A Couple of Worthwhile Pieces to Read While You Watch the Senate Hearing

It’s a short newsletter today because my attention will be on Washington today. I plan to watch as much of the Senate hearing as I can stand. There’s a lot of preview coverage, and almost all of it is essentially meaningless (Bernie is already onto the questions as I write this), so I’m going to pass on throwing a lot of links out there. 

I will say that you should probably read this MarketWatch piece that tackles the topic of list vs. net prices in the context of Bernie Sanders’ muckracking. It’s built on numbers from Antonio Ciaccia of 46Brooklyn/3Axis, so you know it’s solid. The upshot is that we don’t get any smarter (and, indeed, we almost certainly get dumber) when we ignore the rebate system and conduct debates using list prices, as we will today. 

Two other items: 

The New York Times’ hearing preview included this line: “In the United States, negotiations over drug prices are fragmented across tens of thousands of health plans and employers.” That’s an absurd statement in a world where three PBMs dominate the market. I am mentioning it because a) it’s the second time in a month that the NYT has made that argument with a straight face, and b) I want them to feel shame. 

And the American Prospect has a whole article clowning on the WSJ for that facepalm op-ed. (You know, the one that screamed Americans should “Be Thankful for High Drug Prices.”)

There is one judge overseeing four of the IRA lawsuits — those for BMS, JNJ, Novo, and Novartis — and he wants to have one ginormous oral argument in all of those cases, ideally the first full week in March. So that’s going to be something worth circling on the calendar. 

In other IRA lawsuit news, the judge overseeing the AstraZeneca case has asked for relatively short additional briefs from both AZ and the government on whether AZ has standing to bring its suit. That feels like a not-great sign for AZ, but — at the risk of being repetitive — I’m not a lawyer and shouldn’t even be allowed to play one of TV. 

The House passed a bill that would ban the use of QALYs. It’s hard to see a next step for this legislation, but that doesn’t mean that this isn’t a milestone. 

I love the Minnesota-Lilly insulin settlement, in which Lilly agreed to provide Minnesota residents with exactly the same deal that all Americans have access to. I get that there’s a little bit more teeth in having the program backed by the legal system, but it still feels like evidence that there’s not much there there in insulin-price lawsuits. 

This is a good wrap, from Bloomberg Law, on the 500-odd march-in proposal comments. This all still feels like kayfabe, but at least everyone is on the record now. 

Yesterday, I flagged an interesting study on the cost and availability of generic medicines at “direct-to-consumer” pharmacies. This MedPage piece has all of the high points of the study, plus some good commentary. 

This is a great Axios piece on one employer’s effort to tackle medical costs head-on. I suspect we’ll see more of this sort of thing in the future as the focus moves to employers as a lever to address prices. And note that the CEO of the company profiled believes that specialty drugs are the next great frontier for his cost-cutting efforts.