Category: Uncategorized

By Khadijah M. Silver

https://medcitynews.com/2021/01/drug-price-hikes-without-new-evidence-upped-spending-by-1-2b-icer-says/

The Institute for Clinical and Economic Review (ICER) published its second-ever report on Unsupported Price Increases (UPI) last week, compiled from data supplied by SSR Health, which is part of the investment research firm SSR. 

While the medical pricing watchdog found that overall spending was down from the previous year, the report highlighted 10 drugs whose prices increased. Further, it found that seven of these had price hikes that did not correspond with any newly discovered clinical benefit. ICER estimates that patients, insurers and pharmaceutical benefit managers (PBMs) were overcharged $1.2 billion in 2019, alone.

“These are not cherry-picked niche drugs, or some sort of outlier situation,” ICER spokesman David Whitrap said in a phone interview. “These are the costliest price increases for our country and of those ten, seven of them have no evidence for support.”

Not surprisingly, pharmaceutical companies named in the report negatively were none too pleased.

ICER published its first UPI report in October 2019, identifying a different list of seven drugs and saying their unsupported price increases cost Americans an additional $4.8 billion across the two years covered in the report, 2017 and 2018.

Given increased state-level and congressional scrutiny as well as a number of value-based contracts between states and pharmaceutical companies, drug prices have flattened, overall. But ICER does not see that as a reason to stop using clinically driven value-based analysis to determine appropriate drug costs.

“This was never intended to be some sort of broadside against the industry,” Whitrap said. “We should applaud industry as a whole for moderating their price increases over the past two years — but at the same time, just because companies A, B and C have made their industry look better as a whole, I don’t think that’s a reason we should let company D off the hook.” 

Combining Economic and Clinical Research
While the first report covered the price and cost increases over that two-year period, 2020’s report solely includes 2019 price data. According to ICER, two of the drugs had clinically unsupported price increases high enough to render their inclusion in both reports: AbbVie’s Humira (adalimumab) and Biogen’s Tecfidera (dimethyl fumarate).

To compile the 132-page report, ICER first secured a list of 2019’s top 100 drugs by U.S. sales from SSR Health, part of boutique investment research firm SSR LLC. ICER excluded 67 drugs whose increase in wholesale acquisition cost (WAC) was not larger than twice the increase in the medical consumer price index (CPI) and, for the remaining 33, performed analyses to determine the increase in spending that was due to increases in net price as opposed to volume.

From that, the report assessed the 10 drugs with the highest price increases to determine if there was some new clinical finding that might justify charging more. Notably, the organization did not attempt to establish through formal cost-benefit analysis whether the price increases were justified by meeting a health-benefit price benchmark, only that new evidence existed that could justify an increase.

ICER reviewed randomized clinical trials (RCTs), high-quality comparative observational studies and large uncontrolled studies for infrequent harms. It analyzed high- and moderate-quality evidence of a substantial increase in net clinical benefit “compared with what was previously believed.” Those drugs that had evidence meeting this standard were reported as having price increases “with new clinical evidence.”

The seven drugs that were found to have unsubstantiated price hikes were:

• Amgen’s Enbrel (etanercept),
• J&J Janssen’s Invega Sustenna and Trinza (paliperidone palmitate)
• Bausch Health’s Xifaxan (rifaximin),
• Bristol Myers Squibb’s Orencia (abatacept)
• Biogen’s Tecfidera (dimethyl fumarate)
• AbbVie’s Humira (adalimumab) and
• UCB’s Vimpat (lacosamide).

Despite not having been included in the initial group, Enbrel shot up to the No. 1 position on the list after public input calling for its inclusion. This was because it had the greatest increase in impact on national drug spending — $403 million. 

The three drugs for which new evidence of clinical impact aligned with price increases were Novartis’ Entresto (sacubitril and valsartan), Takeda’s Entyvio (vedolizumab) and Astellas Pharma’s Xtandi (enzalutamide).

Source: ICER

ICER contacted manufacturers of the identified top 10 drugs for early feedback on its figures for change in net price, sales volume, and overall net revenue. Given feedback from Novartis saying its drug Cosentyx had not achieved an increase in net sales, it was removed from the top 10 and Astellas’ Xtandi moved from 11th to 10th place.

Drugmakers Dispute Report’s Findings
Four of the seven companies accused of unsubstantiated price increases responded to requests for comment.

The feedback was unanimously negative.

Concerns ranged from ICER’s use of just two years for inclusion of medical evidence to support price increases, to a failure to place net price increases in the context of a rebate-based pharmaceutical industry.

“We believe ICER’s 2020 Unsupported Price Increases report is biased, selective and unreliable,” said Lainie Kelle, a Bausch Health spokeswoman, in an email. “ICER refused to consider relevant clinical, real-world and health economic evidence that supports the value of XIFAXAN as an important treatment option for several conditions.”

Bausch Health called ICER’s timeframe for inclusion of evidence “arbitrary” and “narrow,” saying it “ignores the reality of how long it takes to generate and publish pharmaceutical research.” ICER’s report relies on studies published between Jan. 1, 2018, and Dec. 31, 2019, claiming that is a sufficient look backward to call evidence “new.”

