Arnold Ventures Is Driving Health Policy Discourse In the U.S. Here's How They're Spending Their Money

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I’ve spent far too much time this week looking at the 2023 tax filing for the Laura and John Arnold Foundation, and then coaxing the PDF file into some sort of easily searchable and sortable spreadsheet. 

It’s not glamorous work, but I feel like it deserves a drum roll anyway: here is the Cost Curve/Reid Strategic Arnold Grant Tracker. I have 2022 and 2023 loaded in.** 

The Arnold filings are critical because they give the most complete look*** into the group that may be the most effective entity in the United States at driving policy change around drug pricing. 

Pick your issue, and there are probably Arnold fingerprints all over it. 

I wrote a newsletter edition about the “Arnold Playbook” about a year ago, and everything I said in that post remains true today: Arnold has become expert at funding those creating the foundational research on hot-button topics (picking carefully for both productivity and ideological alignment) and then making sure that research is injected into the political discourse. 

Because that money speaks so loudly, it’s worth thinking about where the Arnolds are spending it. Hence the interest in the tax form. 

A few toplines from the 2023 data: 

• Harvard’s PORTAL group was perhaps the biggest recipient of Arnold’s largess in 2023: two grants worth $2.5 million. 

• 340B -- which didn’t feature in any grants as recently as two years ago -- received about $400,000 in funding, most of it going to the University of Minnesota and the Brigham & Women’s Hospital. The same four groups also received grants with identical descriptions (though larger sums of money) that were disclosed in the 2022 filing.

• Grants mentioning “Medicare” amounted to $9.3 million in spending. About $6 million in grants touched on Medicaid. (There was a lot of overlap there.)

• It’s not just drugs. Millions in grant money were allocated to hospital and provider prices, too. 

• Two grants specifically name-check the IRA: one to Vanderbilt (looking at cancer drug prices) and one to Georgetown. 

I’ll be curious to see what catches your eye as you go through the numbers. And it’s quite possible that small gremlins have reared their ugly heads as I’ve imported the data. Shout with any errors you see. 

** Older data is available, but it’s harder to work with. I aspire to add that in at some point in the future. 

Once upon a time, Arnold Ventures provided details on all of their grants on their webpage, segmented by topic. It was very illuminating and very transparent, but they did away with that for some reason. 

Back in the day, I literally copied and pasted those grants into a spreadsheet, so if you need even deeper cuts on Arnold spending, just reach out. 

*** I’m not sure how comprehensive the filing is, and understanding the structure of the Arnold universe is not in my wheelhouse. Arnold Ventures is an LLC -- a corporation -- that includes three different funding vehicles, of which the Laura and John Arnold Foundation seems to be the most significant. The IRA filing appears to have the high profile grantees that I was expecting, but I can’t say with confidence that there isn’t money elsewhere in the banana stand. 

It’s also worth noting that Arnold gives multi-year grants, so just because a given group doesn’t show up in a specific year doesn’t mean that it’s not Arnold-funded. ICER, for example, doesn’t show up in the 2023 and 2022 data, but they did get a seven-figure grant in 2021. 

Oh, I do love predictions about what the next 15 medicines up for IRA price controls will be. I’ve taken a couple of stabs at it (here and here), and, frankly, I need to update my list again to reflect my continued thinking. . 

But I’m more confident in my list than this new one in Science Translational Medicine, which I suspect misses a couple of picks because of incorrect assumptions around trends in gross Medicare spending. But more data and thinking are always welcome. 

For the record, I think the best academic work on this continues to be the Inma Hernandez & Friends effort from JCMP. I’ll have a breakdown of where all of these guesses align and where the uncertainties may lie next week. 

ELSEWHERE: 

• PBM reform may be getting baked into a year-end legislative package, according to STAT reporting. It sounds like the details are still a little hazy. I predict we’ll have a lot more on this over the next week as the outlines here become better defined. 

• To repeat myself: all 340B content is good content. At the end of the day, people need to be vaguely aware that there is this thing out there. So I was heartened to hear that the new Connecticut task force on drug pricing, which had its first meeting yesterday, is already 340B obsessed: “[I]n a session where task force members could share their priorities, one theme came up over and over again – the 340B pricing program.”

• The U.S. Patent and Trademark Office will not move forward with a new rule that would have made it easier to invalidate IP, even those that have follow-on patents. STAT has the details, though previous STAT reporting foreshadowed this outcome: when the rule was first floated, even proponents gave it only a 5% chance of moving ahead. 

• Four members of Congress have asked the Department of Justice to investigate the role of PBMs in amplifying the opioid crisis, per Barron’s reporting. The move follows a Barron’s piece earlier in the fall that suggested that PBMs may have worked to push wider use of the medicines in return for larger rebates.

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 [email protected].