Bernie Sanders Wants to Talk to CEOs About US vs ROW Pricing. Bring It On, I Say.

I love Thanksgiving for a number of reasons, the two biggest of which are 1) pie and 2) the explicit focus on gratitude. This year, I’ve been especially fortunate. As I’ve launched Reid Strategic, I’ve been lucky to have been able to plug into a network of consultants who have been generous with their time and their wisdom. 

And though I’m probably forgetting some names (oversights that I’ll correct in future editions), I want to extend explicit thanks to these professionals. And if you need thoughtful counsel in their areas of expertise, please, please reach out so I can make introductions: 

• Branding force-of-nature Howie Chan

• Patient advocacy champion Sam Watson

• DE&I and health equity leader Abby Hayes

• Video mastermind Boris Undorf

• Gene therapy doyenne Courtey Rice

• Scribe extraordinaire Gary Karr

• Government affairs expert Dan Leonard

• Health influence data guru Greg Matthews 

• Market access pioneer Marc Watrous

That’s only a subset of those who made a huge impact on me this year. Everyone who opens one of these newsletters, too, has given me the gift of your attention. I can’t adequately express my gratitude, but I hope you all get that last piece of pie.

So Bernie Sanders and the Democrats on the Senate HELP committee have mounted a public pressure campaign to get three pharma CEOs to a Jan. 25 hearing: Merck’s Rob Davis; BMS’s new leader, Chris Boerner; and JNJ leader Joaquin Duato. 

The hearing is titled “Why Does the United States Pay, By Far, The Highest Prices In The World For Prescription Drugs?” so you have a sense of where they’re going with the hearing. 

There’s no question that these kinds of events are basically traps, show trials that allow members from both sides of the aisles to generate social-media pwns of big pharma. 

On the flip side, there are some easy, if uncomfortable, answers to the basic question being posed that would be good to air out. Those answers come down to the basic economic reality that the less you pay for something, the less you get of it. 

That means the rest of the world is paying less for innovation, and they’re getting less innovation. On average, European nations have access to less than half of the medicines approved by the EU.

So here’s a fun challenge to pose to Bernie: “Here’s a list of 200 medicines approved over the past four years or so. Cross out 100, and explain to patients why you think they shouldn’t have access.”

(I know that Senate hearings are not set up to be snarky and disrespectful to Senators, but if we’re going to talk about international pricing disparities, I would love to have a discussion about tradeoffs at the same time.)

• The Wall Street Journal scooped the news that Sens. Elizabeth Warren and Mike Braun have asked the HHS inspector general to try to figure out why it is that insurance companies are charging a lot more for certain generic drugs than, say, Mark Cuban is. This should be an easy one for the OIG, and I look forward to seeing their response, which will be a more verbose version of, “It’s the vertical integration, stupid.”

• The House Budget Committee has asked the Congressional Budget Office if it’s keeping an eye on IRA-related news around drug development, noting that there has been a lot of noise about companies walking back investments in ways that might not have been captured by the initial CBO assessment of the impact of the law. 

• A couple of worthwhile backgrounders today. The American Action Forum has a good overview of the current controversies around the Medicaid Drug Rebate Program, including stacking and penny cap issues. And Brookings looks at all of the ways that CMS might want to look at therapeutic alternatives, nearly all of which would give industry some cause for concern. 

• Medpage Today takes a pretty good look at the prescription drug affordability board phenomenon. Colorado remains the bellwether here, in part because they’re moving most quickly and partly because they have the most expansion law. 

• ICER is going to take a look at Verona’s COPD drug, ensifentrine. I appreciate ICER’s efforts to stay ahead of the curve, but it’s worth noting that Verona has a market cap of about $1 billion, which suggests that maybe the market doesn’t think the company has a budget-destroying blockbuster on its hands.