A New KFF Poll on Drug Prices Undermines My Faith In My Fellow Americans

There is new KFF polling data out in the pharmaceutical industry, and it mostly makes me sad.

I’m not sad because the polling found that most people have a dim view of the pharmaceutical industry. I’ve come to expect that. (And, indeed, I take heart in the rising number of Americans who think that the last two decades of drug development have made lives better.)

Nope: I’m sad because the poll confirms my cynical view that a lot of Americans don’t know anything about anything.

The pollsters asked a series of questions about the Inflation Reduction Act. Turns out that only a quarter of Americans know there will be price “negotiation” in Medicare. An even smaller number know about the IRA’s out-of-pocket cap. About 10% of those polled are tracking on the inflation penalties (more than twice as many respondents answered, confidently, that no such penalties exist).

I assume that’s bad news for Joe Biden, and it’s probably bad news for pharma, helping to explain why -- a year after the most comprehensive set of drug-price controls in the history of the nation -- the number of Americans who think there isn’t enough regulation of drug pricing is up 10 percentage points since 2021.

Oof.

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All that said, coverage of the poll has largely looked at responses around weight loss drugs. Despite the attention, the findings are not that interesting … turns out that in a polling sample where 61% are trying to lose weight, weight-loss drugs are attractive.

Really, the only part of the weight-loss part of the poll that caused me to roll my eyes (and reinforced that “don’t know anything about anything” worldview) is the finding that more than two-third of those interested in obesity meds would stop being interested if they learned that they’d gain the weight back if they stopped taking them.

This has come up a lot in coverage, and I’m stumped by the logic here. No one thinks that you can stop statins once your cholesterol numbers fall, or that diabetes drugs are no longer needed once A1C is below 7. Why the belief that weight-loss meds are somehow different?

We’re at an interesting stage in the conversation over 340B. There seems to be an emerging consensus that something needs to be done legislatively, but there’s no clear consensus on what that “something” might be. There aren’t even really clear battle lines about how to start that discussion.

But, in June, a group of Senators asked for fairly open-ended feedback on a set of six broad questions about how policymakers should start to think about what’s next for 340B.

And that spurred a lot of responses. I’m sure I haven’t captured them all, but here’s a rough list of the some of the groups that have made public their letters:

• American Hospital Association. They’d like more oversight of the drug companies, natch.

• PhRMA. Thinks there should be more accountability and patient-centricity.

• BIO. Similar to PhRMA, they’re all-in on transparency and a more thoughtful approach to contract pharmacies.

• California Hospital Association. They centered their response around the needs of “rural and underserved communities.”

• Community Oncology Alliance. Their response drew a distinction between more-deserving and less-deserving covered entities.

• National Association of Community Health Centers. A big call for transparency from the PhRMA-allied group.

Weirdly, I couldn’t find a response from 340B Health, which is the loudest group representing covered entities. They pushed out a press release when the Senators’ letter dropped, but I don’t see that they’ve made anything else public.

• All I really wanted this week was for Bloomberg’s Matt Levine to talk about the bonkers Martin Shkreli price-slashing, short-selling scheme from the American Prospect lede. I got my wish.

• I’d kind of lost track of Patrick Conway, whose six-year stint at CMS earned him the label, via the New York Times of “one of the most powerful doctors in America.” But then some issues derailed his career for a spell. Turns out he’s been at Optum for the last few years, and he was just elevated to CEO of Optum Rx. I don’t know exactly what that means for the PBM, but I would assume that’s well worth watching.

• STAT covered another push to get Vertex to improve access to its cystic fibrosis meds in low- and middle-income countries.

• I haven’t been too geeky here lately, so let me offer a small corrective: this month’s issue of PharmacoEconomics is jam-packed with studies exploring an important part of the study of value assessment: how to think about measuring costs from a societal POV.