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INFLECTION POINT/ We Still Have to Talk About Tariffs
Look, I’m sorry.
But I have to do a quick tariff section. I don’t find this any more enjoyable than you do.
You really ought to read Derek Lowe’s take on tariffs at “In the Pipeline,” which has a clear view of exactly what the drug supply chain looks like and what tariffs can (and cannot) do. It’s more cynical, and probably more accurate, than other explainers.
To get a more concrete sense of how all of this works, the Washington Post looked at how heparin gets from China to bedsides in the United States. Supply shocks to heparin would be bad.
Less critical, but still worthwhile, is David Wainer’s column at the WSJ on “How to Play the Biotech Meltdown in the Age of RFK Jr. and Tariffs.” But read from the bottom, where he reminds everyone that kick-ass innovation will always get rewarded.
Of course, the “news” is that Commerce Secretary Howard Lutnick said yesterday that the pharma tariffs are indeed coming “in the next month or two.”
What does that mean?
THE ARC/ AHA Charity-Care Numbers Fail to Convince
For a while now, one of the central weapons yielded against nonprofit hospitals in the 340B conversation has been the low rates of charity care that 340B hospitals tend to report.
This has been an effective line of attack, as evidenced by the fact that the American Hospital Association just put out a big report trying to rebut the argument by showcasing data that shows that while straight-up financial assistance has dipped, it’s only because uninsured patients are now on Medicaid, and those patients, too, are costing hospitals money.
It’s all somewhat dizzying, and it fails to account in any meaningful way for findings that show that 340B hospitals tend to do worse on measures of charity care than their non-340B peers.
I stumbled on the report via a LinkedIn post from AEI’s Brian Miller.
Miller was, to put it mildly, unimpressed with the way that the AHA did the math: “Most accountants I know would turn purple at how things are accounted for.”
ON LOOP/ How I Job Interviews Should Go, In My Imagination
LinkedIn now has this new feature where they show you videos that align with certain trends. It is all very LinkedIn-ish. (If you are the kind of person who learns things from 60-second videos from LinkedIn “influencers,” I have terrible news about your long-term career path.)
One of the “trends” that popped up last week was “Things NOT to say in a job interview,” and I figured that I would take that as a prompt to make a terribly (or just terrible) wonky satire:
QUICK TURNS/ A Cheap IRA Fix, Three Arguments Against MFN
A couple of months ago, I shared an analysis that suggested that a “fix” to the IRA that would expand the law’s exemption for orphan drugs would cost about $4 billion over a decade, far less than the $20 billion that Congress suggested it would cost. That analysis has now been updated, and the price tag has dropped to $1 billion over 10 years. Feels like a good deal.
This is a smart STAT First Opinion by Dana Goldman and Darius Lakdawalla giving three reasons why the “most-favored nations” solution to high U.S. prices/global freeloading won’t/shouldn’t work. I’m particularly interested in the third argument, which is that the United States has never been a country eager to adopt the value calculus of Europe in any other fashion, and the idea that we’d import elements of the European health system seems, well, weird.
Ed Silverman has a nice scoop at STAT about Tennessee taking Express Scripts to the woodshed for a number of behaviors that harm retail pharmacy. It’s almost like there is a pattern here.
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.
