Quick update: my social media manager and her teammates did indeed capture their second consecutive USA Hockey national championship, so congrats to the whole Shattuck-St. Mary’s crew. She’s off to Boston University in the fall, and I’m happy to arrange for tickets for any Cost Curve readers who want to catch Terriers women’s hockey next season.
Bristol-Myers Squibb became the latest biopharma to disclose list- and net-prices changes across its portfolio for 2023, as noted by my eagle-eyed erstwhile colleagues at Real Chemistry. Here’s how the numbers broke down, per BMS’ ESG report:
List prices: Up 4.4%
Net prices: Down 0.4%
Average discount: 46%
The BMS report has some other details on pricing approach and discounting (it’s on page 16), but nothing that really digs into the numbers.
As with all of these reports, it’s interesting to speculate on the drivers of the falling net prices, because no two companies are alike. In the case of BMS, there’s likely some big discounting on the company’s flagship product (Eliquis), which we’ve talked about at length in the context of the IRA. It’s also possible that 2023 was a big year for patient assistance around newer-to-market products while formulary coverage (something discussed a bit around #JPM24).
All of that is fun guesswork, but there’s one thing we know for certain, and that’s the old, undercovered reality that net prices remain flat or falling.
Jon Brodo at Todd Strategies flagged to me a handful of additional comments prepared for the Senators exploring reforms to the 340B program. BIO, AEH, AIR340B, Premier, and RWC-340B. The Coalition of State Rheumatology Organizations and the Catholic Health Association are also on the record. I haven’t seen any comments that fundamentally change my view on the program. Generally, covered entities want the current system — unlimited contract pharmacies with minimal transparency, regulation, and oversight — codified. Everyone else wants some breaks put on 340B to make sure that patients are actually helped.
There’s more outcomes data on anti-obesity medicines, and it’s strong. That’s a sentence that I suspect will get written a lot over the next five years, and I apologize for the repetition. But each successive study deepens the case for the value of these meds and makes clear that the underlying problem is handling budget impact, not pricing. I’ll probably write that sentence a lot, too.
The Boehringer Ingelheim’s IRA case will see the inside of a courtroom, with an oral argument scheduled for … June 20 (!?). We’ll probably have at least seven other decisions by then, so I’m not sure how dramatic that particular hearing will be.
I mentioned this CVS Caremark sponcon last week, which included the standard-issue PBM talking points, along with some swipes at Mark Cuban. Unsurprisingly, Cuban clapped back in an interview with Becker’s: “We hope they realize that every time their PBM underpays a pharmacy for a script, starts a pharmacy audit because a patient didn’t pick up a script, charges a DIR [direct and indirect remuneration] fee, or charges a fee when a discount card is used, they are saying, ‘F you’ to every independent pharmacy entrepreneur and doing their best to kill their American dream.” You mess with the bull, etc. etc.
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