republican argument that the administration is trying to impose price controls on a free market, it would be laughable. But, given how many jurors are sympathetic to industry, it would be no surprise if the drug companies win.

    To be clear, the prices that would take effect under this rule are no different from the prices Americans pay if they import drugs from abroad. Right now, the government does not allow people to import drugs from abroad, even for personal use, but millions of people do anyway because they are so much cheaper. There is absolutely no reason that we should be paying twice as much as people in peer nations for our drugs.

    What’s most interesting is that President Trump’s plan is in line with the Democrats’ House bill, HR3, which would also regulate drug prices for people with Medicare based on the price of drugs in other wealthy countries. However, HR3 extends these Medicare prices to private health insurers, and Trump’s executive order does not. However, HR3 only covers 350 drugs over ten years.

    President Trump has another rule that may go into effect that could help lower drug prices. It would end the rebates that go to pharmacy benefit managers (PBMs), which simply inflate the cost of drugs. However, if these rebates ended, there is nothing to stop the drug companies from pocketing the rebate money they would have paid the PBMs and raising the price of their drugs further. Not surprisingly, pharmaceutical companies like this policy.

    Curiously, there is a whacky argument put forward by the PBM industry that eliminating rebates would raise the cost of drug insurance premiums in the Medicare Part D prescription drug benefit. We are living in an Orwellian world. The PBM trade association needs to justify its existence.

    Here’s more from Just Care:

  • What a new Congress should do to lower Rx prices

    What a new Congress should do to lower Rx prices

    Prescription drug prices keep rising. That’s to be expected since Congress has given pharmaceutical companies monopoly pricing power for their brand-name drugs, along with the ability to market them, even when they offer no benefits over lower cost drugs already on the market or, worse still, present safety risks. More than seven in ten Americans say the cost of drugs is unreasonable and that Congress is not doing enough to lower drug prices. Here’s what a new Congress should do to lower drug prices.

    First, Congress should make it legal for people to import drugs from abroad. A large majority of the public agree that safety is not an issue if the US allowed importation from Canada. In fact, safety should not be a reason not to allow importation from anywhere in the world for three reasons.

    1. The government easily could issue a list of verified pharmacies from around the world. Today, there are several web sites to turn to that offer information on drug prices from verified pharmacies around the world, including pharmacychecker.com.
    2. It is hard to make a compelling case that it is safer to ban drug imports and let people go without needed medicines they cannot afford than to allow people to import drugs for personal use. Moreover, we import food from abroad. Is there really a safety difference?
    3. Millions of people already safely import drugs from abroad. As more people import drugs, it becomes harder for pharmaceutical companies to set high prices for their drugs.

    To be clear, allowing drug importation is simply a band-aid since most people will not be able to afford imported drugs from abroad. Their health insurance won’t cover the cost of these drugs. But, once people are paying less for drugs from abroad, it makes it easier for Congress to enact a law regulating drug prices in the US at or near prices around the world and harder lift for Pharma to challenge the constitutionality of the law.

    Second, Congress should pass legislation that brings down costs for all drugs to a level similar to other wealthy countries and applies to everyone in the US. Eight-five percent of Americans support a policy like this, which would allow the government to negotiate drug prices for everyone. The majority of Republicans and Democrats believe that Congress needs to do a better job of regulating drug prices.

    Congress needs to go well beyond HR3, the House bill that would benchmark drug prices for a few hundred drugs to levels in other wealthy nations. HR3 does not cover more than 7,000 drugs on the market. It also does not benefit the uninsured.

    Third, Congress should penalize any drug company that refuses to negotiate a lower price for a drug. It should automatically terminate the patents on the drug and permit generic drug makers to manufacture and sell the drug, which would drive competition and bringing down prices. Congressman Lloyd Doggett proposes such a regulation.

    About one in four Americans find it hard to afford needed medicines. Six in ten Americans take one prescription drug and one in four take four or more. Congress would help the majority of Americans through these reforms.

    Here’s more from Just Care:

  • Pharma doesn’t have your back

    Pharma doesn’t have your back

    You might think that Pharma is doing more good than harm, but, watch out, it does not put your interests first; it doesn’t have your back. Stat News reports that the pharmaceutical industry has given $1.5 million in the last election cycle to Republican State Attorneys General working to repeal the Affordable Care Act. As always, Pharma’s focus is only on its bottom line, driving profits for shareholders.

    Pharmaceutical companies must see more benefits for themselves from overturning the Affordable Care Act than in keeping it. What’s interesting is that the ACA generates a lot of revenue for the pharmaceutical industry. The ACA insures millions of people. And with that coverage comes prescription drug benefits. So, it makes sense that Pharma’s support of the State Attorneys General working to repeal the ACA stems from its belief that it will  generate greater revenue from its repeal.

    The state health insurance exchange health plans tend not to offer particularly good access to care, and they are very expensive. But, they are still a way better option than going without insurance for the millions of Americans who need it. And, the majority of Americans (58 percent) do not want to see the ACA repealed.

    With their support of Republican State Attorneys General, drug corporations are undermining the needs of more than 20 million Americans who depend on coverage from their state health insurance exchanges. Pharmaceutical companies are endangering their health and, in the process, tarnishing the industry’s image. In addition, in the short term, the pharmaceutical companies will lose revenue, if the ACA is repealed.

    But, states can confer lots of additional benefits on the pharmaceutical industry, including tax waivers. States can also fail to enact regulations that would lower drug prices. Pharma does not want states regulating drug prices or otherwise forcing them down. So, it appears that Pharma has chosen to play this long game.

    Of course, Pharma claims it never intended to support the ACA’s repeal. That’s hard to believe. There’s a lot that pharmaceutical companies could be doing now to demonstrate support for the ACA if the pharmaceutical companies so chose. Their inactions speak louder than words.

    Here’s more from Just Care: