Morning Briefing
Summaries of health policy coverage from major news organizations
Alzheimer's Drug Could Potentially Cost More Than NASA's Entire Budget
A newly approved drug to treat Alzheimer鈥檚 disease is expected to become a multibillion dollar expense for Medicare. By one projection, spending on the drug for Medicare鈥檚 patients could end up being higher than the budgets for the Environmental Protection Agency or NASA. There鈥檚 little evidence that the drug, Aduhelm, slows the progression of dementia, but the Food and Drug Administration approved it this month. Analysts expect that Medicare and its enrollees, who pay a share of their prescription drug costs, will spend $5.8 billion to $29 billion on the drug in a single year. Annual spending on NASA is approximately $23 billion. (Katz, Kliff and Sanger-Katz, 6/22)
Employers are urging Congress to take action on drug prices following the FDA's recent approval of controversial Alzheimer's disease drug Aduhelm. Aduhelm, or aducanumab, was developed by Biogen and Eisai and was approved by the Food and Drug Administration earlier this month despite pushback from the scientific community about the drug's efficacy. Following its approval, Biogen said the therapy would be priced at $56,000 per year. (Minemyer, 6/22)
Even if Congress manages to pass the Elijah E. Cummings Lower Costs Now Act 鈥 more commonly known as H.R. 3 鈥 the bill still wouldn鈥檛 let the government immediately slash prices on Aduhelm, which is expected to cost $56,000 annually for a single patient and could quickly become Medicare's biggest prescription drug expense. (Cunningham and Ellerbeck, 6/17)
The eye-popping $56,000 price tag on Biogen鈥檚 newly聽approved Alzheimer鈥檚 medication has generated significant debate on the value of a drug not yet proven to slow the mind-robbing disease. But Aduhelm's price is only the start of what consumers and insurers might pay to get the first new Food and Drug Administration-approved drug to treat Alzheimer's since 2003. Many experts say patients will need expensive tests to verify they have the underlying sticky clumps of protein the drug targets in the brains of Alzheimer's patients. Patients could see other聽bills from doctors, as well as from facilities聽that administer the drug via聽IV聽and imaging centers for MRIs to monitor common side effects such as brain swelling and bleeding.聽(Alltucker, 6/22)
The head of the health insurance industry's main lobbying group doesn't think the $56,000 annual price tag for Biogen's unproven Alzheimer's treatment, Aduhelm, is justified, but the group won't call on insurance companies to deny coverage of it. Instead, insurers are relying heavily on Medicare and an independent drug pricing group for their coverage decisions. (Herman, 6/23)
Also 鈥
Sen. Ron Wyden (D-Ore.), the influential chair of the Senate Finance Committee, is promising that his signature drug pricing package won鈥檛 eviscerate small biotech companies. Wyden, typically a fierce critic of the drug industry, is suddenly giving a shoutout to small biotech companies and their role in developing 鈥済roundbreaking new treatments.鈥澛燞e鈥檚 even promising that the package he is crafting 鈥渃an be tailored to the scale of these companies, as well as other factors that affect their access to capital.鈥 (Florko, 6/22)
Senate Finance Chair Ron Wyden on Tuesday outlined a proposal for curbing prescription drug prices as pressure ramps up on Democratic lawmakers to use the reforms to pay for other priorities in a massive infrastructure package. The new framework, which Wyden has discussed for months with members of his influential committee and Democratic leadership, proposes building on the bipartisan plan he and Sen. Chuck Grassley (R-Iowa) offered last Congress that never came up for a floor vote due to GOP leaders' opposition. It would also include provisions similar to the House鈥檚 landmark drug pricing bill, H.R. 3 (117), that would empower Medicare to negotiate with pharmaceutical companies and apply those lower prices across other public and private insurance programs. (Ollstein, 6/22)
Five Blue Cross Blue Shield plans have launched a new for-profit pharmacy solutions company to combat drug costs, which comprise an ever-growing share of their budgets, the insurers announced today. The Denver-based company, called Evio, will use data from the plans' more than 20 million members across the U.S. to collect real-world evidence into how drugs actually perform, especially across specific patient types and with certain comorbidities. One of the goals is to get drugmakers to agree to outcomes-based contracts, where the plans pay in accordance with drugs' effectiveness. (Bannow, 6/22)
After years of controversy, Teva Pharmaceuticals (TEVA) agreed to pay $925,000 to the state of Mississippi to settle allegations of conspiring to set prices of generic medicines, the first instance in which a state and drug maker have reached a deal over sweeping price-fixing litigation. Several current and former executives also reached a settlement, according to a court document. (Silverman, 6/22)
Tough choices could be coming for many seniors. Some may soon have to decide between paying skyrocketing prices for prescription drugs or paying their bills.19 Investigates found there could be major consequences if inflation like this continues. Higher health care costs could be coming, which will lead to poorer health, a new report from AARP warns. (Goldenberg, 6/17)
Priti Krishtel's first case as a legal aid lawyer in India was as tragic as they come. One day in 2004, she recalls a couple walking into her office in Bengaluru with their three children. Unable to afford life-saving medicine to keep their HIV infections in check, the parents were dying of AIDS. With no other options, they wanted Krishtel to draw up guardianship transfer papers: The rambunctious siblings were to be sent to an orphanage before their parents died. (Sinha, 6/16)
Colorado has become the third state in the nation 鈥 following trailblazer Maryland and Maine 鈥 to create a panel with the power to rein in prescription drug prices. The measure signed by Gov. Jared Polis (D) on Wednesday creates a five-member Prescription Drug Affordability Board, which will evaluate whether medications are fairly priced. In cases where they are determined to be too costly, the board will have the authority to set maximum prices. (DePuyt, 6/21)