PBMs, The Middlemen Of Pharma, Aren’t Completely To Blame For High Drug Prices

Stat: Q&A: Pharma And PBMs Are In A 'Two-Step Dance' That Raises Drug Prices
Over the past several months, drug makers have been particularly vocal in blaming pharmacy benefit managers — the middlemen who negotiate favorable insurance coverage for medicines — for rising prices. PBMs and insurers, in turn, blame drug makers. The truth lies somewhere in between, according to Linda Cahn, a consultant who advises health plans and employers on PBM contract negotiations. However, she does fault PBMs for a lack of transparency and certain contracting practices. So we asked her to briefly explain some of these issues. This is an edited version. (Silverman, 6/13)

The New York Times: Seizing On Opioid Crisis, A Drug Maker Lobbies Hard For Its Product
The ads have been popping up on billboards, buses and subways and in glossy magazines, with portraits of attractive men and women and a simple question in bold letters: What is Vivitrol? Five years ago, Vivitrol was a treatment for opioid addiction that was struggling to find a market. Now, its sales and profile are rising fast, thanks to its manufacturers’ shrewd use of political connections, and despite scant science to prove the drug’s efficacy. (Goodnough and Zernike, 6/11)

NPR: Drugmaker Behind Vivitrol Tries To Cash In On The Opioid Epidemic, One State Law At A Time
Two years ago, a mental health advocate named Steve McCaffrey stood at a lectern in the Indiana statehouse, testifying in favor of an addiction treatment bill. After years of rising overdose rates, lawmakers in the health committee were taking action to combat the opioid epidemic. And they often turned to McCaffrey, who leads Mental Health America of Indiana, to advise them. His brief testimony appeared straightforward. "We rise in support, urge your adoption," said McCaffrey. He said the legislation would move the state "toward evidence-based treatment." But the bill wouldn't do that. (Harper, 6/12)

The Wall Street Journal: U.S. Probe Sheds Light On Charities’ Role In Boosting Drug Sales
U.S. sales of blockbuster prostate-cancer drugs have dropped sharply since the start of a federal investigation into charities that help patients pay for these drugs, as the manufacturers have reduced donations to the charities and instead given away the medicines for free. Drugmakers donate hundreds of millions of dollars a year to charities that help U.S. patients cover out-of-pocket costs for drugs. In turn, the drugmakers rely on the charities to effectively boost the sales of those drugs. The assistance ensures patients fill their prescriptions, and insurance pays the rest of the tab. (Rockoff, 6/11)

Stat: A Senate Bill Would Make Drug Makers Justify Price Hikes
Seeking to put a lid on rising drug prices, U.S. Sen. Ron Wyden has introduced a bill that would require drug makers to justify hefty price hikes, a move that resembles legislation being introduced in a growing number of state legislatures around the country. In this instance, the U.S. Department of Health and Human Services would track increases in list prices and notify manufacturers when those prices exceed certain benchmarks. At that point, drug makers would have to justify the increases — and may also have to provide information on R&D funding and marketing costs — or they can lower their prices. (Silverman, 6/13)

CQ Roll Call: GOP Health Bill Clouds Senate Drug Price Hearing
A Tuesday discussion on drug prices that was supposed to be bipartisan quickly veered to Democrats' criticism of the Republican plan to overhaul the health care system and the lack of hearings held on the issue. It was the first Senate hearing on drug prices held by a committee that can actually legislate on the subject since drug prices became a hot issue in the fall of 2015. At the outset of the Senate Health, Education, Labor and Pensions Committee hearing, Chairman Lamar Alexander, R-Tenn., stressed that the intent was to “better understand this complex subject and agree on some basic facts.” The hearing, he noted, was convened at the request of committee Democrats and Republicans alike. (Siddons, 6/13)

NBC News: Prescription Price Crisis? 28 Million Americans See Spike In Drug Prices
At least 28 million Americans have experienced a spike in the cost of their prescription medications in the past 12 months. And for 4 million of them, the price was so high they walked away without their prescription altogether, according to a new Consumer Reports survey. “We are nearing a crisis point with what Americans can afford for medication, and it's scary," concluded Consumer Reports. "And honestly, as far as we can tell, there are no brakes on it right now. Congress may have a few things up its sleeve, but we're still waiting.” (Velshi, Girvin, Popken and Cappetta, 6/11)

Stat: Amgen May Face Tougher Insurance Coverage For Repatha
Amgen may face yet another setback with its controversial Repatha cholesterol-lowering drug because an influential nonprofit may soon lower its value rating for the medicine. In a new report, the Institute for Clinical and Economic Review indicated that recently released clinical trial results prompted a reassessment, which will be lower than an initial cost-effective analysis issued two years ago. At the time, ICER pegged the value of the drug at between $5,400 and $7,700, which was notably lower than the $14,000 list price. (Silverman, 6/13)

The Wall Street Journal: Blink Health Terminates Pact With Express Scripts For Lilly Insulin Price Discounts
A corporate dispute over a price-discount program for diabetes patients taking Eli Lilly & Co.’s insulin has resulted in an industry middleman’s exit from the deal—the latest sign of discord among players in a prescription-drug supply chain facing criticism for high prices. Blink Health LLC, a provider of consumer price discounts for prescription drugs, said it has terminated its relationship with Express Scripts ESRX 0.18% Holding Co., a pharmacy-benefit manager that helped arrange the new price break for Lilly’s insulin. (Loftus, 6/13)

The Wall Street Journal: Quantum Computing May Speed Drug Discovery, Biogen Test Suggests
Biotechnology company Biogen Inc. has completed an experiment that shows that quantum computers have the potential to speed up drug discovery for diseases such as multiple sclerosis, Alzheimer’s and Parkinson’s. The Cambridge, Mass.-based firm, which declined to be interviewed for this story, is the latest company to experiment with cutting-edge technology that harnesses the power of quantum mechanics to solve complex problems in nanoseconds. Experts say that within five yearsquantum computing will be powerful enough to solve problems that are currently beyond the scope of today’s most advanced computers. (Castellanos, 6/13)

The Washington Post: Cancer Drug Prices Are So High That Doctors Will Test Cutting Doses
A group of prominent cancer doctors is planning a novel assault on high drug costs, using clinical trials to show that many oncology medications could be taken at lower doses or for shorter periods without hurting their effectiveness. As Exhibit A, they point to their pilot study involving a widely prescribed drug for advanced prostate cancer. Cutting the standard dose of Zytiga by three-quarters was as effective as taking the full amount — as long as patients swallowed the medication with a low-fat breakfast rather than on an empty stomach, as directed by the label. (McGinley, 6/8)

Miami Herald: French Pharma Rejects U.S. Request For Fair Price For Zika Vaccine
A French pharmaceutical company developing a Zika vaccine funded with millions of dollars in research grants from American taxpayers has rejected a request from the U.S. Army to set an affordable price for the drug once it becomes available. Sanofi Pasteur has already received $43 million in research grants from the Department of Health and Human Services, and the U.S. Army intends to award an exclusive contract to the company to license and sell a vaccine based on technology discovered with American taxpayer funds. (Chang, 6/12)

Science Daily: Drug Costs Vary By More Than 600% In Study Of 10 High-Income Countries
In a study of 10 high-income countries with universal health care, costs for prescription drugs in 6 of the largest categories of primary care medicines varied by more than 600%, according to research published in CMAJ (Canadian Medical Association Journal). (6/12)