Direct quote from Leonard Schleifer, the 66-year-old co-founder and CEO of Regeneron. Do tell, Lenny – we call him Lenny. According to Schleifer, the difference between a $10,000 drug with a $4,000 rebate and a drug simply priced at $6,000 is that the former lets the benefit manager crow about the savings it delivers and pass money back to the company buying the health plan (not the patient). He would like to see the rebate system go away. What’s this? A pharma executive who believes in “transparent” pricing? Yep. But it’s not completely altruistic as Schleifer’s drive is for the industry to police itself before the government steps in. The article cited above is a good read/story of Regeneron, and Schleifer puts his money where his mouth is when Regeneron submitted to external reviews to come up with fair prices for Dupixent and their cholesterol treatment.
The Department of Health and Human Services has directed the FDA to consider the importation of foreign drugs to address price spikes. The proposed policy would only apply to drugs unaffected by patent or exclusivity, in an effort to avoid intellectual property issues. However, pharma companies may still have something to say through their lawyers if such a policy were to be implemented, especially as an act of a federal agency instead of legislation. If it were implemented though, it would avoid patient access issues in situations like when an HIV medication jumped in price from $13.50 to $750, which had the incredibly unfortunate side effect of catapulting Martin Shkreli’s infinitely punchable face into the limelight. That drug still costs $750 by the way. Or just 5-10 cents in India.
Pfizer announced price increases on about 40 drugs at the beginning of July. But after discussions with President Donald Trump and Health & Human Services Secretary Alex Azar, they’ve decided to cut-it-out. Trump had lambasted drug companies earlier in the week for price increases, noting that other markets like Europe get lower prices. After their meeting, Pfizer decided to roll-back the increases to pre-July figures, “to give the president an opportunity to work on his blueprint to strengthen the healthcare system and provide more access for patients.” And they’re leaving the price drops announced at the beginning of the month intact. The hikes aren’t completely gone though, Pfizer’s just holding off until 2019 or until that aforementioned blueprint takes effect. For a (pink) blueprint you don’t have to wait for, click here.
According to a new report by the IQVIA Institute for Human Data Science, spending on cancer therapies has doubled over the past 5 years. And the retail price tag on these drugs is up, too. The average retail price of the 2017 launches was over $150,000, compared to $79,000 for those launched in 2013. You know, when they were practically garage sale prices. But before we get our knickers in a twist, IQVIA reports the average annual out-of-pocket spend for someone with commercial health insurance was just $500. With 1.7 million cancer diagnoses and over 600,000 deaths in the US alone forecast for 2018, that doesn’t seem like such a bad deal.
What is “it,” you ask? Spark Therapeutics’ new gene therapy Luxturna which can cure blindness in a single treatment. The condition causing the blindness only affects a few thousand people, so the FDA has designated it as an orphan drug. The single dose and orphan drug aspects of this gene therapy combine for a rather expensive R&D bill, and translate into a bit of sticker shock at the selling price: $425,000 per eye. Spark is trying out some interesting commercialization practices to get the drug to patients, like giving rebates to patients whose eyes don’t see better over time. They’re also considering selling the therapy directly to insurance companies so that health care providers don’t have to pay and store the treatment without a guarantee it’ll ever be used.
Replacing President Trump’s initial pick to lead the US Health and Human Services department is recent Eli Lilly alum Alex Azar. Trump expects that experience will give him a good grip on how to better deliver healthcare and lower drug prices. However, some critics are unhappy about the appointment of a “Big Pharma” figure to run the US’ most well-funded department. Eli Lilly and other large drug makers like Johnson & Johnson and Merck have actually made some advances in drug pricing transparency recently. Earlier in 2017 they released high-level reports explaining price hikes, and shifted the blame for high healthcare costs to other players like PBMs. However, these too were criticized for not being granular enough. Well, you can’t please everyone.
Hepatitis C is expensive to treat, which is why a lot of patients don’t get treated for it, and that possibly contributes to why it’s the deadliest infectious disease in the US. It’s gotten to the point where states are considering legal challenges to those precious patent laws that pharma typically spends a lot of money on to make sure no one touches. So, in the fight to increase Hep C treatment, in one corner we have legal challenges, and in the other we have good ol’ market forces. Abbvie’s new Mavyret costs well less than half the amount of some existing treatments, and it can treat all six strains of the infection. Your move competition, may the markets be ever in your favor.
Have you ever looked at the online sex offender registry for your neighborhood? Not reassuring, right? Well, it looks like the state of California may soon have a similar system for drug makers. On Governor Jerry Brown’s desk is a law that would require drug manufacturers to give the state notice of price increases so that these can be posted on the internet. Even the slightest of cynics would wonder if this is being done simply to increase public (and media) pressure on a drug company that might otherwise be tempted to act like a total Shkreli. While this seems like a slam dunk for a left-leaning state like California, recall the ballot initiative that failed last November that would have capped the cost of certain drugs at the price paid by the US Department of Veterans Affairs. Strange days.