ACHP Media Report: Pharmacy News – October 14, 2016

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Note: ACHP has released The Spike in Drug Costs Infographic Series: Cholesterol, the newest installment in our infographic series.

Mylan to pay government for overpriced EpiPen
Mylan Pharmaceuticals has agreed to pay the federal government $465 million in a settlement over EpiPen prices. The Justice Department claims Mylan overcharged Medicaid and Medicare for its EpiPen product by incorrectly classifying the drug as a generic. Mylan expressed in a statement the settlement is not an admission of wrongdoing. Medicaid will be reviewing other drugs to ensure they have not been misclassified. Katie Thomas of The New York Times reports.

 Anthem waits for effectiveness data to cover muscular dystrophy drug
Anthem has declined to cover Exondys 51, a drug approved under the Food and Drug Administration’s accelerated approval pathway earlier this year to treat Duchenne muscular dystrophy. As a condition of approval, the drug manufacturer is required to complete a clinical trial proving the drug’s effectiveness. Mary Ellen McIntire with Morning Consult explains Anthem will re-evaluate covering the drug after the effectiveness data is made available.

States feeling the strain of Medicaid drug costs
States continue to struggle to moderate their Medicaid drug spending even when using prior authorization, preferred drug formularies and comparative effectiveness drug data. Unexpected drug price increases, such as those seen with the EpiPen or hepatitis C drugs, are a strain for state budgets as well as the totality of drugs covered, including oncology and cholesterol drugs. The unpredictability of drug pricing prevents states from balancing their budgets and requires them to find alternative ways to offset costs. If the trend continues, Nathaniel Weixel with The Hill notes states may dramatically limit the drugs they cover and decrease reimbursement rates.

Report: Medicare Part D receives 35 percent discount from drug manufacturers
Medicare Part D averages a 35 percent discount off the list price of drugs from manufacturers as the result of negotiated rebates. PhRMA funded the study by QuintilesIMS Institute, a health care informatics firm, and notes the report finds Medicare Part D has significant negotiating power to keep costs low for its beneficiaries. In PhRMA’s view, this contradicts the need for political proposals calling for changes to drug pricing strategies. Tracy Staton from FiercePharma has the story.

Earlier this week:

Hospitals affected by rising drug costs
Hospitals are joining consumer groups and insurers in the call to curb rising drug costs. In a study for the American Hospital Association and the Federation of American Hospitals, researchers find drug spending on inpatients increased more than 20 percent between 2013 and 2015 due to a rise in cost, not quantity, of medication. According to the Associated Press, hospital leaders say they do not want a scenario where the government controls drug prices directly, but a debate on the issue is necessary.