Whether it is the International Pricing Index, or allowing consumers to purchase drugs from Canada, many of the proposals to address health care costs involve importing ideas from other countries. In The Atlantic, Contributing Editor David Freedman explains that if American lawmakers want to copy other countries they are going to have to get comfortable with other trade-offs, too. For example:
“[O]ne cost-reduction measure used around the world is to exclude an expensive treatment from health coverage if it hasn’t been solidly proved effective, or is only slightly more effective than cheaper alternatives. But when American insurance companies try this approach, they invariably run into a buzz saw of public outrage. ‘Any patient here would object to not getting the best possible treatment, even if the benefit is measured not in extra years of life but in months,’ says Gilberto Lopes, the associate director for global oncology at the University of Miami’s cancer center.”
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TWEETS OF THE WEEK
- Many states & CMS "want to limit [#PBMs'] spread pricing, which they say jeopardizes independent pharmacies and access to care as well as drives costs up." @ronmastro, President and CEO of @HealthView, describes spread pricing as “disgusting.” Learn why: https://bit.ly/2MxsOBE Click here to RT.
- The Arnolds are at it again – this time in Massachusetts pushing a budget bill that would allow Medicaid to negotiate #drugprices. Here’s why that’s a bad idea: https://bit.ly/31gtC0T Click here to RT.
- #Patents play an integral role in fueling the development + commercialization of medicines. ... We believe the patent system needs to provide stability + predictability, protect this #innovation + incentivize US investment in revolutionary treatments. -Laurie Hill of @genentechClick here to RT.
THE STORIES THAT DIDN’T GET ENOUGH ATTENTION
Do you know what it’s like to “go from having a normal day in the morning to, by 3 p.m., being in debilitating pain, unable to walk, barely able to speak”? Mattie Robinson shares this experience and what it’s like to live with sickle cell disease in a new video released by the Alliance to Protect Medical Innovation. Read the full blog post here.
In case you missed them, here are some other recent posts on the APMI blog:
- Curious about the impact House Speaker Nancy Pelosi’s (D-Calif.) revised proposal might have? Check out What Is Binding Arbitration?
- Wondering how much biopharmaceutical firms spend on R&D each year? Check out Addressing Common Myths about Private Sector R&D.
WHAT WE’RE READING
Is Hospital, Insurance Company And Pharmacy Benefit Manager Consolidation Driving Up Prices? A report by Axios, based on a new report by the Open Markets Institute, suggests it is. Axios notes “Hospital systems continue to merge with each other and gobble up doctors’ practices, which lets them charge more for the care they provide” and “insurers and pharmacy benefit managers are also merging, and are now on track to bring in more revenue than the tech industry's biggest powerhouses.”
A Replacement For Chemotherapy? Bloomberg reports, “A class of drugs is emerging that can attack cancer cells in the body without damaging surrounding healthy ones. They have the potential to replace chemotherapy and its disruptive side effects, reshaping the future of cancer care. The complex biological medicines, called antibody drug conjugates (ADCs), have been in development for decades and are now generating renewed excitement because of the success of one ADC in late-stage testing, a breast cancer treatment called DS-8201.”
Hope For Individuals With Diabetes. Reuters reports, “In people at high risk for type 1 diabetes, 14 days of therapy with the experimental drug teplizumab delayed development of the disease by a year or more.” Science Magazine and Reuters have more.
Hope For Individuals With Head And Neck Carcinoma, And Lymphoma. Reuters also reports Merck has gained approval for its cancer drug Keytruda to be used as a monotherapy, as well as in combination with a common chemotherapy regimen, to treat previously untreated patients with head and neck squamous cell carcinoma. Also this week, the S. Food and Drug Administration “granted earlier-than-expected approval to Roche Holding AG’s antibody-drug conjugate Polivy for treatment of patients with advanced lymphoma.”
The Benefits Of Vaccines. According to STAT News, a newly-released wide-ranging study found children who have received the chicken pox vaccine are better protected against shingles as well.
“You’re Investing Huge Amounts Of Money To Do Trials And Innovate Over A Very Long Risky Period.” At Chief Executive, Jeffrey Aronin, CEO of Paragon Biosciences, describes the difficult process of finding cures. He says, “Chemistry is hard. We are doing something that is hard scientifically. It’s remarkably hard from a regulatory FDA perspective. I mean our government, it sets a high bar, as they should. The FDA is very good at what they do. I think the FDA is the pinnacle of what the bar should be. It is very difficult from a clinical and regulatory perspective, and it’s also hard from a financial perspective because you’re investing huge amounts of money to do trials and innovate over a very long risky period. It’s risky, and it’s hard.”
“Be Careful What You Wish For.” In the Albany Democrat-Herald, a former pharmaceutical industry employee explains why drug prices are lower in developing countries and how price controls would harm innovation in the United States.
“States Are Clearly Victims Of … PBM Schemes.” In Ohio’s Canton Repository, David Balto, former policy director of the Federal Trade Commission’s Bureau of Competition, argues state attorneys general should work to rein in pharmacy benefit managers. Balto writes, “States are clearly victims of these PBM schemes, as significant drug price increases take a substantial amount out of state budgets. State attorneys general have the tools and need to use their enforcement powers to stop the egregious practices that are currently harming consumers. They are essential to protecting consumers and making the market work.” The American Medical Association agrees it is time to scrutinize PBMs, and The Columbus Dispatch has more on their practices.
QUOTATION OF THE WEEK
Writing in Morning Consult, Virginia Ladd, executive director of American Autoimmune Related Diseases Association, explains the harmful consequences of step therapy:
“[N]ew research and prior studies indicate that the burdensome health insurance practice of step therapy is disproportionately affecting patients whose conditions require specialty medicines. All patients deserve access to all available medicines. They also deserve to receive the treatment their doctors determine is best for them in a timely manner — regardless of their medical condition.”
At Inside Sources, former U.S. Sen. Blanche Lincoln (D-Ark.) explains how binding arbitration will harm innovation, and therefore, patients:
“Recent reports describe a proposal known as ‘binding arbitration’ as a would-be middle ground, a possible compromise between Congress and the Trump administration on addressing prescription drug costs. But as a Democrat who supported the Affordable Care Act and worked on many bipartisan measures while representing the state of Arkansas, I feel qualified to say: binding arbitration for drug pricing is far from ‘moderate,’ but instead a form of price setting that could do significant harm to the quality of care Americans receive.”
UPCOMING EVENTS TO WATCH
Tuesday, June 18, 9:30 a.m.: Senate Committee on Health, Education, Labor and Pensions Hearing
Location: Dirksen Senate Office Building, Room 430
Topic: Lower Health Care Costs Act
Thursday, June 20, 2 p.m.: Information Technology and Innovation Foundation
Location: Russell Senate Office Building, Room 385
Topic: The Cost of Cures: Drug Price Controls vs. Biopharmaceutical Innovation
Agenda: There is an increasingly intense focus in Washington on reducing the price of drugs to bring down health-care costs. President Trump has proposed a plan that would use an international pricing index model for drugs under Medicare Part B. There are proposals from both sides of the aisle in Congress as well including various forms of government-led arbitration and changes to U.S. patent laws. But much of this debate is taking place without systematic consideration of what effect, if any, mandated drug-price reductions would have on biopharmaceutical innovation and U.S. industry competitiveness.