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Donald Trump is unorthodox, to say the least, when it comes to his opinions about the drug industry. The GOP has historically been a staunch ally for drug companies. But during and after the campaign, the Republican president-elect has sworn he would bring down drug costs, flirting with policies that sound more in line with Bernie Sanders than Paul Ryan. Trump’s ascent is now generating whispers at the highest levels of industry about whether the Republican Party will remain a bedrock of support. Is Trump an aberration — or is he a sign of things to come? (Scott, 12/20)

Congressional Republicans reportedly are considering creating a “piggy bank” to store savings from repealing Obamacare to pay for a replacement plan — and, if they do, that would be good news for the drug industry. As STAT previously reported, the biggest risk for drug makers in the repeal-and-replace debate is probably “offsets,” spending cuts designed to help the GOP pay for its own health care plan down the line. But if Congress instead uses a budgetary mechanism to keep the savings of Obamacare repeal in escrow — the “piggy bank” — to pay for their replacement at a later date, that likely lessens the need for a separate set of cuts that could target pharma. (Scott, 12/16)

Japan said Tuesday it plans to review drug prices annually instead of once every two years in an attempt to curb rising health care spending, rebuffing criticism from the U.S. government and pharmaceutical companies. The move reflects global concern over high pharmaceutical prices, an issue that President-elect Donald Trump has said he wants to address. Stocks in the industry fell earlier this month after Mr. Trump told Time magazine, “I’m going to bring down drug prices.” (Warnock and Landers, 12/20)

Despite having some success in launching and developing new drugs in recent years, the returns on R&D efforts by a dozen of the biggest pharmaceutical companies has declined from 10.1 percent in 2010 to a projected 3.7 percent this year, according to a new report. During that period, the average peak sales for each drug reached $394 million, which represented an 11.4 percent year-over-year drop from 2010, according to the analysis by the Deloitte Centre for Health Solutions. And while costs to discover, develop, and launch a drug have largely stabilized at slightly more than $1.5 billion, the upshot is that blockbuster costs are not producing blockbuster sales. (Silverman, 12/19)

When Sen. Bernie Sanders (I-Vt.) and Rep. Elijah Cummings (D-Md.) opened a probe into huge price hikes for some generic drugs two years ago, an attorney for Heritage Pharmaceuticals wrote the lawmakers that the company had not seen “any significant price increases” for its antibiotic. And Heritage declined to provide any documents. (Silverman, 12/19)

Of all the major health-care stocks to own in 2016, perhaps the worst to own has been Valeant Pharmaceuticals International Inc. Despite getting a new chief executive, promising to pay down its debt, and overhauling its operations, the drugmaker has seen its shares lose 87 percent of their value in 2016. The year-to-date decline is bigger than any of Valeant’s peers belonging to the 60-member Standard and Poor’s 500 Health Care Index. The drop would also make it the eighth-worst on the 180-member Nasdaq Biotechnology Index, whose largest loser was Concordia International Corp. -- a drugmaker sometimes compared to Valeant. The bonds have plunged as well. (Hopkins and Armstrong, 12/16)

Quiet, please! The rough ride for Valeant Pharmaceuticals International continues. Analysts at Morgan Stanley downgraded the stock on Thursday due to woes like “declining business trends and significant leverage.” But, according to chief executive Joseph Papa, those analysts may not have hit on the biggest issue they face: “Noise” in the media. (Grant, 12/15)

At least twice a week, Tanja Vanderlinde says patients call in to say they can’t afford drugs. High-deductible health plans mean they have to dip into their own pockets to pay for generic antibiotics such as doxycycline, a “gold standard’’ for Lyme disease, said Vanderlinde, an internist at Concord Hospital Medical Group in New Hampshire. Doxycycline used to cost about 10 cents for a 100-milligram capsule. Its list price rose to as much as $4.92 in 2013 before dipping to as little as $1.23 recently.“It’s crazy,” Vanderlinde said. (Langreth, 12/16)

A company briefly owned by Allergan, which recently vowed to limit price hikes on its medicines, is the latest drug maker to be accused of price gouging in the United Kingdom. From 2008 to mid-2016, Auden Mckenzie raised the price of its generic version of 10 mg hydrocortisone tablets by more than 12,000 percent, compared with cost of a brand-name version that was sold by a different company before the generic came on the market. (Silverman, 12/19)

For many years, University of Utah Health Care kept the blood-pressure medication vasopressin on hospital crash carts for use in emergencies. But, after watching the drug’s price surge, the nonprofit company is removing the drug from all 100 carts. The goal isn’t to use the drug on fewer patients, but rather to reduce the amount of it that sits around unused, said Erin Fox, who oversees medication policy for Salt Lake City-based University of Utah Health. (Evans, 12/18)

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)

A new federal effort is underway to keep biopharmaceutical manufacturing stateside — and scale up the production of complex biological drugs. A new high-tech trade group, dubbed NIIMBL — the pithy shorthand for the National Institute for Innovation in Manufacturing Biopharmaceuticals — on Friday received $70 million from the Department of Commerce. On top of that, NIIMBL will be getting another $129 million from a public-private consortium of 150 companies, academic institutions, and nonprofits, as well as 25 states. (Keshavan, 12/16)

Is Vivek Ramaswamy the smartest guy in biotech? His business model all but depends on it. The 31-year-old former hedge fund manager has raised $1 billion in just two years to play a sprawling game of pharmaceutical moneyball — sifting through the thousands of would-be drugs that larger companies have left to gather dust and picking out a few gems he believes can be developed into blockbuster medicines. (Garde, 12/15)

In a huge blow to Gilead Sciences, a federal jury ordered the company to pay $2.54 billion to Merck in order to resolve a long-running patent dispute concerning its Sovaldi and Harvoni hepatitis C treatments, which have been blockbuster sellers. The verdict is the latest twist in a heated battle between the two drug giants over hepatitis C patents, which have proven extremely lucrative over the last few years. Since its launch three years ago, Sovaldi has generated more than $19 billion in sales for Gilead, while Harvoni, which is an enhanced version of its predecessor, has notched more than $23 billion since becoming available in 2014. (Silverman, 12/15)

As drug prices have spiraled upward in the past decade, tens of millions of generally law-abiding Americans have committed an illegal act in response: They have bought prescriptions outside the U.S. and imported them. One was Debra Miller, of Collinston, La., who traveled to Mexico four times a year for 10 years to get diabetes and blood pressure medicine. She quit in 2011 after the border patrol caught her returning to the U.S. with a three-month supply that had cost her $40. The former truck driver drew a stern warning not to do it again, but got to keep her pills. (Bluth, 12/20)