AHIP Launches Campaign Tearing into Pharma for Drug Prices
AHIP, representing members of the US health insurance industry, is targeting pharma in its latest ad campaign. The campaign lays the blame for high prescription drug prices at pharma’s feet, highlighting anti-competitive practices, unjustified price hikes, and high profit margins for the largest pharmaceutical companies. However, pharma argues that payers themselves contribute to the problem.
Relentless Health Value Podcast: Talking Medicare Drug Pricing Negotiations with Dr. Peter Neumann
In the latest episode of the Relentless Health Value podcast, host Stacey Richter sits down with Peter Neumann, ScD, of the Center for the Evaluation of Value and Risk in Health (CEVR) at Tufts University to discuss upcoming Medicare drug pricing negotiations. The two discuss how pricing negotiations will account for value and what effects they will have on drug prices for patients.
PhRMA Not a Fan of CMS Drug Price Negotiation Plans
Just as the US Centers for Medicare and Medicaid Services (CMS) closed its public comments for the initial draft guidance for its upcoming Medicare drug price negotiations process, the pharma industry group PhRMA has laid out its complaints in a 76-page letter delivered last week. The comment window, only one month long, was a sticking point for the group.
PhRMA Calls Foul on CMS Policy to Destroy Documents After Price Negotiations
The latest guidance from the US Centers for Medicare and Medicaid Services (CMS) contains a clause that states that manufacturers must destroy all documents from the agency within 30 days after a therapeutic is no longer considered a selected drug. PhRMA, a major industry group, claims this practice is unconstitutional and overreaching, making the process less transparent.
Cigna PBM Announces New Pricing Strategy
Cigna has announced a new pricing plan for its pharmacy benefit manager (PBM) arm that it promises will lead to increased transparency. The move comes as the PBM industry faces increasing public scrutiny over its lack of transparency and allegations of anti-competitive practices that drive up drug prices for patients and payers.
Public Comments Closing for Medicare Drug Pricing Negotiations
As the window for public comments on the US Centers for Medicare and Medicaid Services’ (CMS’s) plan to negotiate Medicare drug prices comes to a close, Republican lawmakers and pharmaceutical companies seem to be in agreement with their complaints. A group of congress members from both the Senate and House argue that the plan will hurt patients, providers, and caregivers if implemented.
US Insulin Pricing Looks Set to Change Across the Board
With new legislation and moves from major insulin producers, the US insulin market is set to see even more changes over the coming months. The process began with a $35 Medicare price cap on the drug enshrined in the Inflation Reduction Act, a cap mirrored shortly by Sanofi, Novo Nordisk, and Eli Lilly. Upcoming legislation may cap the price of the life-saving diabetes medication for all patients.
CMS Sets Date for Medicare Drug Price Negotiation Final Guidance for July
The US Centers for Medicare and Medicaid Services (CMS) will aim to release the final draft guidance on the upcoming Medicare drug pricing negotiations instantiated by the passage of the Inflation Reduction Act. The draft guidance was released last month and is currently open for comments. The agency, according to its administrator Chiquita Brooks-Lasure, has already begun talks with manufacturers.
Internal Tensions Brewing in Generics Industry Group
The Association for Accessible Medicines, a trade organization for drugmakers producing generics, is undergoing an internal riff that may jeopardize its lobbying power. This follows substantial financial losses and a series of high-profile layoffs. Group insiders lay part of the blame on the board of directors who they argue repeatedly fumbled key organizational decisions.
Drug Purchasing Group Sues Takeda Over Gout Drug Pay-For-Delay Deal
Takeda is once again in hot water over allegations it participated in a pay-for-delay deal, this time over its gout drug Colcrys. The plaintiffs, a group of drug distributors, claim that Takeda patent settlements with several generics manufacturers delayed the release of cheaper alternative, preventing price drops for the millenia-old drug.
Patient-Reported Data Collection to Grow Through Medicare Drug Pricing Negotiations
A recent guidance from the US Centers for Medicare and Medicaid Services (CMS) stated that patient experiences will be factored into the upcoming Medicare drug pricing negotiations. As a result, patient-reported data collection is set to grow significantly. However, significant uncertainty surrounds the process and meeting as of yet unset parameters for the datya.
Mark Cuban’s Pharmacy Offers Invokana
Mark Cuban’s Cost Plus Drug Company has announced it now offers Invokana, an SGLT-2 inhibitor used to manage diabetes. The mail-order pharmacy will now provide a total of three brand name versions of the drug, Invokana, Invokamet, and the combination therapy Invokamet XR, which pairs the drug with metformin.