Another pharma company also rebutted ICER’s conclusion about its drug.  

“In reviewing ICER’s final UPI assessment, we firmly believe that VIMPAT’s body of clinical evidence strengthens its value to patients experiencing uncontrolled seizure disorders and supports its net price,” said Allyson Funk, a UCB spokeswoman, in an email. Funk declared that UCB continually evaluates its medications’ prices to ensure they reflect the value they deliver to patients, society, and the healthcare system, and said the company will continue to study VIMPAT’s impact on managing disease.

Janssen echoed concerns about a “narrow” and time-limited literature review, saying it lacked “real-world” evidence and focused too tightly on net cost, failing to weigh factors such as patient cost and outcomes. 

In an email, Janssen representative Katie Upton named ISPOR, the Professional Society for Health Economics and Outcomes Research, and ISPE, the International Society for Pharmaceutical Engineering, as two research organizations that support the company’s assessment, deeming real-world evidence “critical in the accurate assessment of the value of medicines.” Upton said Janssen supports value assessment that is “patient-centric, holistic, and represents the needs of all stakeholders.”

Amgen, accused of the biggest unsupported price hikes, said that ICER did not properly analyze its data and that fault for its price hikes lies with the nature of the highly competitive drug marketplace. 

“When applying ICER’s published methodology and criteria, we believe Enbrel is not qualified as having an unsupported price increase (UPI),” said Kelley Davenport, an Amgen spokeswoman, in an email. “While the ICER report acknowledged the context and the quality of the SEAM-PsA trial, their conclusion that methotrexate and etanercept have similar efficacy is inconsistent with the trial results which demonstrated superior efficacy of etanercept compared to methotrexate for the primary and key secondary endpoint in well-established psoriatic arthritis outcome measures.”

Davenport added that Amgen has raised list prices over the years in reaction to competitors’ price hikes, while offering lower net prices and higher and higher rebates to PBMs to remain covered by health plans and ensure patient access to the drug.

“If we had not done so, we believe the PBMs would have simply removed Enbrel from their formularies in favor of a competitor who provided a higher rebate to the PBM,” Davenport said. “Since Enbrel and its competitor products do not provide the same response in all patients, they are not simply interchangeable — if taken off formulary, many Enbrel patients would not have access to the medicine that they and their doctor had determined worked best for them.”

Amgen is not the only one taking note of the continual one-upmanship occurring among pharma competitors — and placing a fair share of blame on PBMs.

In a withering report issued January 14 investigating rising insulin costs, Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.), co-chairs of the Senate Finance Committee, found that business practices and relationships among drugmakers and PBMs have driven “skyrocketing prices.”

“This industry is anything but a free market when PBMs spur drugmakers to hike list prices in order to secure prime formulary placement and greater rebates and fees,” Grassley said in a statement.

However, Grassley and Wyden’s report would hardly consider Amgen a victim in this story. 

Announcing the report, Wyden argued that “consumers are the only ones losing out in America’s broken drug pricing system, since every part of the pharmaceutical supply chain benefits from higher list prices.”

Interrogating Insulin
After a push from state regulators, ICER included insulin in its financial analysis, based on the “financial toxicity” of high list prices for uninsured patients, those with high-deductible plans, Medicare beneficiaries, and those who turn 26 and must transition from their parents’ insurance. 

Indeed, though it did not interrogate insulin studies to assess whether price increases were clinically supported, ICER found that while net insulin prices overall went down, four of the 10 drugs analyzed showed wholesale acquisition cost (WAC) increase substantially higher than medical inflation overall. One drug increased with medical inflation, and four remained flat at a rate that ICER had previously deemed high. Along with the Senate Finance Committee, diabetes patient advocates are deeply concerned by this trend.

“Inventors Frederick Banting and Charles Best sold the insulin patent for a mere $1 in the 1920’s because they wanted their discovery to save lives and for insulin to be affordable and accessible to everyone who needed it,” Carol Wysham, M.D., president-elect, Endocrine Society, wrote in a position statement published January 13 in The Journal of Clinical Endocrinology & Metabolism, pushing for government action to control skyrocketing costs. “People with diabetes without full insurance are often paying increasing out-of-pocket costs for insulin resulting in many rationing their medication or skipping lifesaving doses altogether.”

Balancing Innovation and Access
ICER hopes reports such as this one will keep costs down on drugs that provide limited clinical benefit without stifling the development of pioneering new drugs. It previously championed the most expensive drug in America, Zolgensma, as priced to value, saying its $2.1 million price tag is reasonable given that it completely cures an otherwise fatal childhood disease.

“But the only way we’re going to be able to afford the Zolgensmas of the country is if we stop overpaying for drugs that do far too little for patients,” Whitrap of ICER said. “We feel there is a way to do both, here: to keep the incentives alive for innovation and new research on drugs already on the market while also stopping costly increases for drugs where there is no evidence of a new benefit.”

https://www.abqjournal.com/1535539/time-to-make-drugs-more-affordable.html

By Rep. Angelica Rubio (D-Las Cruces)
Wednesday, January 13th, 2021

I was disheartened and angered to learn that nearly half of New Mexicans have skipped taking medication or not filled a prescription because of cost concerns, according to a recent statewide survey. That is unacceptable.

