Yesterday, I misstated the companies involved in the Sagebrush/HRSA 340B lawsuit. The plaintiffs in that case are Amgen, Lilly, and UCB. I’ve fixed yesterday’s post online but wanted to correct the record here.
There is no dumber holiday tradition that the media pile-on about Jan. 1 price hikes for prescription drugs, and I regret to inform you that those stories have already begun to flow. Reuters is the first out of the gate.
You all are sophisticated, and I’ve whined about this so much over the years, so I’m going to spare you the usual rant.
I stand by what I wrote four years ago: these stories are only useful if they include five critical pieces of context. That includes an explanation of the difference between list and net, a sense of who is harmed by increasing list prices, historical perspective on the change in list and net prices over time, and some attempt to differentiate between price hikes that are egregious and those that are not.
Reuters went 0-for-5 on providing that context.
2025 could be a long year.
If you’re a reporter and your editor is pressing you to write something this week, I have some suggestions that would allow you to avoid just defaulting to the same, silly Jan. 1-price-hike narrative.
Blue Shield of California is moving to its (kind of) PBM-less future in January. There’s been almost zero coverage. Maybe worth a call over there to see how that’s going.
The Sagebrush lawsuit I flagged yesterday names names … including a handful of physician practices that seem to be abusing the 340B program. I’d certainly be interested in knowing more about those docs and how they ended up in the middle of things.
Yesterday’s newsletter also included a note on a Pennsylvania-based Blue plan is planning to deny coverage of all non-oncology accelerated approval drugs for 18 months after approval, which is ironic given that the point of accelerated approval is to get medicines to patients quicker. That feels like something worth digging into.
There has been a ton of good work this year on United Healthcare behaving badly (especially from STAT and WSJ), and the latest installment from the WSJ hit yesterday, further detailing how the insurer is gaming Medicare Advantage.
Here’s some more coverage of the $2,000 out-of-pocket cap from CNN and NPR.
I can’t break through the Bloomberg Law paywall, but the headline on their story about PBM oversight in the Trump administration is illuminating on its own: “PBMs Will Stay in Crosshairs as Trump Antitrust Team Settles in.”
Cost Curve is produced by Reid Strategic, a consultancy that helps companies and organizations in life sciences communicate more clearly and more loudly about issues of value, access, and pricing. We offer a range of services, from strategic planning to tactical execution, designed to shatter the complexity that hampers constructive conversations.
To learn more about how Reid Strategic can help you, email Brian Reid at brian@reidstrategic.com.
