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August 26, 2024 Price and Costs

Dozens of state and local governments are suing drug companies and pharmacy benefit managers, alleging that they're unfairly hiking the price of insulin. The plaintiffs say they're fighting for patients. They're less forthcoming about the fact that they've profited handsomely from the system they're now decrying. For years, these cities and states have insisted on a cut—if not all—of the rebates that these pharmacy benefit managers extract from drug makers when negotiating over whether and how to cover specific drugs.  ...

August 15, 2024 Blog, Innovation, Policy Proposals, Price and Costs

The federal government has announced the long-awaited results from the 2022 Inflation Reduction Act’s (IRA) drug price negotiations.[1] The Biden Administration has been crowing that they have achieved “a historic moment that will help lower prescription drug prices for millions of people across America.” Nothing could be further from the truth. The Biden Administration has sold out patients and the hope for future cures to achieve results that pale in comparison to the benefits enabled by efficient market competition. According to...

August 12, 2024 Issues, Price and Costs

Any day now, the Biden administration will publish the prices it has set for ten drugs covered by Medicare's Part D prescription drug benefit. These price controls will provide "meaningful financial relief for millions of people with Medicare," administration officials say. Many seniors are about to see just how false that promise is. Millions of beneficiaries won't see a nickel in relief at the pharmacy counter. In fact, their costs will go up. Click to read the full article in Forbes. ...

August 5, 2024 Innovation, Issues

The U.S. House Committee on Oversight and Accountability held a hearing last month with the CEOs of the nation's three largest pharmacy benefit managers: CVS Caremark, Express Scripts, and OptumRx. The hearing coincided with a new report from the committee on the outsized role these prescription-drug middlemen play in determining what people pay for their medicines. Unsurprisingly, the CEO confab revealed little that lawmakers didn't already know. Click to read the full article in Newsmax. ...

July 26, 2024 Issues, Price and Costs

By Anthony M. DiGiorgio, DO, MHA and Wayne Winegarden, PhD Enacted by the US Congress in 1992 to help entities serving lower-income and uninsured patients stretch their resources, the 340B Drug Pricing Program mandated drug companies give large discounts to covered entities (CEs). Judging the program on its outcomes, not its intentions, there is growing evidence that the 340B program fails to achieve its primary goal. Giving discounts to entities, rather than to patients, primarily shifts resources from payers and drug companies to...

July 23, 2024 Coronavirus-Alternate2, Issues

"We have seen complete fabrications become some people's accepted reality," Dr. Anthony Fauci laments in his new memoir "On Call: A Doctor's Journey in Public Service." Surely the good doctor means to speak about his ideological foes, who have long decried the heavy-handed response to COVID-19 that Dr. Fauci symbolizes. But today, more than four years after the world first met COVID-19, it's fair to wonder whether Dr. Fauci's depiction of reality is the one that's fabricated. Click to read the full article in Newsmax. ...

July 22, 2024 Issues, Price and Costs

Earlier this month, the U.S. Food and Drug Administration approved donanemab, a novel treatment for Alzheimer's disease that Eli Lilly will sell under the brand name Kisunla. The drug targets amyloid, a type of protein that builds up in the brains of people with the disease. It was shown to slow the progression of Alzheimer's by 35% over 18 months compared to a placebo. Donanemab's approval comes about a year after the agency gave the green light to lecanemab, another monoclonal antibody proven to slow...

June 27, 2024 Issues, Price and Costs

House lawmakers recently introduced legislation that would at last repair a program meant to provide low-income Americans with affordable medicine. In theory, the federal 340B Program, named after the section of the 1992 law establishing it, allows hospitals serving underprivileged groups to buy medications at steep discounts. The idea was to improve access to drugs in areas where price was a barrier. The problem is that the law has a loophole big enough to drive an ambulance through. Hospitals have exploited it,...

June 25, 2024 Issues, Price and Costs

The Biden administration proposed a rule this month that would remove medical debt from credit reports. It's sure to be popular, if for no other reason than that it's expected to boost credit scores for the more than 15 million people with such debt by an average of 20 points. But as with so many of President Joe Biden's signature health reforms, his latest ploy fails even the most basic cost-benefit analysis. Implicit in the proposal are two assumptions. Click to read the...