Medications don’t work if people can’t afford them.

That’s why I am introducing legislation to create a Prescription Drug Affordability Board. Until now, big drug companies have been the only businesses in the health care industry whose rates are not regulated. The Legislature can and must act to hold them accountable.

The survey, conducted by GBAO Strategies, found that 44% of New Mexicans skipped medication and nine in 10 are either very or somewhat concerned about the cost of prescription drugs. Those concerns are justified. A study released last month by the nonpartisan policy research group West Health Policy Center found “more than 1.1 million Medicare patients could die over the next decade because they cannot afford to pay for their prescription medications.”

Numerous studies have also shown how the big drug companies have taken advantage of the COVID-19 pandemic to raise prices on a wide range of medications needed to treat everything from respiratory disease to heartburn.

It is time for the state Legislature to step up and ensure all New Mexicans have access to affordable medications. A Prescription Drug Affordability Board (PDAB) would serve as an independent body with the authority to evaluate high cost drugs and set reasonable rates for consumers to pay.

The state regulates the cost of health insurance, electricity and other critical utilities and it ought to look out for consumers of prescription medications as well.

Maryland and Maine established PDABs in 2019, and in 2020, 13 states introduced legislation. The intent is to set the maximum amount purchasers and health insurers pay for the costliest drugs, which reduces costs and increases access for consumers and payors.

An affordability board can review information from public sources and establish an upper payment limit that allows an affordable way for everyone in the state who should get the drug access to it.

By setting an upper payment limit, PDABs regulate in-state costs for particular drugs among state-licensed health care providers. This is a common practice in the health care industry, where the upper payment limit caps what insurers can reimburse or what can be billed to a given purchaser.

The PDAB would consider a broad range of economic factors when setting appropriate payment rates for reviewed drugs, allowing pharmaceutical manufacturers the opportunity to justify existing drug costs. Staffing the board would be funded by a fee on pharmaceutical manufacturers.

The emperor has no clothes when it comes to the high prices charged by drug companies. Their profits and CEO salaries have skyrocketed over the past two decades as consumers have been forced to pay more. Americans pay four times as much for the same medicines as people in other countries.

New Mexico can fight back and protect our most vulnerable. This session we should create a Prescription Drug Affordability Board.

https://www.reuters.com/article/us-usa-healthcare-drugpricing-exclusive/exclusive-drugmakers-to-hike-prices-for-2021-as-pandemic-political-pressure-put-revenues-at-risk-idUSKBN2951Q2?il=0

The hikes come as drugmakers are reeling from effects of the COVID-19 pandemic, which has reduced doctor visits and demand for some drugs. They are also fighting new drug price cutting rules from the Trump administration, which would reduce the industry’s profitability.

The companies kept their price increases at 10% or below, and the largest drug companies to raise prices so far, Pfizer and Sanofi, kept nearly all of their increases 5% or less, 3 Axis said. 3 Axis is a consulting firm that works with pharmacists groups, health plans and foundation on drug pricing and supply chain issues.

GSK did raise prices on two vaccines – shingles vaccine Shingrix and diphtheria, tetanus and pertussis vaccine Pediarix – by 7% and 8.6%, respectively, 3 Axis said.

Teva Pharmaceuticals Inc hiked prices on 15 drugs, including Austedo, which treats rare neurological disorders, and asthma steroid Qvar, which together grossed more than $650 million in sales in 2019 and saw price hikes of between 5% and 6%. Teva hiked prices for some drugs, including muscle relaxant Amrix and narcolepsy treatment Nuvigil, as much as 9.4%.

More price hikes are expected to be announced on Friday and in early January.

In 2020, drugmakers raised prices on more than 860 drugs by around 5 percent, on average, according to 3 Axis. Drug price increases have slowed substantially since 2015, both in terms of the size of the hikes and the number of drugs affected.

The increases come as pharmaceutical companies like Pfizer are playing hero by developing vaccines for COVID-19 in record time. The hikes could help make up for lost revenue as doctors visits and new prescriptions plummeted during the global lockdown.

Pfizer plans to raise prices on more than 60 drugs by between 0.5 % and 5%. Those include roughly 5% increases on some of its top sellers like rheumatoid arthritis treatment Xeljanz and cancer drugs Ibrance and Inlyta.Slideshow ( 2 images )

Pfizer said it had adjusted the list prices of its drugs by around 1.3% across all products in its portfolio, in line with inflation.

“This modest increase is necessary to support investments that allow us to continue to discover new medicines and deliver those breakthroughs to the patients who need them,” spokeswoman Amy Rose said in a statement, pointing in particular to the COVID-19 vaccine the company developed with Germany’s BioNTech SE.

It said that its net prices, which back out rebates to pharmacy benefit managers and other discounts, have actually fallen for the last 3 years.

France’s Sanofi plans to increase prices on a number of vaccines 5 percent or less and will announce more price increases later in January, spokesperson Ashleigh Koss said.

None of the company’s price increases will be above the expected growth rate of U.S. health spending of 5.1 percent, she said.

Slashing U.S. prescription drug prices – which are among the highest in the world – was a focus of U.S. President Donald Trump, after making it a core pledge of his 2016 campaign. He issued several executive orders in late 2020 meant to cut prices, but their impact could be limited by legal challenges and other problems.

