HAPPY NEW YEAR
A Decade Marked By Outrage Over Drug Prices
Martin Shkreli, the former CEO of Turing Pharmaceuticals, who was called before Cummings’ committee in2016. After hiking the price of an old drug for parasitic infections to $750 a pill from $13.50, Shkreli became the poster boy for pharmaceutical greed that helped define the past decade.
Meanwhile, nearly 1 in 4 Americans has trouble affording prescription drugs, according to a Kaiser Family Foundation poll.
Of relevance, perhaps to our NA members, Daraprim: An old drug gets a huge new price
For decades, Daraprim has been the go-to medicine for treating toxoplasmosis, a parasitic infection especially dangerous for people with compromised immune systems, such as people living with HIV and patients who’ve undergone organ transplants.
The drug was approved by the Food and Drug Administration in 1953, and its patents expired long ago. But there wasn’t a generic version available, and there was only one supplier in the United States. Even so, Daraprim cost just $13.50 a pill in early 2015.
Then Turing Pharmaceuticals bought the rights to the drug and raised its list price more than 5,000% overnight.
Another company called Valeant did the same year when it bought two old heart drugs — Isuprel and Nitropress — that had little competition.
Despite public outcry, Daraprim’s price hasn’t budged.
Today, many health insurance companies won’t pay for the drug, and it’s too expensive for many hospitals to keep in stock, says Armstrong. As a result, she says, doctors have been forced to turn to cheaper alternatives that have more side effects and less proof that they work.
Then there is EpiPen, used to counteract allergic reactions.
By the time the EpiPen’s list price reached $300 per auto-injector in 2016, its manufacturer, Mylan, had made more than a dozen price hikes in just six years.
People clamored for a cheaper generic of the product, which injects a dose of epinephrine to counteract allergic reactions. Mylan had a virtual monopoly on it. In the spring of 2016, the FDA had rejected two applications from other firms that wanted to make generic versions.
State and federal lawmakers took notice. For years, they had been passing laws that pushed for schools and other public places to have EpiPens on hand.
Mylan started offering its own generic at half the price in December 2016 and left the price of its brand-name product where it was. Mylan’s new version is called an authorized generic. These are usually introduced to undercut competition from other companies’ generics — and eat into some of the competitors’ profits.
Next consider Sovaldi: a first-of-its-kind hepatitis C drug, priced at $1,000 per pill. To rid a patient of the hepatitis C virus would cost $84,000 per person.
State health systems struggled to pay for the treatment, and health insurers denied the drug to all but the sickest patients. An investigation led by Iowa Republican Sen. Chuck Grassley and Oregon Democratic Sen. Ron Wyden found that state Medicaid programs spent more than $1 billion on the drug in 2014, but less than 2.4% of Medicaid patients with hepatitis C got Sovaldi.
Now, there are a few other brand-name hepatitis C cures on the market, creating some competition.
Finally: Insulin
After insulin was discovered nearly 100 years ago, the rights to it were transferred to the University of Toronto for $1 so that insulin could be made widely available at a low cost.
But insulin prices have continued to creep upward at a rate that’s higher than inflation. As a result, some patients have rationed their medicine, skipping doses or cutting them in half.
In 2017, a group of patients sued the three major insulin-makers — Sanofi, Eli Lilly and Novo Nordisk — when they noticed that the companies were increasing their prices in lockstep.
When Congress and the media took notice, the price hikes mostly stopped, but prices didn’t drop.
In December, the House passed a bill to lower prescription drug prices. The proposed legislation would allow the government to negotiate prices of some drugs prescribed to Medicare patients, cap Medicare patients’ out-of-pocket costs for prescription medicines and penalize drugmakers for raising prices faster than inflation. But the Senate isn’t expected to move forward on the House bill, and the White House has vowed to veto it.
Democratic-Led States Ask Supreme Court For Fast Review of Obamacare Ruling
A coalition of 20 states led by Democrats has asked the U.S. Supreme Court to fast-track a review of a recent court ruling that the Affordable Care Act’s requirement that Americans have health insurance is unconstitutional.
The coalition, led by California Attorney General Xavier Becerra, would likely get a hearing and a decision by this summer, before the November elections, the Associated Press reported.
While it would be unusual for the Supreme Court to agree to such a timetable, it would not be unprecedented, the AP reported.
“The lower courts’ actions have created uncertainty about the future of the entire Affordable Care Act, and that uncertainty threatens adverse consequences for our nation’s healthcare system, including for patients, doctors, insurers, and state and local governments,” the states’ filing read.
There was no immediate reaction from the Trump administration, the AP reported. President Donald Trump had hailed the latest ruling, calling it “a win for all Americans.”
Prescription drug pricing is an important issue in the 2020 presidential election.
Every Democratic presidential hopeful from the Senate has sponsored legislation centered on lowering prescription drug costs, and the remaining candidates have pushed their own proposals on the campaign trail.
Several candidates back legislation empowering the Department of Health and Human Services to negotiate directly on prescription drug prices with manufacturers for patients covered under Medicare Part D.
Candidates have supported legislation to enable direct government regulation or control of prescription drug prices beyond Medicare Part D. Finally, they have supported legislation enabling the importation of prescription drugs from Canada.
Be sure to research what all candidates suggest in the run up to the General Election this year and check our resources at nabwmt.org
Sources: NPR, HealthDay
https://www.healthaffairs.org/do/10.1377/hblog20190826.689286/full/
