I thought Cost Curve would be off today, but there’s just too much popping to leave it to Monday. So let’s touch some bases before we all go into our last few days of meteorological winter. Spring is around the corner.
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Here are some quick hits on items that I’d rather not have rattling around my brain this weekend:
Let’s start with something fun: This is a humdinger of a letter from Rep. Greg Murphy to Langone NYU asking pointed questions about the hospital’s Super Bowl ad. Murphy wants to know how much NYU spent on the ad, how much it’s getting in 340B dollars, and how much it’s spending on charity care. There’s also some stuff on NYU’s investments in the Caribbean, which makes this just a little more spicy. Of course, Rep. Murphy has since released a really boring letter in which he notes that he spoke with the hospital and came away “thoroughly impressed.” So we may never get answers on 340B. Or whatever beachfront sidelines NYU may have.
Less fun: legal filings. But this brief from the government in the Novartis IRA appeal is important because it signals that — for now — the Trump administration is going to pick up where the Biden administration left off in defending price controls. I don’t know that anyone expected that the whole process was going to get blown up, but there’s been lots of expectation-defying blowups lately, so the dog that’s not barking is significant.
More legal filings: The pharma companies that are suing to implement a “rebate model” in 340B are fighting an effort by providers to intervene in the case. The manufacturer’s argument, in a nutshell, is that no providers have been affected by the new approach yet because no one is letting them implement it.
Even more legal action: The effort by the big PBMs to get the FTC lawsuit against them tossed has run aground, with a federal judge ruling that the FTC has every right to go after the PBMs. The industry had objected to the FTC’s move to try the case in the agency’s administrative court.
Speechless: I feel like I should have something to say about gene therapy/gene editing. This Ryan Cross Endpoints piece on CRISPR was a hard read because it sounds like the technology is absolutely a winner, but the business model hasn’t caught up. “Maybe for the first time, our technology has surpassed our social capacity to administer the technology,” is how St. Jude’s Mitchell Weiss put it. And that’s scary, because without a viable business model, investment disappears.
Not unrelated: There’s news today that bluebird bio, a gene therapy pioneer that has three products ON THE MARKET is selling itself at a discount to a private equity company. And Pfizer is continuing to slowly back away from gene therapy and will stop selling its Beqvez gene therapy for hemophilia. Again: the issue isn’t the technology or the clinical impact. It’s the business model.
I spent the week in DC: The pharmaceutical industry has taken a “If you can’t beat ’em, join ’em” approach to the new administration — that’s Axios’ phrasing — but Axios raised the question of whether the change in tone in Washington would be a net benefit to drugmakers. The Axios calculus seems to be that while the Trump administration may show skepticism toward PBMs and price controls, the broader impact on R&D and vaccine policy could leave a mark.
You’ve heard this before: I think that the California effort to make its own insulin is mostly silly in an environment where insulin prices are low and falling. And there’s evidence that the initiative is moving more slowly than expected, too. (The last time I made fun of California, it was suggested to me that a publicly supported low-cost source of insulin could provide a critical safety net in an era of drug shortages. I’m sympathetic to that argument! But the idea that California insulin is going to rewrite the economics of insulin has clearly not panned out.)