A federal judge earlier this month blocked a last-minute Trump administration rule aimed at lowering drug prices that was set to be implemented at the beginning of the year. It was challenged by drug industry groups including PhRMA, the nation’s leading pharmaceutical trade group.

President-elect Biden has also vowed to reduce drug costs and to allow Medicare, a U.S. government health insurance program, to negotiate drug prices. He has support from Congressional Democrats to pass such legislation, which the Congressional Budget Office has said could cost the industry more than $300 billion by 2029.

Reporting by Michael Erman, Editing by Nick Zieminski

https://www.globalbankingandfinance.com/category/news/ahf-thanks-hhs-for-clarifying-rules-on-340b-drug-pricing-blasts-pharmas-greed/

AIDS Healthcare Foundation (AHF) welcomed and praised an advisory opinion issued earlier today by the Office of the General Counsel for the United States Health and Human Services Department (HHS) which concluded that drug manufacturers are required to deliver discounts under the 340B Drug Pricing Program on covered outpatient drugs when contract pharmacies are acting as agents of 340B covered entities. (HHS press release)

The opinion came on the heels of widespread public pressure on HHS by safety net providers after nine rogue drug companies including Amgen, AstraZeneca, Eli Lilly, Merck, Novartis and Sanofi-Aventis, among others, announced they planned to refuse to continue to provide certain drugs at the legally required ˜340B price as required by section 340B of the U.S. Public Health Services Act.

In addition, 28 U.S. state attorneys general recently drew a line in the sand trying to protect this essential part of the healthcare safety net against the seemingly limitless greed of the drug industry. In a December 14 letter, the bipartisan group of elected attorneys general demanded that U.S. Health and Human Services Secretary Alex Azar take immediate steps to enforce the law to address drug companies unlawful refusal to provide critical drug discounts to covered entities such as community health centers under the 340B Drug Pricing Program.

On December 7, 2020, Senator Richard Blumenthal (D-CT) also spoke to reporters at a federal qualified health center in East Hartford, Conn., about drug manufacturers recent denials of 340B pricing on drugs shipped to contract pharmacies.

What the pharmaceutical drug companies are doing here is absolutely unconscionable and unacceptable, Blumenthal said. They are required by law to provide discounted drugs not out of the goodness of their heart, but because they participate in the Medicaid program that yields them tons of profit. They are making money from the Medicaid program, and one of the conditions for those profits is that they provide discounted drugs to federally qualified health care centers, to clinics, and hospitals, and others that serve the most vulnerable people in our society.

We thank HHS for really listening to safety net providers, the attorneys general and others in recognizingand checkingthe unbridled greed of the pharmaceutical industry. We also thank HHS for recognizing the crucial need the 340B programand the many contract pharmacies that provide services to 340B covered entitiesfulfills, particularly in more rural areas of the country, said Michael Weinstein, president of AHF. The 340B program represents at most just six percent of the industrys billions and billions in annual revenue, yet they are still not satisfied. Instead, they chose to break their contractual obligations underlining their participation in 340B and have now been taken to task by HHS. Thank you, HHS, for this important and very definitive opinion.

340B is a lifeline that allows nonprofit safety net providers, such as rural hospitals and HIV/AIDS clinics receiving funding through federal programs, to obtain prescription drugs at below-retail prices. It was established with bipartisan support as part of the Veterans Health Care Act of 1992. With 340B savings, Ryan White HIV clinics and other covered entities are able to stretch their grant funds, offer a wider range of services, and improve the quality of care for under-insured vulnerable populations, such as people living with HIV.

In todays advisory opinion, Robert P. Charrow, general counsel for HHS, wrote, ¦we conclude that to the extent contract pharmacies are acting as agents of a covered entity, a drug manufacturer in the 340B Program is obligated to deliver its covered outpatient drugs to those contract pharmacies and to charge the covered entity no more than the 340B ceiling price for those drugs.

AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and/or services to over 1.5 million individuals in 45 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia/Pacific Region and Eastern Europe. To learn more about AHF, please visit our website: www.aidshealth.org, find us on Facebook: www.facebook.com/aidshealth and follow us @aidshealthcare.

Ged Kenslea,Senior Director, Communications, AHF +1.323.791.5526 [cell] +1.323.308.1833 [work] gedk@aidshealth.org

John Hassell,National Director of Advocacy, AHF +1.202.774.4854 [cell] John.hassell@aidshealth.org

https://www.santafenewmexican.com/opinion/commentary/legislature-can-make-prescriptions-more-affordable/article_088b6578-4b1f-11eb-b7f0-1b6162f760cb.html

That’s why I am introducing legislation to create a Prescription Drug Affordability Board. Until now, big drug companies have been the only businesses in the health care industry whose rates are not regulated. The Legislature can and must act to hold them accountable.

The survey, conducted by GBAO Strategies, found that 44 percent of New Mexicans skipped medication and 9 in 10 are either very or somewhat concerned about the cost of prescription drugs. Those concerns are justified.

A study released recently by the nonpartisan policy research group, West Health Policy Center, found “more than 1.1 million Medicare patients could die over the next decade because they cannot afford to pay for their prescription medications.”

