Overnight Health Care — Sponsored by PCMA — New details on Trump’s drug pricing plan

Welcome to Overnight Health Care, sponsored by the Pharmaceutical Care Management Association. 

We’re still dissecting President Trump’s drug pricing plan and hoping this Monday is derecho-less.

 

New details on Trump’s drug pricing plan.

Secretary of Health and Human Services Alex Azar gave a speech and made two media appearances on Monday to try and put some more meat on the bones of Trump’s new drug pricing plan. But there are still a lot of questions that remain unanswered.

Some highlights:

Pushback on Medicare negotiation. Azar is not happy with claims that President Trump is backing down from his previous call for Medicare to negotiate drug prices. Azar said he thinks this would not be effective and calls such a proposal a “cheap, political, gimmick.” Instead, he says he’s trying to increase negotiation from private players.

Naming and shaming. HHS will start making public the names of drug companies they say are “gaming” the system to delay the entry of competition from cheaper generic drugs. The FDA will post the information as soon as this week, officials said.

Shifting drugs from Part B to Part D. Officials have long criticized Medicare Part B as lacking negotiation powers and driving up costs. Azar said he would explore using his authority to move drugs into Part D, which has more negotiation from private players. Azar didn’t have a definitive answer when he was asked what drugs could shift, but the list could be substantial. The idea is sure to get major opposition from drug companies. To back up: Part B is Medicare’s program that covers doctor-prescribed drugs and drugs from other health provider visits. Part D is Medicare’s prescription drug benefit program.

Drug rebates could change. Azar has been a harsh critic of the current system of drug rebates, which are negotiated between insurers and drug companies by pharmacy benefit managers. In his speech, Azar floated the idea of eliminating rebates completely, and prohibiting pharma companies from paying PBMs.   

Azar wants to show he’s standing up to Big Pharma:  “I’ve been a drug company executive–I know the tired talking points: the idea that if one penny disappears from pharma profit margins, American innovation will grind to a halt. I’m not interested in hearing those talking points anymore, and neither is the President,” he said.

Read more here.

 

***

Sponsored content – Pharmaceutical Care Management Association

Pharmacy benefit managers (PBMs) are hired by employers, unions, and government programs to negotiate aggressive discounts from drug companies and drugstores.  PBMs continue to keep overall spending and out-of-pocket costs down despite massive price hikes by drugmakers. Learn how PBMs are part of the solution to reducing Rx costs at DrugBenefitSolutions.com.

***

 

Trump to speak at anti-abortion gala on May 22

President Trump is set to speak at the Susan B. Anthony List’s gala next week as it pushes for administrative action on Planned Parenthood funding.

SBA List and other anti-abortion groups are pushing the administration to bring back Reagan era regulations that would essentially block some Planned Parenthood clinics from getting Title X family planning funds.

Anti-abortion lobbyists say the administration has been receptive to their calls, and it’s only a matter of time before officials take action.

The gala is also an opportunity for SBA List to raise money for the midterms. The group has been active in campaigning for anti-abortion lawmakers in tight House and Senate races.

Dannenfelser called the 2018 midterms the “most important election for the pro-life movement since Roe. v. Wade.”

Read more here.

 

The administration is also urging a federal court to rehear a case on Planned Parenthood funding in Ohio.

Last month, a panel of federal judges for the U.S. 6th Circuit blocked Ohio from cutting off funds to Planned Parenthood, ruling that it would be unconstitutional to do so.

HHS is urging the full court to rehear the case, arguing that the panel’s judgment was based on the “mistaken” assumption that abortion providers have substantive due-process (h/t Bloomberg Law. Read more from Bloomberg here.)

Why it matters: It shows that the administration thinks states should be able to defund Planned Parenthood and is pushing to make that case in the courts. The administration is also closely watching similar lawsuits as it reviews waiver requests from states that want to cut Planned Parenthood from their Medicaid programs.

 

 

Dem wants FDA to help end the EpiPen shortage.

Sen. Richard Blumenthal (D-Conn.) on Monday called on federal health officials to help end the shortage of EpiPen and other epinephrine auto-injectors.

In a letter to the Food and Drug Administration, Blumenthal said the agency should work with manufacturers and distributors to eliminate the shortages. He asked for FDA to detail the steps it has taken to alleviate the shortage, when it became aware of a problem, and why it didn’t publish a notice on its website until May 9.

“FDA has attributed the scarcity to manufacturing problems, but has done little to address the emergency or indicate when the critical medication will be available,” Blumenthal wrote.

Blumenthal has been a past critic of Mylan, the EpiPen manufacturer. When Mylan increased the price from about $50 to $600, Blumenthal was one of the senators who signed onto a letter criticizing the drug’s affordability and accessibility. He also criticized the company’s $465 million settlement with the Department of Justice over claims it was overcharging Medicaid for the device.

Click here for more background on the EpiPen shortage.

 

Top Democrats on the House Energy & Commerce Committee are asking Chairman Greg Walden (R-Ore.) to hold a hearing on the maternal mortality crisis in the U.S.

“As the Committee with broad jurisdiction over public health and women’s health issues, we have a responsibility to understand why more women die from pregnancy-related complications in the United States than in any other developed country and what we should be doing to combat this crisis,” the ranking members of the full committee and the health subcommittee, Reps. Frank Pallone (N.J.) Gene Green (Texas), wrote.

“We urge the Committee to hold a hearing as soon as possible to begin considering proposals to reverse this unconscionable trend and help save the lives of American women.”

Why it matters: As The Hill wrote last month, a bipartisan bill that would address maternal mortality rates in the U.S. has been stuck in the Energy & Commerce Committee for about a year for no clear reason. When asked when the committee would take action, Walden said he wasn’t sure, and that it had been tied up with the opioid crisis.

 

Also today – latest on Michael Cohen payments.

A group of Senate Democrats is demanding answers from AT&T and Novartis after it was revealed the two companies paid large sums of money to President Trump’s personal attorney, Michael Cohen.

Sens. Elizabeth Warren (D-Mass.), Richard Blumenthal (D-Conn.) and Ron Wyden (D-Ore.) sent letters to the companies on Monday raising questions about whether the payments were appropriate.

Both companies have apologized for the consulting contracts.

Read more here.

 

***

Sponsored content – Pharmaceutical Care Management Association

A drug company’s decision to increase the price of a forty-year-old drug by 1400% – despite no change in the supply chain – undermines drugmakers’ attempt to blame their prices on the insurers, pharmacies, PBMs, and wholesalers through which patients access medicines. 

***

 

What we’re reading

Consumers brace for premium hikes while lawmakers grasp at remedies (Kaiser Health News)

Kushner-backed health care project gets ‘devastating’ review (Politico)

Ebola has infected dozens so far in Congo, killing 19, WHO says (The Washington Post)

If Republicans hold on to Congress in 2019, ObamaCare repeal could come back (Vox)

The 5 most expensive drugs in the United States (CNN)

 

State by state

Where California’s candidates for governor stand on fixing health care (San Francisco Chronicle)

First, marijuana. Are magic mushrooms next? In Oregon and Denver (Kaiser Health News)
Eyes turn to Vermont as it sees success with health system (The Associated Press)