September 22, 2017
Drug Cost Conversation Continues
Price increases continue, but at lower rate than 2016
Price increases for prescription drugs have been less severe for the first two quarters of 2017 than they were last year, although they continue to outpace inflation. SSR Research, which tracks pharmaceutical industry trends, notes drug prices rose 7.1 percent in the second quarter this year, less than the 9.7 percent increase in the same period last year. While SSR has noticed a trend in lower price hikes over the past year, the organization warns that trend seems to be ending, and that price increases will likely continue at roughly the current rates they are now. SSR’s research demonstrates specialty drugs account for most of the price increases over the past year.
Cost transparency could help reduce generic drug prices
The disclosure of production costs for generic drugs could help lower generic drug prices. Competition between generic drugmakers has helped push down the price that PBMs and pharmacists pay manufacturers for treatment; however, these savings have largely not been passed onto consumers or health plans. An analysis from the Brookings Institute demonstrates selective disclosure of manufacturing prices to health plans helps lower costs by providing health plans additional leverage in price negotiation for generic drugs.
Anthem raises California premiums in anticipation of increasing prescription drug use
Anthem Blue Cross projects increased prescription drug use, rising drug costs, and a sicker risk pool will force the insurer to raise premiums by more than 30 percent for Californians in 2018. Consumer advocacy groups are questioning Anthem’s rationale for the premium hikes: most other insurers have filed much lower increases in the state, and Anthem itself has proposed significantly lower premium increases—as low as 11.4 percent—in other states. Anthem stands by its forecast and believe prescription drug use will jump significantly among enrollees in 2018.
Legal tricks help delay biosimilar competitors
Promising biosimilar treatments are being held up by legal maneuvers, including patent filings and drugmaker-payer agreements. As existing biologic drug patents expire, brand drugmakers are often able to file new patents on previously unprotected components of the process, delaying biosimilars’ entry into the market. Many drug companies have also have been able to sign exclusive contracts that ensure payers only cover the brand-name treatment, depressing the market for biosimilar treatments and leading to lackluster sales.
Walgreens gains approval for Rite Aid purchase
A Federal Trade Commission (FTC) decision will allow Walgreens to purchase 1,932 Rite Aid stores. The FTC has blocked Walgreens’s attempts to purchase Rite Aid stores three times over the past two years, citing concerns about competition. The FTC, which currently only has two commissioners, was deadlocked on whether to open an in-depth investigation into the deal, clearing the way for the purchase under current antitrust rules. The purchase will make Walgreens the largest pharmacy chain by number of stores.
Pfizer sues Johnson&Johnson over use of exclusive contracts
Pfizer has filed a lawsuit against Johnson&Johnson (J&J) for anticompetitive behavior aimed at undermining Pfizer’s ability to sell a biosimilar drug based off a J&J biologic. Pfizer is accusing J&J of coercing insurers, hospitals, and health clinics into signing exclusive contracts with J&J in exchange for price rebates. Johnson&Johnson denies its contracts are anticompetitive and points out it has been forced to drop prices for the original drug.
NVO pays more than $58 million in settlement
Novo Nordisk (NVO) has agreed to pay more than $58 million for failing to comply with an FDA program that requires companies educate doctors and monitor distribution of drugs that may have serious side effects. Regulators required NVO to set up a program to adequately alert doctors its diabetes drug Victoza may be associated with thyroid cancer. Instead, the company created the impression that the FDA program would be unnecessary, leaving some doctors unware of the drug’s connection to cancer. In a statement, NVO said the company’s priority “will always be to ensure that those caring for patients have the data they need to make the most informed treatment decision.”
FDA says Vertical Pharmaceuticals failed disclosure requirements for promoting opioid
The FDA issued a warning letter to Vertical Pharmaceuticals last month over how the company promoted the opioid painkiller ConZip to doctors. According to the FDA, Vertical omitted key risk factors associated with the drug and failed to remind doctors to only prescribe the treatment when alternatives are ineffective. The FDA notes these omissions gives a false impression that the drug is safer than it is and imperils patient safety. Vertical Pharmaceuticals has not commented on the warning.
Drug products may require evaluation similar to medical devices
In a speech this week, FDA Commissioner Scott Gottlieb said new types of medical technology, many which have long-term effects, may need to be evaluated similarly to the FDA’s current process for evaluating medical devices. Gottlieb also announced FDA plans to speed up product development of new medical technology before the clinical trial stage by working to prevent unnecessary testing and recommending research trial designs.
Warren and Capito push partial fill policies
Sens. Elizabeth Warren (D-MA) and Shelley Moore Capito (R-WV) are encouraging health officials at all levels of government to support partial fill policies to curb over-prescription and help address the opioid epidemic. The policies—which are allowed thanks to the 2016 Comprehensive Addiction and Recovery Act—permit pharmacists to dispense portions of a prescription; patients can return for the rest of the prescription if necessary.
McCaskill report highlights Imsys’s fraudulent sales tactics for painkillers
Sen. Claire McCaskill (D-MO) has released a report revealing a major drugmaker engaged in deceptive practices to influence PBMs and insurers into authorizing reimbursement for unneeded drugs—including opioids. Employees at Imsys frequently encouraged doctors to prescribe cancer pain drugs as an off-label treatment and, in some cases, directly called PBMs and insurers and provided misleading patient information to acquire prior authorization. Consultants had warned Imsys that the organization needed tighter guardrails to prevent such fraud. Six former executives at Imsys are under indictment, and one pleaded guilty to wire fraud conspiracy. McCaskill believes Congress should continue investigating sales and marketing practices in the pharmaceutical industry, and has not ruled out introducing legislation on the topic.
Opioid drugmakers sued by New Mexico over marketing practices
New Mexico is suing prescription drug manufacturers and distributors for helping fuel the opioid epidemic. The state accuses drugmakers of engaging in deceptive marketing that downplays risks associated with opioids. The state also alleges distributors failed to properly detect and investigate large opioid orders that have been diverted for illicit uses. New Mexico is just the latest in a wave of state and local governments pursuing legal action against drugmakers for their role in the opioid crisis.
Analysis suggests opioid addiction has fueled drop in labor force
Research conducted by Princeton University economist Alan Krueger suggests opioid addiction may be partially responsible for a decline in labor-force participation. Krueger’s research indicates opioid addiction may be responsible for as much as 20 percent of the workforce reduction among working age men and 25 percent among working age women. While Krueger acknowledges most of the decline in labor-force participation is due to an aging population and broad population trends, his analysis suggests the opioid epidemic is having a broader economic impact than initially thought.
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