Numerous studies have also shown how the big drug companies have taken advantage of the COVID-19 pandemic to raise prices on a wide range medications needed to treat everything from respiratory disease to heartburn.

It is time for the state Legislature to step up and ensure all New Mexicans have access to affordable medications. A Prescription Drug Affordability Board would serve as an independent body with the authority to evaluate high cost drugs and set reasonable rates for consumers.

The state regulates the cost of health insurance, electricity and other critical utilities and it ought to look out for consumers of prescription medications as well.

The intent is to set the maximum amount purchasers and health insurers pay for the costliest drugs, which reduces costs and increases access for consumers and payors. An affordability board can review information from public sources and establish an upper payment limit that allows an affordable way for everyone in the state who should get the drug access to it.

By setting an upper payment limit, PDABs regulate in-state costs for particular drugs among state-licensed health care providers. This is a common practice in the health care industry, where the upper payment limit caps what insurers can reimburse or what can be billed to a given purchaser.

The PDAB would consider a broad range of economic factors when setting appropriate payment rates for reviewed drugs, allowing pharmaceutical manufacturers the opportunity to justify existing drug costs. Staffing the Board would be funded by a fee on pharmaceutical manufacturers.

The emperor has no clothes when it comes to the high prices charged by drug companies. Their profits and CEO salaries have skyrocketed over the past two decades as consumer have been forced to pay more. Americans pay four times as much for the same medicines as people in other countries.

New Mexico can fight back and protect our most vulnerable. This session we should create a Prescription Drug Affordability Board and make drugs more affordable for New Mexicans.

Angelica Rubio is a Democratic state lawmaker representing House District 35 in Las Cruces.

By Barbara Webber / Health Action New Mexico and Melissa Ontiveros / New Mexico Public Health Association 

New Mexicans continue to struggle to afford the prescription drugs they need, often having to choose between their medication and other necessities, such as rent and groceries. Drug costs were out of control before COVID, but are even worse now. The big drug companies have taken advantage of the pandemic to raise prices on 645 brands almost 6% in the first eight months of 2020, according to the data firm Analysource.

That is outrageous and unacceptable. It is critical the state legislature take action to help ensure that all New Mexicans have access to affordable medications, because drugs don’t work if people can’t afford them. By creating a Prescription Drug Affordability Board, as other states are doing, New Mexico can have an independent body with the authority to evaluate high-cost drugs and set reasonable rates for consumers to pay. 

Prescription drug companies are the only businesses in the health care industry whose rates are not regulated. It’s time to hold them to the same standard as all other health care providers. 

We’ve all heard the heartbreaking stories of profiteering in the pharmaceutical industry. Drug companies increased the cost of EpiPens, needed to save people’s lives when they have allergic reactions, from $100 to over $600. This endangers the lives of people who can’t afford them. They charge $94,000 a year for a breast cancer drug, $300,000 a year for a drug that treats infants who have seizures, and $60,000 for a sleep disorder drug for blind people. 

Meanwhile, the drug companies that produce these drugs make billions of dollars a year in profits. The Journal of the American Medical Association reports 35 big drug companies raked in $8.6 billion in profits between 2000 and 2018. Nine of the top 10 companies spend more money on marketing and advertising than they do on researching new drugs. There is no excuse for the high prices they charge. 

Enough is enough. Health Action New Mexico and AARP are part of a statewide coalition of health experts, patient advocates and consumers – the New Mexico Coalition for Affordable Prescriptions – urging our lawmakers to create a Prescription Drug Affordability Board and end the prescription drug price gouging that hurts our families and neighbors. 

The board would look at prescription drugs with costs that greatly impact New Mexicans, including high-cost, brand-name medications. High costs can prevent patients from accessing the prescription drugs they need, cause significant affordability issues for the state and threaten public health. 

The board would consider a broad range of economic factors when setting appropriate payment rates for reviewed drugs, allowing pharmaceutical manufacturers the opportunity to justify existing drug costs. Once a fair payment rate is determined, the board sets an upper payment limit that applies to all purchasers and payor reimbursements in New Mexico, ensuring lower costs benefit consumers. Staffing the board would be funded by a fee on pharmaceutical manufacturers. 

On average, Americans pay four times as much for the same medicines as people in other countries. As prescription drug companies continue to increase prices, even in the midst of a pandemic, it’s time to stand up to those who are harming vulnerable New Mexicans. We need controls to make drugs more affordable for people. New Mexico needs a Prescription Drug Affordability Board. 

https://www.abqjournal.com/1522746/nm-needs-prescription-drug-price-controls-ex-legislature-should-create-review-board-to-determine-charges.html

https://www.westhealth.org/press-release/study-predicts-1-million-deaths-due-to-high-cost-prescription-drugs/

WASHINGTON, DC and SAN DIEGO, CA – Nov. 19, 2020 – More than 1.1 million Medicare patients could die over the next decade because they cannot afford to pay for their prescription medications, according to a new study released today by the West Health Policy Center, a nonprofit and nonpartisan policy research group.

