Judge Rules Govt. Wrong For Trying To Force Drugmakers To Discount Prices
The U.S. government had warned a list of manufacturers, including Eli Lilly, that they would be breaking the law by ending discounts to a program sending drugs to facilities in mainly low-income areas — but this was deemed wrong by a federal court judge. CVS, PBMs, Purdue, Aduhelm and Biomet are also in the news.
Judge Rules Against U.S. Bid To Force Drug Makers To Offer Discounts
In a big win for the pharmaceutical industry, a federal court judge ruled the U.S. government acted incorrectly when it warned Eli Lilly and several other drug makers they would violate the law by ending discounts to a program that provides medicines to hospitals and clinics serving mostly low-income populations. The U.S. Department of Health and Human Services took administrative steps that were “arbitrary and capricious” when it warned the companies about curtailing the discounts, the judge wrote in an opinion issued Friday. At the same time, Eli Lilly was criticized for “unilaterally” ending discounts in a way that inhibited the program, and caused some hospitals and clinics to complain they were inappropriately overcharged for medicines. (Silverman, 10/30)
In other pharmaceutical and biotech industry news —
AIDS Healthcare Foundation Intervenes In CVS Class-Action
A group of patients with HIV and AIDS gained another ally in their class-action against CVS Health's Caremark on Thursday, with the AIDS Healthcare Foundation telling the U.S. Supreme Court that the pharmacy benefit manager's patient steering practices violated federal disability law. AHF's amicus brief supports a suit at least five patients brought against the retail health giant in 2018, claiming the company's blanket requirement that all customers receive prescriptions from a CVS mail-order pharmacy or retail pharmacist threatened their health and privacy. The patients receive their drug benefits through their employers, which have contracted with CVS to administer their benefits. They argue that they are being disproportionately impacted by a CVS requirement that applies to all plan participants. (Tepper, 10/29)
PBM Clawbacks Sidestep State Bans On Spread Pricing
Pharmacy benefit managers seem to be getting the better of the 21 states that banned spread pricing and are continuing to bill Medicaid for more than the price paid to drugstores for medicines. Spread pricing is a financial boon to PBMs. Under this practice, PBMs pay pharmacists for dispensing medications at one rate, then return months later to "claw back" the difference between that amount and the contracted rate established by a Medicaid managed care carrier—after state Medicaid agencies have closed the books on the prescription purchases. (Tepper, 10/29)
The Purdue Bankruptcy Plan Was Approved. Where Is The Money?
Nearly two months ago, a U.S. bankruptcy court judge approved a controversial Purdue Pharma plan that would funnel billions of dollars to pay for the harm caused by the OxyContin opioid painkiller. At the core, the deal calls for some members of the Sackler family — which controlled Purdue — to contribute more than $4.3 billion over nearly a decade to compensate individuals, state and local governments, and tribal communities for the cost of the opioid crisis. (Silverman, 11/1)
Aduhelm's Loudest Physician Proponents Have Taken Money From Biogen
A small group of physicians with deep, at times undisclosed, financial ties to the drug maker Biogen has emerged as the most vocal defenders of the company’s questionably effective and costly Alzheimer’s drug, Aduhelm. The four doctors, who all served as consultants to Biogen in 2020, have written articles in scientific journals defending the drug, praised the drug in the press, and appealed directly to the Food and Drug Administration to approve the drug — sometimes without disclosing that they had served as paid consultants for the company. Since 2014, the four have taken in $117,000 in consulting fees from the company. (Florko, 11/1)
Can Zimmer Biomet's Smart Knee Implant Transform Orthopedic Tech?
Last month, surgeons implanted the first of a new, souped-up knee implant, developed by Zimmer Biomet as a way to passively collect data about recovery after one of medicine’s priciest and most common procedures. Zimmer Biomet, which pulls in $7 billion a year selling implants and other musculoskeletal care products and services, is unsurprisingly bullish on the new device, called Persona IQ, which gives the century-old company the sheen of a Silicon Valley tech innovator. (Aguilar, 11/1)