June 25, 2024 Issues, Price and Costs

There's never been a better time to get lung cancer in the United States. That may sound morbid. But this deadliest of cancers appears to be losing a bit of its punch. The combination of smoking reduction, increased screening, and pharmaceutical advancements has caused the lung cancer death rate to drop 20% over the past five years, according to reporting from the Wall Street Journal earlier this month. The last leg of that three-legged stool is the most impressive. The Journal highlighted a suite of new treatments...

June 11, 2024 Briefs, Innovation, Resources, Studies

A new brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute provides the latest evidence that biosimilar competition is saving patients billions – and additional competition would increase savings even more. Click to download the brief From 2019-2023, patients saved $15 billion from biosimilar competition.  Had there been competition during the same period for two other biologics, Humira and Enbrel, patients would have saved another $13 billion, for a total of $28 billion. “The growing...

June 10, 2024 Innovation, Issues

Every day, nearly 10,000 people in the United States are diagnosed with skin cancer. The good news is that applying sunscreen can substantially reduce a person's risk of getting skin cancer. The bad news is that the federal government is doing its best to keep effective sunscreens out of the hands of ordinary Americans. Unlike most developed countries, the United States classifies sunscreen as a drug, not a cosmetic. That means sunscreens are subject to regulation by the U.S. Food and Drug Administration, which...

May 31, 2024 Innovation, Issues

For years, the left's campaign to dictate the price of prescription drugs has focused on one medicine above all others — insulin. The hormone was discovered more than a century ago by Canadian doctor Frederick Banting and his medical student Charles Best. They famously sold their patent to the University of Toronto for $1 apiece. How can insulin still be a financial burden for some of the people with diabetes who need it? This problem motivated the $35 insulin price cap for Medicare enrollees, which...

May 28, 2024 Issues, Price and Costs

Earlier this year, European authorities recommended approval of tofersen, a new drug that treats a rare genetic form of amyotrophic lateral sclerosis, or ALS. That decision came nearly a year after American regulators granted the drug accelerated approval. Patients with that rare form of ALS in England aren't so lucky. The National Institute for Health and Care Excellence, or NICE, which evaluates whether treatments are "cost-effective" for the country's National Health Service, announced a decision in March that would effectively render the drug unavailable to them. It's a...

May 20, 2024 Innovation, Issues

Congress faces a year-end deadline to extend its relaxed pandemic-era rules permitting greater use of telehealth by Medicare beneficiaries. If our lawmakers fail to step up, millions of seniors as well as privately insured patients could lose access to what has become an essential form of medical care. The expansion of telehealth is a perfect example of how cutting red tape can improve people’s lives. Congress should make these changes permanent and use the experience as a model to remove roadblocks to...

May 20, 2024 Issues, Price and Costs

Last month at a White House event, President Joe Biden and Sen. Bernie Sanders, I-Vt., took a victory lap for supposedly having "beat Big Pharma" through drug-pricing provisions in the Inflation Reduction Act. Beaming with pride, they hailed new powers for Medicare to "negotiate" drug prices as a historic achievement. But their self-congratulation rests on a false premise. Far from being a big win for Americans' health, the IRA bankrolls billions of dollars' worth of left-wing policy priorities at the expense of life-saving pharmaceutical innovation...

May 7, 2024 Issues, Policy Proposals

Americans collectively owe some $220 billion in medical debt. In response, a growing number of states, including New Jersey and Connecticut, are using public funds to relieve those debts. Gov. Josh Shapiro, D-Pa., proposed doing something similar in his state earlier this year. But is canceling medical debt the best way to help cash-strapped Americans? Click to read the full article in Newsmax. ...

April 23, 2024 Issues, Value

Cost Plus Drug Company CEO Mark Cuban recently pointed out that self-insured businesses could save over $70,000 per employee annually by getting their workers to switch from AbbVie’s blockbuster anti-inflammatory treatment Humira to a lower-cost biosimilar called Yusimry. Humira has a list price of roughly $7,000 per month. Since it lost market exclusivity last year, nine nearly identical copycats have hit pharmacy shelves. A year’s supply of Yusimry costs the same as just one month of Humira. Why doesn’t every employer in America follow Cuban’s advice? The answer has three letters: PBM. Click to read the...