If current drug pricing trends and associated cost-sharing continue, researchers estimate cost-related non-adherence to drug therapy will result in the premature deaths of 112,000 beneficiaries a year, making it a leading cause of death in the U.S., ahead of diabetes, influenza, pneumonia, and kidney disease. Millions more will suffer worsening health conditions and run up medical expenses that will cost Medicare an additional $177.4 billion by 2030 or $18 billion a year for the next 10 years.

Researchers also modeled what would happen if Medicare was allowed to bring down drug prices for its beneficiaries through direct negotiation with drug companies, as described in H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, passed by the U.S. House of Representatives last year. They found Medicare negotiation could result in 94,000 fewer deaths annually. Additionally, the model found that the policy would reduce Medicare spending by $475.9 billion by 2030.

“One of the biggest contributors to poor health, hospital admissions, higher healthcare costs and preventable death is patients failing to take their medications as prescribed,” said Timothy Lash, President, West Health Policy Center. “Cost-related nonadherence is a significant and growing issue that is direct result of runaway drug prices and a failure to implement policies and regulations that make drugs more affordable.”

The price of prescription medications has skyrocketed in recent years. Between 2007 and 2018, list prices for branded pharmaceutical products increased by 159% and there are few signs of it slowing.[i] According to the Centers for Medicare & Medicaid Services (CMS), spending on prescription drugs will grow faster than any other major medical good or service over the next several years.[ii]

Under Medicare, beneficiaries must pay 25% of the cost of generic and brand-name medications. For many people with multiple chronic conditions, this could add up to thousands of dollars a year in out-of-pocket costs.

“The costs of doing nothing about high drug prices are too high especially when policy changes such as allowing Medicare to negotiate drug prices would result in saving millions of lives and billions of dollars,” said Sean Dickson, Director of Health Policy at West Health Policy Center and Chair of the Council for Informed Drug Spending Analysis (CIDSA), an independent group of experts on drug spending from leading academic institutions.

For the study, researchers developed a 10-year model representative of the majority of Medicare beneficiaries with chronic conditions. The model allows users to estimate how different levels of price reductions would lower the number of premature deaths and decrease Medicare spending on a sliding scale. The interactive tool and the complete technical report can be found on the CIDSA website.

https://www.salon.com/2020/11/27/our-worst-pre-existing-condition-big-pharma/

Before COVID, the headlines you might read about the pharmaceutical industry tended towards corporate malfeasance — violations of the Foreign Practices Corruption Act, insider trading, abusive mass marketing of opioids or predatory pricing, that sort of thing. Few think of such a notoriously manipulative industry as heralding medical breakthroughs.

But with a quarter of a million American deaths and another 12 million COVID cases, we are being told by the corporate news media these same companies are going to save life on the planet as we once knew it pre-pandemic.

Several months of worsening news about the pandemic, including decimating personal tragedies and loss on a scale not seen since the beginning of the last century, has reduced us to a childlike state looking for our parents that may already be dead.

Lost in transit

The mainstream news media agrees that Donald Trump’s attempts to derail the peaceful transition of power is reckless. Yet they have failed to critically examine his decision to have our nation defer to the profit-driven pharma sector the efforts to beat COVID. Indeed, the research to create a vaccine is almost entirely publicly-funded, though the effort has entrusted to the private sector with little oversight.

As Michael Hiltzik recently wrote in his Los Angeles Times op-ed entitled “The Colossal Problem of Publicly Funded Vaccines in Private Hands,” the Trump junta’s blank check is going to an industry that has long “profited from billions of dollars in government scientific research without returning anything to taxpayers.”

The U.S. Treasury’s largesse towards the multinational pharma profiteers includes not merely billions of dollars in taxpayer funded-research for them to profit off of, but also guaranteed orders for the millions of doses of vaccine from the government.

Hiltzik quotes Peter Maybarduk, director of the Access to Medicines Program at the non-profit Public Citizen, who suggests the US has “considerably slowed the global timetable” in the COVID fight “by bestowing billions in grants to companies “and asking them to develop manufacturing arrangements that are in their interest rather than pooling resources saying we’re going to teach the world how to make these vaccines and using all the available manufacturing capacity.”

There’s a tragic irony that we are relying so heavily on an industry that’s a pillar of our for-profit health care system — one that rations care and feeds off of scarcity and disease — to deliver us from a pandemic. 

The multinational pharmaceutical industry is the foundation of the American health care system that rations medical care based on the ability to pay. It has been its own kind of killer virus, and the industry permitted the proliferation of chronic diseases in the ranks of the poor and working classes — in turn serving as a form of race- and class-based social control, one that is increasingly revealing itself with each day’s new COVID body count.

As Reverend William Barber pointed out during the Democratic primary campaign of 2020, there was, long before COVID, a raging pandemic that fed off of poverty playing out daily. This pandemic lived below the corporate news media radar, and prematurely claimed the lives of 250,000 Americans every year.

Big pharma, and our winner-take-all economic system, is implicated in those deaths. Back in 2018, a report by the Harvard T.H. Chan School of Public Health, the Harvard Global Health Institute, and the London School of Economics found that the US paid twice as much as other high-income countries for health care only to get poorer population health outcomes.

