There’s no big news today, and I’m a bit bereft of deep thoughts right now.
So, some quick hits:
Actually: One (short) deep thought. I’m starting to see the rough edges of the HHS following last week’s cuts. One of my go-to resources at the FDA is its list of the year’s approvals. That list hasn’t been updated since the firings. That’s a minor irritation. I’m also increasingly worried that HRSA — which wasn’t very good at FOIA even before the cuts — won’t release the 340B numbers later this year.
I know: These are small worries in the broader context. But they’re a reminder that there has been immediate damage done. If the impact of the cuts are showing up, publicly, in small ways, you can bet that other, bigger problems exist in much more meaningful ways.
I’m sometimes accused of being overly rosy on topics of value, so — in the interest of balance — here’s a worthwhile paper that looks at cancer drug approvals between 2008 and 2022 and tries (and fails) to match price and clinical metrics. From the analysis, it doesn’t look like there’s a connection between various outcomes (OS, PFS, QALY gains, etc.) and price.
The “caveats” graf of the paper is worth a careful read, and I’d be curious to know how the trend of smaller patient populations played into this, but the paper is a signal that oncology seems to exist outside of the usual value rules. (This isn’t a U.S. phenomenon … similar trends have been seen in Europe.)
Next week, CMS will start hosting “roundtable” events to gather background for its “negotiations” of the next 15 medicines to face price controls. I have heard exactly zero about any of these sessions. Would love to hear from anyone who may be involved in those sessions. My DMs are open, as they say.
Bloomberg Law took a step back to look at the efforts to use the ERISA law to go after employers who overpay for health benefits. We’ve talked about this a lot here over the past year or so, and I don’t think there’s anything new in the Bloomberg piece, which gets at both the promise of the approach as well as its limits. Still good that we’re talking about this.
Endpoints said that the HHS decision not to extend coverage of obesity medicines in Medicare is not necessarily the final word on the subject. This makes sense, and it’s probably (somewhat) good news that the Trump administration didn’t undermine the underlying legal logic of the expansion effort, which suggests that Medicare is barred from covering drugs for “weight loss,” which is a whole different thing than “obesity.”
I feel like all the news I share about the adoption of the Medicare Prescription Payment Plan is negative, so I supposed its good news that the rules governing Medicare for next year call for patients who are enrolled in M3P will automatically be re-enrolled. (Hat tip to Brooks Conway.)
There’s lots of commentary out there about biopharma from Wall Street over the past 24 hours, including a reminder that the next shoe has yet to drop on tariffs. But the real must-read report is from Cantor (teased here by STAT). The Cantor folks fielded a survey of investor types and biopharm executives and found a nearly unanimous desire to get rid of RFK Jr.
It’s not directly about pricing, but this report about what’s needed to counter China in biopharma — from a special congressionally backed committee — is what folks are talking about this morning. It’s somewhat interesting to me that Chinese-developed drugs haven’t yet been used as a lever to compete on price. (That was the EQRx strategy for a hot second, but it never ended up being tested.)
