ICER Weekly View: April 12, 2019

From the desk of David Whitrap

A quick programming note this morning: Weekly View will be off next week, but we promise to be back in your inbox on April 26. Given how quickly the drug pricing storylines have been changing, I can’t begin to imagine what headlines I’ll be sharing with you then.

But for this week, let’s take a look at:

  • ICER in the News: Bloomberg reviews the cost conundrum brought about by gene therapies, and the role ICER is playing to help the health system better balance pricing, access and innovation. Also, our draft evidence report on peanut allergy treatments, a draft scope for our assessment of rheumatoid arthritis therapies (which will include a biosimilar), and the initiation of a new assessment of treatments for Type 2 diabetes.
  • Pharmaceutical News: Multiple drug price hearings in DC, potential collaboration between the Democratic House and the Trump Administration, Maryland’s new drug affordability board, debating the impact of including a drug’s list price in its TV ad, and trying to untangle how the drug pricing and rebate world evolved the way it did.

ICER in the News

Writing for Bloomberg, James Paton discusses how the scientific promise of gene therapy could potentially threaten US budgets in such a way that would be harmful to everyone involved — patients, payers, and the pharmaceutical industry. He quotes ICER’s President, Steve Pearson: “We have to create a system that means we don’t have a speeding freight train hitting a brick wall, and really high prices that seem disconnected from the value to patients.” The article goes on to discuss ICER’s review of the SMA gene therapy Zolgensma, as well as the international collaborative we have formed to improve methods of assessing the value of potentially curative therapies, so that our health system can better achieve fair pricing, fair patient access, and sufficient incentives for future biopharmaceutical innovation.

Gene Therapy Was Hailed as a Revolution. Then Came the Bill (Bloomberg)

Earlier this week, ICER released our draft evidence report assessing the clinical effectiveness and value of Viaskin Peanut and AR101, two new technologies for inducing immune tolerance to peanuts. We’re now accepting public comment through May 8, and the feedback we receive may be reflected in our revised Evidence Report.

ICER Releases Draft Evidence Report on Treatments for Peanut Allergy

Yesterday, we published the draft scope of our assessment of treatments for rheumatoid arthritis. In addition to incorporating data that has emerged since our 2017 assessment of this therapy class, we’ll be evaluating upadacitinib, which is currently under FDA review, as well as the approved biosimilar Inflectra. We’re accepting public comment on this draft scope through May 1.

ICER Posts Draft Scoping Document for the Assessment of Treatments for Rheumatoid Arthritis

Also yesterday, ICER initiated a new assessment on therapies to treat Type 2 diabetes. We’ll be comparing oral semaglutide to Victoza, Jardiance, Januvia, and potentially the sulfonylurea class of drugs. We’re accepting public input through April 29.

ICER to Assess Treatments for Type 2 Diabetes

Pharmaceutical News

It was quite a week in Washington DC around drug pricing and transparency. The Associated Press recaps Tuesday’s testimony of PBM executives in front of the Senate Finance Committee. And Kaiser Health News takes a look at what happened on Wednesday when some of those PBMs were joined by three drugmakers to explain to the House Energy and Commerce subcommittee why insulin prices keep going up.

Heated debate over high drug costs returns to Capitol Hill

Patient bills, competition and secrecy shared the spotlight Tuesday as pharmacy benefit managers testified before Congress about prescription drug prices. Members of a Senate Finance Committee investigating drug costs pushed the benefit managers to explain why they can’t do more to control prices and to reveal the details behind the contracts they negotiate.

The Blame Game: Everyone And No One Is Raising Insulin Prices

A casual observer of Wednesday’s House Energy and Commerce subcommittee hearing might think insulin prices just go up by themselves. After all, the key industry executives filed opening statements to the congressional panel outlining patient-assistance programs, coupons and discounts – a range of price reductions that might make one think this life-or-death diabetes medication is easily affordable to the patients who need it.

In advance of the hearing on insulin pricing, Sanofi announced that it would lower the price of its company’s insulin products to only $99 per month for patients who are not using insurance.

Sanofi to cut U.S. insulin costs for some patients to $99 per month

Sanofi SA said on Wednesday it will cut the cost of its insulin products to $99 per month for uninsured patients and others who pay cash for it in the United States, as the French drugmaker contends with intense criticism over the high price of the life-sustaining diabetes medication.

Meanwhile, House Speaker Nancy Pelosi continues to engage with the Trump administration on potential drug pricing legislation, including Medicare negotiation.

Pelosi: ‘We must hold the president to his campaign promises’ to lower drug prices

Speaker Nancy Pelosi President Trump Donald John Trump Koch network launches ad campaign opposing Trump’s proposed gas tax Trump laments EU ‘being so tough’ on Brexit Inslee knocks Trump for wind turbine remarks MORE should fulfill a campaign promise by signing a bill Nancy Patricia D’Alesandro Pelosi John Legend, Chrissy Teigen lash out at Trump at Dem retreat Sanders sets bar for 2020 Dems with ‘Medicare for all’ rollout Barr testimony opens new partisan fight over FBI spying on Trump MORE (D-Calif.)

Unrelated to those talks, the Trump administration is attempting to finalize a new rule that would require drug makers to include list prices in their TV ads for prescription drugs. Marketplace weighs in on whether this rule would curb price gouging, or instead curb the filling of necessary prescriptions.

Would requiring prices in pharmaceutical ads make drugs cheaper?

The Trump administration is expected to finalize a new rule soon that would require drug makers to include list prices in their TV ads for prescription drugs. The idea is that such transparency will lead to more competition and ultimately to lower cost for consumers.

Just up the road from DC — and despite significant industry lobbying efforts — Maryland lawmakers this week passed a first-of-it-kind law to create a drug affordability board for the state that could cap payments for unreasonably expensive prescription drugs.

Despite pharma’s best efforts, Maryland advances major drug pricing bill

A NNAPOLIS, Md. – The drug industry has long been seen as invincible in this small state capital, where last year it retained more than 100 lobbyists: two for every state senator, plus a dozen to spare.

And finally this week, Time magazine takes a step back to look at how we got here… how drug prices are chosen in the first place… how the supply chain has evolved to encourage large rebate payments… and how all sides are putting forth significant time and money to try to preserve the status quo.

Why Does Medicine Cost So Much? Here’s How Drug Prices Are Set

Confused by drug pricing? Here’s a guide to the complex variables that determine what you pay for medication at the pharmacy counter.


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