Inflation Fears, Pharma Interests Could Alter Drug Pricing Measures

Politico: Dems’ Plan To Limit Drug Price Inflation Faces Test In Senate
Democrats managed to strike a compromise on drug prices to advance their sweeping social spending bill. But as the House prepares to send the package to the Senate, the way the plan would extend price controls beyond Medicare to private health coverage is stoking another battle over the package. At issue is Democrats’ push to penalize drugmakers if they hike prices of medicine faster than inflation, a provision Republicans and the drug industry see as government overreach — and, they say, a violation of the Senate’s parliamentary rules for considering the bill because it’s a non-budgetary item. (Miranda Ollstein and Wilson, 11/13)

Bloomberg Government: Industry Groups Fault Drug Pricing Measure
Democrats are facing pressure from a host of health care industry groups to make key changes to their drug pricing proposal before voting on it in coming weeks, Alex Ruoff reports. Generic drug companies are telling Democrats their legislation to empower the government to negotiate lower drug prices would cut into their profits and make it harder to bring low-cost versions of pricey medicines to market. “It would greatly effect the rate of return for a generic,” Jeff Francer, senior vice president for the Association of Accessible Medicines, said. Their ask: exempt medicines from negotiations if a generic version is on the way. (Lee and Ruoff, 11/15)

KFF: Potential Costs And Impact Of Health Provisions In The Build Back Better Act
Congress is considering a broad package of health, social, and environmental programs supported by President Biden, called the Build Back Better Act. The total cost of the original package had been pegged at $3.5 trillion (much of which would be offset by savings and new revenue), though the legislation has since changed in ways that will likely reduce the total. This brief summarizes major health provisions as of the bill reported to the House Rules Committee on November 3, 2021, which, at the time of publication, has not yet received a CBO score. Negotiations are ongoing and there may be future changes. Here, we walk through 10 of the major health coverage and financing provisions of the Build Back Better Act, with discussion of the potential implications for people and the federal budget. We summarize provisions relating to the following areas and provide data on the people most directly affected by each provision and the potential costs or savings to the federal government. (Cox, Rudowitz, Cubanski, Pollitz , Musumeci, Ranji, Long, and Freed, 11/16)

AP: Alzheimer's Drug Cited As Medicare Premium Jumps By $21.60
Medicare’s “Part B” outpatient premium will jump by $21.60 a month in 2022, one of the largest increases ever. Officials said Friday a new Alzheimer’s drug is responsible for about half of that. The increase guarantees that health care will gobble up a big chunk of the recently announced Social Security cost-of-living allowance, a boost that had worked out to $92 a month for the average retired worker, intended to help cover rising prices for gas and food that are pinching seniors. (Alonso-Zaldivar, 11/12)

The New York Times: Biden Chooses Robert Califf To Lead F.D.A., Despite Drug Industry Ties
President Biden announced on Friday that he would nominate Dr. Robert M. Califf, a former commissioner of the Food and Drug Administration, to lead the agency again. His decision ends nearly a year of political wrangling as the White House vetted then dropped several candidates after complaints that some were too close to the pharmaceutical industry. In the end, White House officials might have concluded that they could not find a suitable candidate with no industry ties. Dr. Califf, 70, a respected academic and clinical trial researcher who ran the agency during the last year of the Obama administration, has long been a consultant to drug companies and ran a research center at Duke University that received some funding from the drug industry. (Gay Stolberg and Kaplan, 11/12)

Stat: California Wants To Revoke An OptumRx Pharmacy License For Lapses
The California Board of Pharmacy is seeking to revoke or suspend a pharmacy license held by OptumRx, which is one of the largest pharmacy benefit managers in the U.S., for a series of prescribing failures that allegedly jeopardized patient health. The infractions, which occurred between 2016 and 2020, involved failures to refill prescriptions promptly; substituting a medicine without written consent; telling a patient his health insurer denied a refill due to cost; and dispensing a generic version of a drug with a costly co-pay when the customer had no co-pay for the brand version, according to the complaint, which was filed in August but shared online recently by the agency. (Silverman, 11/16)

New Jersey 101.5: NJ Looks To Take On Prescription Drug Costs With New Review Board
Among the ideas advancing in the final months of the legislative session is the creation of a state board that would study and potentially cap prescription drug prices. Legislation creating the Prescription Drug Affordability Board advance in the Assembly back in June and through the Senate health committee last week, despite concerns from business groups that it would lead pharmaceutical companies to move their work to the states. (Symons, 11/15)

Oregon Public Broadcasting: Oregon Pharmacies Are Short On Staff And Drug Price Managers Have Something To Do With It
Customers all around Oregon have reported standing in line for hours at pharmacies and waiting weeks for prescriptions to be filled. ... Explaining the pharmacy problemKevin Russell spent 28 years working in community pharmacies and is now the Central Oregon Regional Director on the Oregon State Pharmacy Association board.Russell told OPB that intermediary companies called Pharmacy Benefit Managers have too much control over the prices of prescription drugs, and that causes a ripple effect. (Cuthill, 11/13)