News & Views: 5/4 - 5/10

May 11, 2021

The House Committees on Energy & Commerce and Education & Labor held legislative hearings on lowering the cost of prescription drugs.

The Democrats of both committees focused their questions on how H.R. 3 would work to lower costs for patients and address the real cause of high prices, while H.R. 19 puts industry concerns over patient concerns. The Republican members of both committees argued that H.R. 3 is an aggressive power grab that will only cause a reduction in access to drugs and lead to lose of innovation and American jobs. To watch the Energy & Commerce hearing, click here. To watch the Education & Labor hearing, click here.

ICER estimated Biogen’s Alzheimer’s drug, aducanumab, should be priced as low as $2,500 to be cost-effective.

Aducanumab has been being closely watched, as it is the first potential treatment for Alzheimer’s, however the FDA advisory board voted against its approval due to less than ideal clinical trial results. Wall Street analysts had previously estimated that the drug would be priced between $50,000-$70,000 due to the significant burden that Alzheimer’s disease is. Yet, even when only considering the positive trail results, ICER’s estimate for cost-effective price was at most $23,100. To read the full report, click here.

Incyte is the most recent large drug manufacturer to be found to paying illegal kickbacks.

Incyte had been the sole donor to an independent foundation that had been helping Medicare and TRICARE beneficiaries pay the copay for the drug Jakafi, which is used to treat blood cancer myelofibrosis. However, shortly after the foundation opened, Incyte helped patients without a myelofibrosis diagnosis file applications for the assistance and file false reimbursement claims through Medicare and TRICARE. Following the settlement, the Department of Justice released a statement on how programs like this that help manufacturers avoid anti-kickback rules are just one reason why drug prices are so high in the US. To read the entire article, click here.

  • To read the DOJ’s statement on the settlement, click here.

Researchers from the Schaeffer Center for Health Policy and Economics at USC published their analysis of out-of-pocket costs for competitive drugs when Part D beneficiaries do not directly benefit from rebates in JAMA.

Between 2015-2018, rebates have nearly doubled, however for every additional dollar of rebate, there has been a $1.17 increase in list prices. While the rebates have contained net prices, the continual list price increase has caused patients to pay more out-of-pocket each year. The study concluded that the existing rebate system does not benefit patients paying list price-based coinsurance, particularly when it is for a competitive drug. To read the full study, click here.

Researchers from Brigham and Women’s Hospital published their study of the correlation between changes in brand name drug prices and out-of-pocket costs in JAMA.

The study looked at commercially insured patients with varying pharmacy benefits to determine how changes in the price of brand drugs impacts the patient’s out-of-pocket costs. The study concluded that patients who only pay prescription copays are protected from increases in their drugs’ prices; however, the majority of patients pay deductibles or coinsurance which are not protected from price increases. To review the entire study, click here.  

CIDSA Experts in the News

Sean Dickson was on 340B Insight podcast by 340B Health to discuss his research on how 340B fits into the larger drug pricing policy discussion. To listen to the full podcast, click here.

Rachel Sachs testified in front of the House Energy & Commerce’s Health subcommittee on drug pricing policies. Sachs was questioned by the majority of the members on how the titles in H.R. 3 work with each other to effectively lower drug prices. She also discussed how H.R. 19 would be an ineffective attempt to lower prices. To read her written testimony or watch the hearing, click here.

Ameet Sarpatwari and colleagues examined the impact of brand competition has on the net price of diabetes drugs in the most recent Health Affairs issue. The researchers compared changes in inflation-adjusted, revenue-weighted mean list and net prices of a one-month supply of three classes of diabetic drugs between 2005 to 2017. They found annualized list prices of all drug classes studied increased by 8 to 15%, whereas the annualized change in net price changed by -9 to +10%. To read the full study, click here.  

Mariana Socal testified in front of the House Education& Labor’s HELP subcommittee on drug pricing reform. Socal was questioned on and testified primarily on how H.R. 3 is the only current proposal that would allow all insured patients to directly benefit rather than benefiting the industry. To read her written testimony or watch the hearing, click here.

View Full Article
Want to submit an Insight to be featured by CIDSA?
If you have performed research or written opinion pieces we want to see them. Please use the link below to submit your work.
Back to all Insights >