The IRA Is in the Legal Crosshairs (Redux)

I’m not remotely sure what to do with the anti-price-control lawsuit that the U.S. Chamber of Commerce filed against HHS to stop implementation of the Inflation Reduction Act. Legally, it’s a more expansive endeavor than the Merck filing last week, going after -- among other things -- the mammoth taxes that would be levied on companies that choose to sit out the process.

But it’s not clear to me what the legal strategy behind the Chamber filing the suit, or why the Chamber name-checked AbbVie and AbbVie alone in the complaint, or or why they filed in southern Ohio. (Three of the four judges in the division in which the suit was filed are Trump appointees. Could that be it?)

And coverage was light, so there’s not a lot of legal commentary. Announcing lawsuits late on a summer Friday, when a former president is getting indicted, is not a recommended way of garnering attention.

It’s always good, when you’re launching a newsletter, to catch the eye of rich and powerful people. So I was tickled when I saw, late on Friday, that billionaire John Arnold was tweeting about Curve:

But while I was flattered, I feel like I should be explicit that even though -- yes -- I think that Arnold has done a great job of shaping the health policy debate, I wasn’t really arguing that was an unambiguously good thing.

So, some quick exposition.

First, the basic point that I was making when I cited Arnold Ventures last week: Arnold funds a huge chunk of the work around drug-pricing policy. The Harvard PORTAL folks. The pharma IP work out of the University of California, Hastings. ICER. The National Association for State Health Policy. Patients for Affordable Drugs. And on. And on.

The question is whether -- or how -- that enormous amount of funding is bending the dialogue in the direction of Arnold Ventures viewpoints (pro-price controls, etc.).

To be clear, I’m not suggesting that any of the work is anything other than genuine, only that the decisions around who and what gets funded has an impact on the conversation.

In the academic press, anyway, a tilt toward Arnold-funded folks seems to have led to relatively more analysis of, for example, international reference pricing (something most Americans are not fans of) and relatively less work on, say, the IRA’s pill penalty.

And that’s OK! (Mostly.) But, at a minimum, it’s a phenomenon to be aware of.

Anyway: I’m appreciative of your readership, John.

Colorado has a fun tool for looking at drug prices: the dashboard that its prescription drug advisory board will use to pick medicines to regulate is live. The visualizations offer worthwhile ways of comparing medicines.

Two giant caveats: First off, the PDAB process itself is somewhat fraught, with unelected bureaucrats working off of vague guidance to steer the economics of prescribing. Second, the dashboard has some missing data values. There’s no info on rebates, for the usual trade-secret reasons. But list prices, too, are being held back as confidential, which is unfortunate from both a practical and a philosophical point of view.

Other Things Catching My Eye This Morning:

• STAT’s Bob Herman flagged some dramatic PBM-on-PBM violence over whether Express Scrip’s erstwhile president can start her new gig at CVS. (Right now, legally, the answer is no.)

• Axios has lots on a Senate patent bill that has been bouncing around for years, but the piece doesn’t really make clear the most important point: the legislation isn’t getting passed unless it sneaks into a year-end spending bill.

• Do you care that the WSJ editorial board is going after the FDA’s Rob Califf for saying drug prices are too high? I don’t think I do, but noting the editorial here, for the record.

• This is a little bananas. The Washington Post has a story documenting insurance company efforts to slow prescribing of GLP-1 drugs for obesity, including sending “education letters” threatening to refer “suspected inappropriate or fraudulent activity … to the state licensure board, federal and/or state law enforcement.