A Quick Look At Everything I Missed While I Was Gone

So I wasn’t gone that long, but I feel like I missed a ton. Eschewing the usual format in favor of some quick hits, grouped by importance.

BIG DEALS

• The UK drug-pricing approach was clearly not working, and I’m curious to see if the new approach -- detailed in this press release and summarized in this STAT story -- is going to do the trick. The new deal is objectively better, but it’s still probably an open question about whether it's good enough. Any process that tries to cap spending growth in a time of increasing utilization feels fraught. 

• The plural of anecdote is not data, so you ought not take seriously, as an indicator of a trend, this Wall Street Journal story that tracks down three organizations -- over four years -- fleeing big PBMs. But it’s a big deal that the media sees this as a phenomenon worth tracking and elevating. If every PBM failure gets this kind of media treatment, then, eventually, this kind of thing will be a legit trend. 

• It’s not particularly a surprise that the United States has greater access-related disparities based on income than other similarly situated nations, but that represents the rot at the heart of the U.S. system. That’s always worth paying attention to.  

WONKY BUT WORTHWHILE

• Sen. Bill Cassidy is continuing to look under rocks to best understand the abuses in the 340B system, including this letter demanding 340B data from two large community health centers. 

• Speaking of 340B, this JAMA Health Forum piece tracks how much of the Medicare Part D segment now flows through the 340B program. (Hint: it’s a lot, and it could probably be even more.)

• I’ve been shouting that the CMS patient listening sessions around the Inflation Reduction Act are worthless, so I felt some amount of validation upon learning that the National Pharmaceutical Council feels the same way.

• A House subcommittee voted to move a number of PBM reforms forward, though I have no earthly idea if anything other than spending-bill showdowns will happen in Congress before 2025. 

• One of the guys on that subcommittee is Rep. Buddy Carter, whose dim view of the PBM industry is well-articulated in this piece in The Hill. 

• The battle against copay accumulators is not yet won, per this HIV and Hepatitis Policy Institute press release calling for the government to formally incorporate a recent anti-accumulator legal ruling into its regulation of health plans. 

MORE HEAT THAN LIGHT

• Oral obesity medicines are a hugely interesting subject, but I don’t think that past performance is particularly indicative of the future of the market, this Bloomberg piece notwithstanding. 

• It feels like a stretch to blame obesity medicines for an upcoming spike in medical costs -- my guess is that any increase in obesity costs will be offset by lower spending on Humira alone -- but it sure is good for clicks to hold obesity drugs responsible. 

• I don’t think there’s anything new in this NPR article about Bernie Sanders’ quest to use the power of the NIH to drive down drug prices, but it’s probably important to know how NPR is framing things. 

TURKEYS

• I should have seen this coming, but there are at least two pieces -- one from AP and one from Bloomberg -- looking at the Thangsgiving-related implications of anti-obesity medicines. I mean, really? 

• The folks at ATI Advisory are unquestionably smart. That means a report like this one, making the case that the IRA hasn’t had any impact on pharma R&D spend and, therefore, that the IRA isn’t material for the industry, is intentionally misleading, not accidentally misguided. I’d be inclined to just pretend I didn’t see it, but STAT mentioned it in a newsletter last week, so I feel compelled to point out how bad it is.