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Morning Briefing

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Tuesday, Jun 25 2019

Full Issue

Perspectives: The Science And Economics Of Drugmaking Has Changed, But The Way We Pay For Them Hasn't

Read recent commentaries about drug-cost issues.

Many Americans are angry and worried about the price of prescription drugs. Yet underneath the anecdotes and headlines, a deeper, more consequential issue is often ignored. A major transformation in the drug industry has occurred in recent years — and continues today. The science and economics of the pharmaceutical industry have fundamentally changed, but the way we pay for medicines has not. We essentially have 21st-century drugs with a 20th-century payment system. It’s like using a 1999 road atlas in the era of Google Maps. There’s been a huge shift, and few policymakers understand its implications or what to do about it. (Rep. Devin Nunes, 6/20)

Patients who come to the Havelhöhe cancer clinic in the leafy outskirts of Germany’s capital are often very sick. Struggling with advanced-stage cancers, many need strong doses of expensive, cutting-edge chemotherapy that can run into the hundreds of thousands of dollars. But like all Germans, none of the patients sitting quietly in the infusion ward here pay more than 10 euros a prescription, or about $11. “We never talk about costs,” said Dr. Burkhard Matthes, a senior oncologist at the clinic. (Noam N. Levey, 6/19)

When the maker of the top-selling arthritis drug says it’s buying a leader in anti-wrinkle treatments, you’d be forgiven if your initial response to the news was that it seems like a match made in heaven. But take a closer look, and AbbVie Inc.’s $63 billion purchase of Botox maker Allergan Plc isn’t such a perfect fit. AbbVie is desperate for diversification as sales of its $19 billion arthritis blockbuster Humira begin to slow; in Allergan, it has the opportunity acquire a rival at a relative bargain. Even at a 45% premium to Allergan’s closing share price Monday, AbbVie is paying a fraction of what the drugmaker was worth just a couple of years ago, and Botox is still growing. (Max Nisen, 6/25)

The presidential debate stage is never the first place to look for objective analysis. Candidates are looking to score political points, not solve vexing problems. Keep that in mind when Democratic presidential hopefuls take the stage in Miami for two nights of debates, particularly if the issue of prescription-drug prices comes up. You will probably hear about how prices are skyrocketing and pharmaceutical companies alone are to blame for the soaring costs of American healthcare. What you won’t hear is that prescription drugs represent a relatively small slice of the overall healthcare market or that overall spending on these drugs has slowed dramatically in recent years, especially compared with other health costs. (Patrick O'Connor, 6/25)

Earlier this month, the Food and Drug Administration announced the creation of Project Facilitate. This pilot program facilitates access to innovative treatments for cancer that have not yet been approved by individuals who aren’t able to enroll in clinical trials. This move suggests that the FDA finds the approval process for cancer drugs to be too slow. (Jason Shafrin, 6/21)

The longstanding debate in the United States on its sky-high prescription drug prices and access to health care is raging where you might least expect it — within the pages of President Trump’s new trade deal: the U.S.-Mexico-Canada Agreement (USMCA).  Critics of the USMCA are very concerned that it would increase medicine prices in North America and strengthen the hand of one of the world's most powerful industries.  At Boston University’s Global Development Policy Center and School of Public Health, we have been studying the impact of trade treaties on access to medicines and can confirm that there is real truth to these concerns. They require policy action. (Veronika J. Wirtz, Warren A. Kaplan and Kevin Gallagher, 6/23)

Massachusetts is a relatively affluent state with near universal health insurance coverage. But even here, a new WBUR poll finds that a large majority of Massachusetts residents say the cost of prescription drugs is too high, and most place the blame squarely on the shoulders of pharmaceutical companies and health insurers. Three-quarters of residents (76%) call the cost of prescription drugs unreasonable. Another two-thirds (67%) call drug costs a “major problem” with Massachusetts’ health care system, second only to the high cost of health insurance. And nearly as many (61%) hold an unfavorable opinion of pharmaceutical companies. (Maeve Duggan and Steve Koczela, 6/25)

Biologic drugs—pharmaceuticals produced from living organisms—are at the forefront of medical innovation and hold tremendous potential to improve and save lives. Unfortunately, their pricing has been a driver of rapidly escalating, unsustainable drug costs. Congress recognized the need for competition to slow price growth, and in 2010 passed the Biologics Price Competition and Innovation Act. That opened the door to the development of biosimilars—lower-cost versions of brand-name biologics that are interchangeable in clinical efficacy and safety. Yet nearly 10 years later, brand-name manufacturers are using a combination of coercive, anticompetitive tactics to box out biosimilars and maintain their monopolies. If policy makers want to reduce drug prices and maintain patient access, it’s time to end the manipulative practices that take choice away from physicians and patients. (Denny Lanfear, 6/23)

Following the introduction of generic alternatives into the market, drug costs have been shown to have declined by an impressive 85 percent. Overall, the use of generics, in combination with the innovation from brand name drugs, has produced tremendous savings — $1.67 trillion from 2007 to 2016 alone. This shows the positive benefits of competition. However, for prices to remain low and quality to remain high, it is critical that the incentives for everyone to innovate and compete remain preserved. While some believe that the government can achieve this balance through new rule-making processes, the empirical data shows that no one knows how to best strike this stability than the private companies themselves. (Michael Busler, 6/20)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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