CMS Releases Guidance To Help States Better Monitor ‘Spread Pricing’ That Can Increase Drug Costs
Over the past year, so-called "spread pricing" has generated controversy over allegations that pharmacy benefit managers pocket portions of payments that should go to state programs. CMS is trying to mitigate that with new guidance. In other pharmaceutical news: a false advertising lawsuit, a dispute over immunotherapy, a health-tracking forum, and more.
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Seeking To Contain Drug Costs, CMS May Have ‘Killed’ A PBM Billing Practice
In another bid to attack high prescription drug costs, the Centers for Medicare and Medicaid Services released guidance this week to help states monitor so-called spread pricing that can unnecessarily increase what health care programs are paying for medicines. Despite the arcane-sounding name, spread pricing is an important, behind-the-scenes issue in the opaque pharmaceutical world. Basically, this refers to what pharmacy benefit managers pay pharmacies for medicines and then bill back to state Medicaid programs. Recently, though, a growing number of states are trying to clamp down on the practice after concerns surfaced about overcharging. (Silverman, 5/17)
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Allergan Wins A Novel Case Over False Ads By A Compounder, But Gets Just $48,500 For Its Trouble
In a closely watched case, Allergan (AGN) won a lawsuit in which it used a novel legal theory to blunt competition from a compounding pharmacy, although the victory came at a price. Here’s the backstory: The drug maker accused Imprimis Pharmaceuticals of falsely advertising compounded versions of its eye treatments for cataracts and glaucoma because the smaller company failed to follow federal regulations. (Silverman, 5/17)
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Dana-Farber Prevails In Immunotherapy Dispute Over Patents
A leading cancer center on Friday prevailed in a lawsuit seeking to add its researcher’s name to patents for a form of cancer immunotherapy, a decision that will allow it to license the intellectual property behind the patents to companies developing new therapies. A U.S. District Court judge ruled in favor of the Dana-Farber Cancer Institute on all six counts on which it was challenging the patents, which underlie the blockbuster cancer drug Opdivo. (Cooney, 5/17)
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PatientsLikeMe Founder Frets U.S. Policy Could Chill Collaboration In Biotech
The result was an online health-tracking site, including a forum, that offered not just a new place for patients to communicate, but a source of scientific studies. In the past few years, PatientsLikeMe data have been used to run a study that indicated a soy-derived supplement did not benefit ALS patients, that financial hurdles made it difficult for patients with multiple sclerosis to access new medicine, and that being on a plane does not make it more likely that a person will cry during a movie. For drug companies, the database provided both scientific and health economic research; arrangements with industry made PatientsLikeMe money. (Herper, 5/20)
The Associated Press Fact Check:
Trump's Miscues On Trade And Drug Prices
President Donald Trump spoke this past week as if he's unaware that drug prices have gone up and tariffs came before him. His boast that the U.S. never collected a dime on goods from China until he imposed them marked a series of statements misrepresenting how trade works as the two countries escalated their dispute with new and retaliatory taxes on each other's products. (Yen, 5/18)
