Lord, this is lousy.
The New York Times is out with an explainer on why the United States has high drug prices. To the extent that there are myths around drug prices, the piece pretty much hits them all. The idea that there’s no negotiations in the U.S. system. That prices are set at what the market will bear. Stuff like that.
The piece isn’t all bad or wrong, but that inconsistency, somehow, makes it worse. Cost Curve readers can separate the ridiculous from the helpful. Joe American? Not so much.
There are plenty of takedowns of the piece on social media, so let me go in a different direction. The reporters here are dedicated, smart scribes. This is not an example of bias. Instead, it’s evidence of the fact that no one really understands the system. Even New York Times reporters.
And that’s a problem for everyone.
Last week, I asked Northwestern’s Craig Garthwaite what the biggest education need for the general public was around drug pricing. His take was that three different prices are important when talking about medicines: the list price, the net price, and the out-of-pocket price. If everyone just understood those distinctions, we’d be far more able to have a smart dialogue about drug prices.
Indeed, if you put that frame on the NYT effort, the issues would immediately become clear, and we could start talking about the impact of PBMs, how prices are negotiated, and where value does — and does not — come into the equation. Instead, we get cringeworthy lines like this one: “In the United States, negotiations with drug makers are split among tens of thousands of health plans, resulting in far less bargaining muscle for the buyers.”
Anyway: we desperately need a smarter conversation about drug prices. The NYT moved us further away from that conversation.
I wrote yesterday about the amazing reduction in breast cancer death rates. For some additional perspective — and some context for where those gains fit in the larger picture of cancer — this New York Times piece is excellent.
The quarterly Samsung Bioepis reports on the state of the biosimilar market are absolute treasure troves of data, though each one raises more questions than it answers. The latest installment — available here — is worth checking out to better understand how well AbbVie has been able to keep market share for Humira and why that’s both a short-term and a long-term problem.
I’m not deep enough to quite know what to make of the Biden administration’s moves to better regulate prior auths. The Washington Post coverage did a good job of explaining what’s going down (digital systems, deadlines, only in federal programs) and STAT gathered a lot of good reactions. But it’s pretty clear that this move will not remotely put the issue to rest. (Indeed, KFF Health News is still gathering examples of people screwed over by prior auth … if you want to contribute to that effort, here’s the link.)
It sure feels like the 340B issue is getting coiled tighter and tighter, making me wonder when it’s going to explode. Sen. Bill Cassidy is now asking CVS and Walgreens pointed questions about their participation in the program. It feels like we’re going to have some battle lines drawn around policy reform real soon.
This Minnesota Public Radio piece on the state’s new prescription drug affordability board is long on bravado and short on details. If we’ve learned anything from the experience in other states, implementation is going to be a bear, and I’m super-curious as to how Minnesota plans to deal with the inevitable procedural potholes.
ngl: I really don’t understand the methodology behind this new AARP report that purports to show how drug prices skyrocketed between 2006 and 2020. My impression is that it’s a piece of pro-payer propaganda wrapped in layers upon layers of questionable assumptions.
“Good chemistry appears to be more powerful than the IRA,” Endpoint’s Drew Armstrong wrote in his #JPM24 wrap, noting the buzz around small molecules. The binary framing around the “pill penalty” is going to have to fade at some point. Small molecules can be both good investments and harmed by the IRA, but I fear that nuance is generally an obstacle to understanding.
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