US Senators Propose Bill to Cap Insulin Costs for Every Patient
US Senators Raphael Warnock (D-GA) and John Kennedy (R-LA) have advanced a new bill that would lock the max price of insulin at $35 a month for all patients. The bill, entitled the Affordable Insulin Now Act of 2023, comes after manufacturers have voluntarily lowered insulin prices following price caps for Medicare patients in the Inflation Reduction Act.
CMS Trims Down List of Drugs Targeted for Price Hike Penalties
The US Centers for Medicare and Medicaid Services (CMS) has pulled 7 drugs from its list of medicines facing penalties for drug price hikes. The Inflation Reduction Act included a provision that would penalize drug manufacturers for raising the price of drugs faster than inflation. This brings the total down to 20 drugs.
HHS Shoots Down Call to Use March-In Rights for Xtandi
In a win for Pfizer and Astellas, the US Department of Health and Human Services decided against using march-in rights to lower the price of Xtandi, a blockbuster prostate cancer drug. Exercising march-in rights would the government to share patents made using public funds with third-party manufacturers if a drug is difficult to access and is priced too high.
Takeda Reveals Pricing for Dengue Vaccine
Fresh off approval of its dengue vaccine in Brazil, Takeda has announced its pricing strategy for the shot. Prices will be determined by endemic status of the disease in a given country. Indonesia, where the virus is endemic, will see the vaccine priced at $40 per dose, while travel markets like Germany will pay $115 a shot.
US Congress Preps for Health Spending Battle
As US Republicans ramp up their ongoing fight to cut government spending, Department of Health and Human Services (HHS) Secretary Xavier Beccera will stand before the Senate Finance Committee this Wednesday. Republicans have their sights set on a proposed policy by the Centers for Medicare and Medicaid Services (CMS) that would lower payouts for drugs approved under accelerated review.
Sanofi Cuts Insulin Prices and Sets Out-of-Pocket Price Cap
Hot on the heels of Novo Nordisk and Eli Lilly, Sanofi announced it will cut the price of its main insulin formulation, Lantus, in January of next year. Just outstripping the others, the cuts amount to a 78% price drop for the life-saving drug used by millions of people with diabetes. In addition, Sanofi set an out-of-pocket cap of $35 a month for patients.
US CMS Releases Guidance on Upcoming Drug Price Negotiations
The pharma and biotech industry has waited with bated breath for more information on impending drug price negotiations with the US Centers for Medicare and Medicaid Services (CMS) that begin in 2026. The agency released its guidance on the process, laying out the process in detail. CMS has also put out a call for feedback. Responses are due by April 14th.
US HHS Picks 27 Drugs for Inflation Rebates
A recent rule will let the US Department of Health and Human Services (HHS) require drugmakers to pay back rebates on drugs that increase in price faster than inflation. The department has announced its list of the first 27 drugs to face this process, including therapeutics from pharma giants like Pfizer, Gilead, and AbbVie.
Novo Nordisk Announces 75% Price Drop on Insulin in US
Novo Nordisk has announced it will cut US insulin list prices by 75%, following in the footsteps of Eli Lilly who announced a $35 dollar a month copay price cap a few weeks prior. The news is a relief to patients and advocacy groups who’ve long protested the high prices of the drug, which is manufactured at a tiny fraction of the price. The trend comes after legal troubles for several pharma companies over US insulin prices.
Which Drugmakers Will Face US Drug Pricing Negotiations in 2026?
Although many likely contenders have been named, the first slate of drugs to face Medicare drug pricing negotiations in 2026 is yet to be determined. The first 10 drugs to be selected will be announced in September, likely including cancer drugs from AbbVie and Pfizer and BMS’s blood thinner Eliquis, among others.
Pharma’s Take on Drug Pricing Data Transparency in South Korea
Korea’s drug pricing policies are complex and lack transparency, according to Eli Lilly Korea’s General Manager Christopher J. Stokes. Stokes notes that he has spent considerable time talking with other pharma leaders, who generally agree with his take on the complicated nature of the South Korean Market.
Bristol Myers Scraps Cancer Drug Launch in Germany Over Pricing
Bristol Myers Squibb’s (BMS) cancer drug Opdualag will not be launched in Germany for the foreseeable future, despite its EU approval last September. The decision was made due to pricing conflicts with a 2010 drug pricing law in the nation that requires evidence that a new drug has a benefit over current alternatives. While clinical trial data showed the drug to be more effective than the standard of care in treating advanced melanoma, the endpoints used are a sticking point for the Gemeinsamer Bundesausschuss (G-BA).
Biden Administration Looks into Expanding Reach of Medicare Drug Pricing Negotiations
During a statement about his administrations budgetary plans, US president Joe Biden argued that more drugs should undergo Medicare pricing negotiations. In addition, he called on the process to go more quickly, considering that only a small number of drugs will be negotiated starting in 2026 under the Inflation Reduction Act.