“The main drivers of higher health care spending in the U.S. are generally high prices — for salaries of physicians and nurses, pharmaceuticals, medical devices, and administration,” the report’s researchers say.

Making a killing

It’s been the pharma companies, along with big tech firms like Amazon and Google, that have perfected the legal three-card-monte of profit-shifting to offshore jurisdiction hundreds of billions of dollars annually that starves public health care systems globally.

For decades, economists and public interest tax experts have flagged this accelerating “race to the bottom,” where multinationals and the holders of vast personal fortunes reduce or eliminate entirely their tax bill by pitting the nations of the world against each other.

This continued beggaring of local, state and national governments by the wealthiest, including pharma companies, comes as our public health sector crumbles under the weight of the resource scarcity that resulted from generations of this hoarding and hiding of profits often generated by taxpayer-funded research.

A nurse’s pay a second

Last week, thanks to the research generated by the international Tax Justice Network (TJN), we were able to quantify the scale of the impact of how pharmaceutical (and other) corporations have rigged tax codes to their advantage across the world.  

TJN reports that even as the world’s “pandemic-fatigued countries… struggle to cope with second and third waves of coronavirus,” they have been losing “over $427 billion in tax each year to international corporate tax abuse and private tax evasion, costing countries altogether the equivalent of nearly 34 million nurses’ annual salaries every year – or one nurse’s annual salary every second.” 

“Pharma companies like Pfizer, along with software and internet companies, have been the major players in global tax dodging and designing the new mechanisms since the later 1990s that move lots of profits to low tax jurisdictions in the form of untaxed royalties that they pay themselves to offshore companies that they own,” explains  James Henry, a New York based economist and lawyer who is a senior advisor  to TJN.

There are surely tens of thousands of committed scientists and technicians working at “warp speed” to develop a safe and effective vaccine out of a sense of moral duty. But we would be foolish to forget that big pharma itself is fueled by a maniacal pursuit of profits. And as an industry, it has shown the same kind of contempt for the law as the current occupant of the White House.

Above and beyond the law

Like Trump, Big Pharma are ruthless and unrepentant. Yet, because of the scale of the money involved in their crimes, our legal system actually shields them from personal criminal prosecution — as it did with the Wall Street banks in the Great Heist of 2008.

As it turns out, the most important duty for our Department of Justice, no matter which party controls the White House, appears to be to twist the law to preserve capital and keep great fortunes intact, while feigning to prosecute the corporate shell in the public interest.

This is critical, because today’s federal prosecutors and regulators are all-too-often the farm team for tomorrow’s over-compensated captains of industry.

Take Purdue Pharma, whose predatory marketing of the highly addictive opioid Oxycontin helped set off double-digit percentage spikes in drug overdose deaths that have killed more than 400,000 Americans since 1999.

In 2007, Purdue Pharma entered into a Department of Justice deal that required they plead guilty to a felony and pay a $600 million dollar fine for misleading and defrauding the public, including physicians, about their signature drug OxyContin.

Yet, some members of the bulletproof Sackler family, some of whom were heirs of the Purdue fortune, were allowed to transfer $10 billion out of their accounts between 2008 and 2018, according to an audit that was released while Purdue sought bankruptcy protection in September.

Last month, serial offender Purdue Pharma agreed to plead guilty to three federal crimes including producing highly addictive drugs “without legitimate medical purpose” in a deal with the Trump/Barr Department of Justice that was denounced as a “failure” by Massachusetts Attorney General Maura Healey.

“DOJ failed,” tweeted Healey. “Justice in this case requires exposing the perpetrators accountable, not rushing a settlement to beat an election. I am not done with Purdue and the Sacklers, and I will never sell out the families who have been calling for justice for so long.”

Walking wounded

Even before COVID, 140 million Americans struggled week to week trying to make ends meet, which they often did by cutting health care corners.

For three years before COVID hit, America’s life expectancy was on the decline. How many members of Congress sounded the alarm? The last time such a demographic event happened was in the years leading up to the First World War and the Spanish Flu epidemic, when 675,000 Americans, and 50 million people worldwide, died.

Currently, with more than 250,000 deaths here in the U.S. and 1.2 million globally, there seems to be something truly exceptional about America’s bout with the COVID scourge.

In the post-election interregnum, the prognosis is bleak. The U.S Treasury is sending out billions to Big Pharma, while rushing to close off access to Federal Reserve borrowing for small businesses and local governments. Unemployment benefits for 12 million Americans sidelined by COVID are set to run out the day after Christmas.

Just as individuals may have preexisting conditions that make them more susceptible to COVID-19, so does our economic system, which lets tens of millions of families teeter on the edge so as to provide the cheap labor on which billionaires’ fortunes rely.

There can be no honest critique of how we got here without noting “the gross failure of the U.S. private, profit-driven, capitalist medical-industrial complex (four industries: doctors, drug and device makers, and medical insurance firms)” who “decided not to prepare for a serious virus problem,” writes economist Richard Wolff in his latest book “The Sickness is the System.”

Our only enduring remedy is radical change.

Commentary: Citing new data that big drug companies have taken advantage of the COVID-19 pandemic to raise prices on hundreds of medications, AARP New Mexico, Health Action New Mexico and a statewide coalition of health experts, patient advocates and consumers today launched New Mexico Consumers for Affordable Prescriptions (NMCAP), calling on legislators to ensure all New Mexicans have access to affordable drugs. 

