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The latest wrinkle in the fight against rising drug prices involves insurers and pharmacy benefit managers asking drugmakers to accept lower prices for the latest medicines emerging from their labs when they don't achieve the desired results. Insurers like Aetna, Cigna and Harvard Pilgrim Health Care, as well as pharmacy benefit managers such as Express Scripts, are engaging major manufacturers including Novartis, Merck and Astra Zeneca in these risk-based deals because many of the latest blockbusters drugs are lacking long-term benefits data. In most of the deals, insurers agree to offer reimbursement for a drug at a set price as long as the drugmaker agrees to pay a penalty if certain metrics aren't met. (Rubenfire, 12/10)

“The West Wing,” Aaron Sorkin’s television series about a fictional White House, had a knack for crisply summarizing complex real-life issues. In an episode from 2000, pharmaceutical executives and leaders of an AIDS-plagued African country are summoned to the White House. The purpose is to see if reluctant businessmen can be persuaded to sell the Africans desperately needed drugs at a modest price. “The pills cost ’em 4 cents a unit,” a presidential aide grouses about the companies. “You know that’s not true,” a colleague says. “The second pill cost ’em 4 cents. The first pill cost ’em $400 million.” (Haberman, 12/11)

The Obama administration is rolling out a major report on the prices paid by federal programs for prescription drugs — but it has one big flaw, in the eyes of the Democrats who helped push for it. (Silverman, 12/13)

Today we’ve updated our Dollars for Docs interactive database, adding an additional year of data and some new features that make it easier to see how much money your physician receives from pharmaceutical and medical device companies. Dollars for Docs now includes payments made from August 2013 through December 2015. (Grochowski Jones, Tigas and Ornstein, 12/13)

More than a dozen cancer drugs that were approved based on so-called surrogate markers, such as the ability to shrink tumors, failed to improve the quality of life for patients. Yet most of the medicines, which previously were found not to extend lives, are also expensive, with many costing much more than $100,000 annually, and all but one remain on the market, according to a new analysis. Of 18 cancer drugs approved between 2008 and 2012, only one registered an improved quality of life, and no statistically significant improvement was seen in six others compared with a placebo or an observation group. Four more showed mixed signs and two drugs actually displayed worsening patient outcomes. (Silverman, 12/7)

One of the most powerful tools in the Justice Department’s arsenal is the Racketeer Influenced and Corrupt Organizations Act, better known as RICO, that can result in long prison sentences for members of criminal organizations. Although the law has rarely been used against corporate executives, an indictment that includes a RICO conspiracy charge last week in a health care fraud case in Boston could signal a more aggressive approach to violations involving senior management. (Henning, 12/12)

A sales rep for Grifols is accusing the Spanish drug maker of illegally marketing an expensive orphan drug and defrauding US health care programs in a whistleblower lawsuit that was unsealed in federal court. (Silverman, 12/13)

Despite intense congressional and public criticism, retail prices of the brand name drugs most commonly used by older Americans rose more than 130 times the rate of inflation between 2006 and 2015, according to a new report issued Wednesday morning by the AARP Public Policy Institute.AARP calculated the average annual cost of brand name pharmaceuticals on the list at about $5,800 last year. Seniors took, on average, 4.5 different prescriptions every month last year. If someone used only name-brand drugs, that comes out to about $26,000, exceeding the $24,150 median annual income for Medicare beneficiaries. (12/13)

Virginia prison officials have paid a secret compounding pharmacy $66,000 to obtain lethal injection drugs for its next two executions — roughly 63 times last year’s going price for the state’s three-drug lethal injection package. Like other states, Virginia has struggled to obtain these drugs as pharmaceutical companies block their sale for executions to avoid being publicly accused of violating medical ethics. But under a new law, the state can have the drugs made at a compounding pharmacy and shield its identity from the public. (Richer, 12/11)

Should a drug company that’s agreed to pay billions in criminal and civil fines for illegally marketing its drugs to children and dementia patients be honored with an ethics prize? That’s what will happen next month when Johnson & Johnson receives the annual Ethical Leadership Award from a nonprofit organization called the Fellowships at Auschwitz for the Study of Professional Ethics, or FASPE. (Kaplan, 12/13)

Drug developers have tried for decades without success to develop treatments for sepsis, a brutal infection that can lead to organ failure. Now a leading immunotherapy company is taking the novel approach of using cutting-edge cancer drugs to try to beat back the deadly infection of the blood. Sepsis is implicated in up to half of hospital deaths, amounting to hundreds of thousands of deaths in the US per year. Doctors can use antibiotics to help control septic infections, but they don’t work in many cases. And when the immune system ramps up in its attempt to overcome the bacteria, it often inflicts collateral damage on the heart, kidney, lungs, liver, and brain. (Mullard, 12/7)

In short, the drugs won’t help most of the people who take them. In some cases, they are almost as likely to produce a negative side effect as a benefit. (Fauber, Wynn and Fiore, 12/13)