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Resource: ACHP Drug Cost Toolkit (Members only)
Presidential Transition Brief
– Confirmation hearings for President-elect Trump’s cabinet nominees continue. The first hearing for Secretary of Health and Human Services nominee Tom Price is scheduled tentatively for January 18. Politico has created an annotated schedule of the hearings.
– According to HealthLaw360, Rep. Tom Price (R-GA), Donald Trump’s nominee for Health and Human Services Secretary, has agreed to sell any stocks he owns in health care related organizations (subscriber’s content).
Report: ACA helped slow opioid epidemic
The Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services has released a report outlining how the Affordable Care Act (ACA) has helped slow the opioid epidemic. Key findings of the report include a reduction in hospitalizations of uninsured individuals for substance abuse or mental health related issues. Hospitalizations for uninsured individuals in states that expanded Medicaid decreased by 15 percent, and the number of individuals who did not participate in treatment for mental health issues due to cost reasons has also decreased. ASPE notes the repeal of the ACA will increase uninsured rates significantly in those states with highest overdose rates.
Trump calls for action against drug companies
President-elect Donald Trump put pharmaceutical companies on notice for their drug pricing practices during a recent press conference. The president-elect asserted the government needs to negotiate drug prices through a bidding process. Sarah Karlin-Smith of Politico found some pharmaceutical lobbyists took Trump’s statements as a potential warning of pricing policy to come. Political leaders, including Sen. Bernie Sanders (I-VT), are using Trump’s comments to encourage fellow leaders to support related legislation such as policies that allow drug importation.
Recent legislation targets drug pricing
Sen. Sherrod Brown (D-OH) reintroduced the Medicare Prescription Drug Price Negotiation Act to allow the Medicare program to negotiate lower prices on prescription drugs. By providing the ability to negotiate, Brown and lawmakers anticipate savings being passed down to taxpayers. The bill is supported by Democratic senators and advocacy group AARP. President-elect Donald Trump has also said he would like to see Medicare negotiate better prices for seniors. Ana Veciana-Suarez of the Miami Herald has the story.
Biden plans to address drug costs
During the JP Morgan Healthcare Conference, Vice President Joe Biden reiterated his plan to focus on making drugs affordable. Biden plans to transition his work with the “cancer moonshot” into a new organization, the Biden Cancer Initiative. Dylan Scott and Rebecca Robbins with STAT News outline the focus of the organization, including removing barriers to scientific development, getting more patients enrolled in clinical trials, improving access to care across geographic and economic lines and improving data sharing between the pharmaceutical industry and insurance companies to promote more affordable treatments.
Upcoming J&J report on drug price increases
Johnson and Johnson (J&J) plans to release a report outlining the average amount it has raised the price of drugs next month. Average prices for drugs before and after discounts will be provided, along with details on the amount J&J spends on research and development compared to marketing and revenue related to sales growth versus price increases. Critics point out exact price increase numbers provide more substantive information than averages. Jonathan Rockoff of The Wall Street Journal notes J&J asserts they are not able to release exact numbers without compromising pricing negotiations (subscriber’s content).
PBMs are putting pressure on independent specialty pharmacies
Independent specialty pharmacy Prime Aid recently had its contract with Express Scripts terminated after several high-priced drugs entered the market, a pattern other specialty pharmacies have also noted. Express Scripts’ explains the terminations are for a variety of reasons, including contract infractions. Specialty pharmacies speculate Express Scripts hopes to direct business to its own specialty pharmacy. If large pharmacy benefit managers (PBM) continue to take over more market share, these independent specialty pharmacies will not be able to sustain their local business models. Katie Thomas of The New York Times reports.
Mylan plans to bypass pharmacies to curb cost on EpiPens
Mylan Health Management, the pharmacy operated by Mylan NV, plans to sell EpiPens directly to organizations such as restaurants and sporting venues, bypassing “middlemen” pharmacies such as CVS and Walgreens. Mylan asserts the change will prevent additional expenses from being passed to the consumer. Heather Bresch, Mylan’s chief executive officer, has publicly lobbied for public entity legislation that would allow such proposed sales tactics. According to Jared Hopkins and Robert Langreth with Bloomberg, the move would position Mylan to offer the EpiPen at a significant discount to consumers while still maintaining the same profit.
Pharmacists and insurers embrace generic EpiPen
CVS Caremark announced it will sell a generic version of Impax Labratories’ Adrenaclick, an EpiPen competitor. The company plans to price the generic at one third less than the original $300 list price of Mylan’s EpiPen. CVS executives note this action is in direct response to customer concerns about continued price increases. Critics speculate CVS may have financial motivations for the move, as the organization continues to lose market share to competitors, explains Nathan Bomey of USA Today.
Cigna will no longer cover Mylan’s EpiPen epinephrine autoinjector and will cover the company’s generic version launched late last year instead. The generic is currently available in pharmacies and is half the price of the branded drug product. Julie Horowitz of CNN Money reports.