Morning Briefing
Summaries of health policy coverage from major news organizations
Perspectives: Among All The Finger-Pointing On Drug Prices, We Should Be Looking At The Government's Mistakes
The Wall Street Journal: Trump’s Dubious Prescription-Price Plan
Drug manufacturers and pharmacy-benefit managers are bickering over who’s to blame for rising prescription prices at the drugstore. At a Senate hearing in February, CEOs of seven drugmakers took turns lambasting PBMs, and on Tuesday the benefits managers will get the chance to defend themselves. As usual, the biggest culprit is government, which is why the Trump administration’s plan to ameliorate the problem should be met with caution. As AstraZeneca CEO Pascal Soriot recently noted, the current system of drug pricing “is not sustainable—for patients, payers and society as a whole.” The way that system works—or rather the way it’s evolved to operate, since nobody thinks it works—drugmakers pay rebates to PBMs, which negotiate discounts for insurers in return for favorable placement on the list of covered medications. (Allysia Finley, 4/5)
The Atlantic: Do PBMs Delay Drugs And Drive Up Drug Prices?
Lynn Lear finished her final round of chemotherapy for breast cancer in December. To help keep the cancer from coming back, Lear’s doctor told her about a new medication she could take called Nerlynx. Lear, who is 46, wanted to do everything she could to remain healthy, so she asked her doctor to order the drug for her.Unlike, say, an antibiotic or an antidepressant, a Nerlynx prescription can’t be filled at a neighborhood CVS or Walgreens. (Olga Khazan, 4/9)
San Jose Mercury News: Trump Administration Puts Cancer Patients At Risk
Right now, Medicare prescription drug plans are required to cover all drugs in six classes of medications that treat complex illnesses like cancer, epilepsy, mental illness and HIV/AIDS. These protections ensure that vulnerable patient populations have access to a wide array of medication options to treat their illnesses, with the understanding that no two patients’ needs or conditions are the same. But the administration’s proposal does not take these realities into account. Instead, the proposed changes would allow insurers to offer patients increasingly restrictive coverage, while impeding patients’ ability to access innovative, potentially more effective treatments. Clearly, this is unacceptable to the millions of patients and doctors who have come to rely on these treatment choices to fight these deadly diseases. (Bonnie J. Addario, 4/8)
The New York Times: Why I Am Stockpiling Insulin In My Fridge
My parents and I used to high-five one another when we learned that the child of someone very rich had been found to have Type 1 diabetes. We weren’t being mean, just desperate. I was given my diabetes diagnosis in 1987, when I was 9, and the years immediately following were spent fantasizing about a cure. A cure would solve all my problems, the physical, mental and financial strains of having a chronic illness. A cure would require fund-raising for charities that would then be able to sponsor life-changing research. Put more simply, a cure would require money — lots of it. So, like monsters, my family and I rooted for offspring of the wealthy to join the broken-pancreas club, so that diabetes would become their pet cause and their fancy friends would get involved. The Juvenile Diabetes Research Foundation’s charity auction would make a killing. (Kreizman, 4/9)
Columbus Dispatch: Proposal Could Lower Patients’ Out-Of-Pocket Drug Costs
Patient advocacy groups also are calling for more scrutiny of PBM practices and greater accountability for their role in drug pricing. We often hear about the “list price” of a drug. Most every patient will not pay the list price but will pay a co-insurance or other copay cost. The HHS proposal will have the greatest impact on these direct patient costs, which are determined by health plans and PBMs. (Scott Eitman, 4/9)
The Fiscal Times: Why Prescription Drug Prices Keep Rising – And 3 Ways To Get Them Under Control
Prescription drug prices have been rising at a blistering rate over the last few decades. Between 1980 and 2016, overall spending on prescription drugs rose from about $12 billion to roughly $330 billion, while its share of total health care spending doubled, from 5% to 10%. Although lawmakers have shown renewed interest in addressing the problem, with pharmaceutical CEOs testifying before the Senate Finance Committee in February and pharmacy benefit managers (PBMS) scheduled to do so this week, no comprehensive plan to halt the relentless increase in prices has been proposed, let alone agreed upon. (Michael Rainey, 4/8)
Stat: Creating New Antimicrobials Will Require Public-Private Partnerships
As the number of infections resistant to antimicrobial drugs continues to rise around the world, and with it their huge human and financial toll, we urgently need new ways to preserve the effectiveness of existing antibiotics and to develop much-needed new ones. Creating state-run or publicly owned pharmaceutical companies, an idea recently floated by British economist Jim O’Neill, isn’t the way to proceed. (Thomas B. Cueni, 4/9)