“New Mexicans continue to struggle to afford the prescription drugs they need,” said Barbara Webber, Executive Director of Health Action New Mexico. “Drug costs were out of control before COVID, but it is even worse now. No one should have to choose between their medication and other necessities, like rent and groceries.” 

According to the data firm, Analysource, pharmaceutical companies have taken advantage of the pandemic to raise prices on 645 brands almost six percent in the first eight months of 2020.

• On average, Americans pay four times as much for the same medicines as people in other countries.
• The Journal of the American Medical Association reports 35 big drug companies raked in $8.6 trillion in profits between 2000 and 2018.
• Nine of the top ten companies spend more money on marketing and advertising than they do on researching new drugs.

“Enough is enough,” said Joseph P. Sanchez, AARP New Mexico State Director.  “Even before COVID-19, Americans were paying the highest drug prices in the world. It is unconscionable that prices may have increased even more during the pandemic. New Mexico needs an independent body that can evaluate drug costs and set reasonable rates for consumers to pay. With the establishment of the Prescription Drug Affordability Board, New Mexicans will have an advocate to ensure they are not being price gouged by drug companies.”

The coalition launched a website, www.newmexicocap.org, to educate and activate New Mexicans on state policy options to reduce drug costs. A Prescription Drug Affordability Board (PDAB) would regulate prescription drugs with costs that greatly impact New Mexicans, including high-cost, brand name medications. High costs can prevent patients from accessing the prescription drugs they need, cause significant affordability issues for the state and threaten public health.  

The Board would consider a broad range of economic factors when setting appropriate payment rates for reviewed drugs, allowing pharmaceutical manufacturers the opportunity to justify existing drug costs. Once a fair payment rate is determined, the Board sets an upper payment limit that applies to all purchasers and payor reimbursements in New Mexico, ensuring that lower costs benefit consumers. Staffing the Board would be funded by a fee on pharmaceutical manufacturers.

“Prescription drug companies are the only businesses in the health care industry whose rates are not regulated. It’s time to hold them to the same standard as all other health care providers. Creating a Prescription Drug Affordability Board is a commonsense solution to hold big drug companies accountable and drive down the cost of prescription drugs,” Webber said.

Source: https://www.krwg.org/post/consumer-and-health-advocates-launch-campaign-take-high-cost-drugs-new-mexico

FOR IMMEDIATE RELEASE

CONTACT: Barbara Webber, Executive Director, Health Action New Mexico
505-508-6531 (cell) barbara@healthactionnm.org

ALBUQUERQUE, NM – Citing new data that big drug companies have taken advantage of the COVID-19 pandemic to raise prices on hundreds of medications, AARP New Mexico, Health Action New Mexico and a statewide coalition of health experts, patient advocates and consumers today launched New Mexico Consumers for Affordable Prescriptions (NMCAP), calling on legislators to ensure all New Mexicans have access to affordable drugs.

“New Mexicans continue to struggle to afford the prescription drugs they need,” said Barbara Webber, Executive Director of Health Action New Mexico. “Drug costs were out of control before COVID, but it is even worse now. No one should have to choose between their medication and other necessities, like rent and groceries.”

According to the data firm, Analysource, pharmaceutical companies have taken advantage of the pandemic to raise prices on 645 brands almost six percent in the first eight months of 2020.

• On average, Americans pay four times as much for the same medicines as people in other countries.
• The Journal of the American Medical Association reports 35 big drug companies raked in $8.6 trillion in profits between 2000 and 2018.
• Nine of the top ten companies spend more money on marketing and advertising than they do on researching new drugs.

“Enough is enough,” said Joseph P. Sanchez, AARP New Mexico State Director.  “Even before COVID-19, Americans were paying the highest drug prices in the world. It is unconscionable that prices may have increased even more during the pandemic. New Mexico needs an independent body that can evaluate drug costs and set reasonable rates for consumers to pay. With the establishment of the Prescription Drug Affordability Board, New Mexicans will have an advocate to ensure they are not being price gouged by drug companies.”

The coalition launched a website, www.newmexicocap.org, to educate and activate New Mexicans on state policy options to reduce drug costs. A Prescription Drug Affordability Board (PDAB) would regulate prescription drugs with costs that greatly impact New Mexicans, including high-cost, brand name medications. High costs can prevent patients from accessing the prescription drugs they need, cause significant affordability issues for the state and threaten public health. 

The Board would consider a broad range of economic factors when setting appropriate payment rates for reviewed drugs, allowing pharmaceutical manufacturers the opportunity to justify existing drug costs. Once a fair payment rate is determined, the Board sets an upper payment limit that applies to all purchasers and payor reimbursements in New Mexico, ensuring that lower costs benefit consumers. Staffing the Board would be funded by a fee on pharmaceutical manufacturers.

“Prescription drug companies are the only businesses in the health care industry whose rates are not regulated. It’s time to hold them to the same standard as all other health care providers. Creating a Prescription Drug Affordability Board is a commonsense solution to hold big drug companies accountable and drive down the cost of prescription drugs,” Webber said.