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Wednesday, Sep 14 2016

Full Issue

Patients With High Deductible Plans Sometimes Face EpiPen Cost Issues

News outlets report on stories related to pharmaceutical drug pricing.

When Isa Traverso, of Morrison, Col., went to fill her son's EpiPen prescription in early September 2016, the pharmacy said it would cost her $1,500 for a pair of the life-saving devices鈥攄espite having health insurance coverage. That's because her family's Blue Cross Blue Shield health plan requires that they meet a $5,200 deductible before insurance coverage kicks in, a figure they haven't reached yet for the year. That left Traverso on the hook for the full price鈥攁nd she couldn't afford to fill the prescription. "I'm angry. This is not something you want to have. It's something you have to have," says Traverso. She says she'll consider not using her insurance and switching to the cheaper EpiPen alternative,聽generic Adrenaclick ($140 at Walmart using a GoodRx.com coupon). (Skinner, 9/12)

A major聽food allergy advocacy group said this week聽that it would stop accepting donations immediately from drug companies selling epinephrine auto-injectors until there is 鈥渕eaningful competition鈥 in the market. While not mentioning Mylan by name, the statement from Food Allergy Research and Education (FARE) implies that the EpiPen manufacturer聽is one of the targets. (Swetlitz and Silverman, 9/9)

Congress is starting to get some answers on EpiPen pricing. And though, so far, Mylan鈥檚 not offering much beyond what鈥檚 readily available via Google search, that could change later this week. The House Committee on Oversight and Government Reform, which demanded answers earlier this month, is expecting documents late this week, sources close to the investigation said. The committee had set a deadline for initial word from the company Monday. (Staton, 9/13)

Mylan, the company that makes the EpiPen, has been under fire for making the drug too expensive for many consumers. EpiPen is an auto-injector form of ephedrine that can stop a severe allergic reaction. It's only sold in pairs, retailing for about $600. But it's not the only prescription drug with an exorbitant price. (Goldberg, 9/12)

A bee sting while swimming one year ago prompted聽Donna Myrowto start聽carrying a life-saving EpiPen. When a pharmacy recently聽called to say her cost for a new pen had jumped $100, the Palm Springs retiree felt stung all over again...Myrow's pharmacy told her in August聽she would be responsible for roughly $300, or about half of the total price for her EpiPen renewal. Medicare and supplemental insurance would cover the rest.聽A year ago she paid $200. (Newkirk, 9/12)

Anyone who has watched college football on TV or played the game Words with Friends on their phone in recent days may have seen the ad featuring Stephanie Haney, Bill Remak and Ryan Dant, all of whom were beneficiaries of biotechnology treatments. The ad, called 鈥淚nnovation Saves,鈥 suggests that money聽spent by biotech companies on research and development ultimately saves healthcare costs, because drugs lessen the need for hospital stays, reduce the number of surgeries performed and, in some cases, cure costly diseases. The group behind the ad is the Biotechnology Innovation Organization (BIO), which is running it as part of a larger campaign to counter all the negative publicity surrounding drug companies of late, much of which has been fueled by pricing controversies surrounding drugs like Mylan鈥檚 EpiPen and Turing Pharmaceuticals鈥 Daraprim. (Weintraub, 9/13)

An Ohio court has given a significant boost to a controversial ballot measure that is designed to lower the cost of medicines. In a ruling last Friday, the state Supreme Court decided that thousands of contested signatures on petitions submitted to the General Assembly were valid. And the court also ordered the Secretary of State to permit consumer activists to submit yet another petition that is required for final approval by county officials so the measure can go before voters in November 2017. (Silverman, 9/12)

It's easy to see why EpiPen has become the focus of America's fury over drug prices. It treats potentially deadly allergic reactions 鈥 for example, in a child who is stung by a bee 鈥 and its price has spiked by over 500% in a few years. While it's easy to jump all over drugmakers, like EpiPen's maker, Mylan, other actors in the healthcare system ought to draw as much scrutiny.One group of companies, called pharmaceutical-benefit managers, or PBMs, serve as middlemen, and they touch every part of the purchase of a prescription drug. (Lopez, 9/12)

Generic drug prices in Medicare Part D decreased significantly in recent years, a new report from the U.S. Government Accountability Office (GAO) says. So why the worry about price hikes? Hundreds of products saw 鈥渆xtraordinary price increases," that's why. For a group of 2,378 generic drugs--including those that entered or exited the market from聽2010 to 2015--Medicare Part D聽prices fell overall by 59%. But 鈥渆stablished generics"--the聽1,441 drugs that stayed on the market the entire time--fell by just 22%. More than 300 cases of 鈥渆xtraordinary price increases鈥 kept prices from falling further, the GAO said. (Sagonowsky, 9/13)

The popular furor over rising drug prices has led to increased scrutiny of the patent protections that can allow drugmakers to sell medicines exclusively for many years. A new study helps quantify just how much a generic competitor聽can drive down the price of a brand name drug. The price of brand name drugs falls steeply in the first year after the loss of聽exclusivity and continues to fall over the next three years, according to聽a study published by the聽IMS Institute for Healthcare Informatics with numbers聽from IMS Health, a medical data wholesaler. (9/12)

Yet another drug maker is under scrutiny for its pricing. The US Department of Justice last Thursday sent grand jury subpoenas to Taro Pharmaceuticals and two of its senior commercial officers in its US unit seeking documents about generic pharmaceuticals and pricing, according to a filing聽that Taro made with the US Securities and Exchange Commission. (Silverman, 9/12)

European Commission court upheld an antitrust fine that was imposed three years ago against Lundbeck and four other drug makers for allegedly conspiring to delay the availability of a lower-cost generic version of an antidepressant. The ruling by the General Court of the European Union came in response to an appeal of a 2013 decision that found Lundbeck and the generic drug makers pursued a pay-to-delay deal that violated European Union anticompetition regulations. The European Commission had fined the companies a total of $165 million with Lundbeck ordered to pay the bulk of the fine, or about $105 million. (Silverman, 9/8)

Drugmakers have been under scrutiny since Mylan's EpiPen price hike, but government involvement in controlling costs is not necessarily the answer, Wells Fargo Securities analyst David Maris said Thursday. Democratic presidential nominee Hillary Clinton has said if elected, she would create an oversight panel to monitor price increases and impose penalties for unjustified hikes. "I don't think that having government run that process is really the right way, because it's a Trojan horse for price controls. Once they start controlling a little bit of price, then the temptation is to control all of price, and if you do that, you really get fewer drugs invented," he said. (Fox, 9/8)

Last June, Celator Pharmaceuticals proudly displayed a large poster touting its experimental Vyxeos medication as an effective salve for treating acute myeloid leukemia. The poster was, in fact, one of countless placards featured prominently on the exhibit floor at the American Society of Clinical Oncology meeting in Chicago, a sort of Woodstock for cancer doctors and eager investors. Despite the numerous displays, however, the Celator poster managed to stick out.That鈥檚 because Vyxeos has not yet been approved to treat AML. (Silverman, 9/7)

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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