The Alliance

The Weekly Dose | 03.22.19

March 22, 2019 5:25 pm

This week, we got a stark reminder of just how risky it is to develop cutting-edge medicine when two late-stage trials for an experimental drug to treat Alzheimer’s failed. The loss is a blow to the millions of people living with Alzheimer’s and the more than 70 million Americans who have a relative who has with the disease.


The search for a cure will continue, but the loss, once again, harshly illustrates the cost of bringing a new innovation to market. As we have noted in the past, it takes $2.8 billion to develop a new treatment. Failure is a big reason for that steep price tag. Only 10 percent of these potential treatments make it to Phase 1 Food and Drug Administration testing and only a sliver of those are approved. As a recent column in Being Patient, a news resource about Alzheimer’s disease, noted, the average cost to develop a new drug has doubled about every nine years since 1950. “As a result,” the column concludes, “adjusted for inflation, it costs 80 times more to develop a new drug today than it did in 1950.”


The conversation around drug prices needs to better account for the extraordinary risks of developing new treatments.


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Patrick O’Connor – Executive Director

Rosemarie Calabro Tully – Communications Director



The Toledo Blade published a letter to the editor from APMI Executive Director Patrick O’Connor that explained that, in 2018, drug manufacturers paid $166 billion in rebates and discounts, amounting to a 40 percent reduction in prices for off-brand drugs.



Click here to RT: "We deserve to know more because, while these discounts have kept prices in check, they’re not making it into consumers’ pockets." Patrick O'Connor's @toledonews letter to the editor highlights concerns about #PBM practices: … #DrugPrices #patients #drugs

Click here to RT: Some policymakers have suggested importing #drugs from Canada to address the U.S. #DrugPricing debate, but ‘it’s Pollyannaish to believe that Canada, which is experiencing widespread drug shortages, would allow its limited supply to be exported.’

Click here to RT: A @MorningConsult survey found that 82% of American voters find #QALY systems concerning. Why have #patients, doctors, and others in the health care industry spoken out against QALY assessments like those proposed by @icer_review? @HonTonyCoelho explains:



What’s In The Pew Drug Pricing Report? The Pew Charitable Trusts has attempted to put a lot of the data that is out there on drug pricing in one place, releasing a report this month called “The Prescription Drug Landscape, Explored” that looks at retail pharmaceutical spending between 2012 and 2016. We take a look. Read the full blog post here.

In case you missed them, here are some other recent posts on the APMI blog:

- Context On Medicaid Outpatient Prescription Drug Costs

- As Evidence Mounts, President Acknowledges Drug Prices Falling

- Headlines Overstate Drug Pricing Data



Innovation Nation: Treatments In The Making For Super Rare Disease. STAT News looks at how patient groups and researchers are working to find a treatment for fibrodysplasia ossificans progressiva, or FOP, a genetic disease in which the body’s machinery for healing goes awry, growing immovable bone where it doesn’t belong” that affects only 800 people worldwide. Three medicines currently are undergoing testing.

 What Patients Need: PBM Reform. Noting that drug manufacturer discounts have risen from $59 billion in 2012 to $127 billion in 2016, Institute for Policy Innovation Resident Scholar Merrill Matthews says, “Even with manufacturer discounts, patients aren’t feeling relief … because insurance companies and middlemen in the drug supply chain have enjoyed the lion's share of the savings.” In The Hill, Dr. Madelaine Feldman, a rheumatologist, also argues PBM reform is needed while Dr. Dara Grieger, a preventative medicine physician, discusses PBMs in the Brownsville Herald. (In related news: the Toledo Blade reported the Ohio attorney general has filed a lawsuit accusing a PBM of fraudulently overcharging the state $15.8 million.)

 Innovation Nation II: New Drug To Treat Postpartum Depression Approved. UPI reports on a new drug that has been approved to quickly treat postpartum depression. STAT News has more. Dr. Marcela Almeida, a psychiatrist at Brigham and Women’s Hospital in Boston said, “This is a game-changing drug. … Current antidepressants can take weeks to be effective. [Zulresso] works within a couple of days, and women see significant improvements in three days. This is important because it’s a crucial period for a new mother’s relationship with her baby.”



Former Rep. Tony Coelho (D-Calif.), author of the Americans with Disabilities Act, writing in Morning Consult:

“The use of value assessment standards to determine health care coverage and payments are increasingly under consideration in the United States, even though these standards are not reasonable or fair solutions for patients. The reality is, these assessments employ the quality-adjusted-life-year (QALY) as a metric to determine the value of a treatment, and this assigns a value to patients’ lives based on their age, condition or disease to assess whether a treatment is cost-effective. As more patients and people with disabilities become familiar with cost-effectiveness assessments, the more Americans are reluctant to have our own government adopt this policy across the nation.”



Date and Time: April 1, 12 p.m., “How Much Should Medicare Pay for Drugs?”

Location: 2075 Rayburn House Office Building

Topic: Of the myriad policy priorities established by the current administration and congressional leadership, the tackling of skyrocketing prescription drug prices may have the best chance of moving through the legislative process over the next two years. Bipartisan proposals to address rising prescription drug prices have been introduced in both the House and the Senate; President Trump identified the issue in his State of the Union address as his next major priority; and Speaker Pelosi’s first speech to the 116th Congress listed it as a top issue for the new Democratic majority.

Agenda: Michael F. Cannon, Director of Health Policy Studies, Cato Institute, Peter Van Doren, Senior Fellow, Cato Institute and moderated by Jeff Vanderslice, Director of Government and External Affairs, Cato Institute

Contact: 202- 842-0200