Tuesday Is (Apparently) the Day When CMS Releases the First 10 Meds for Price Controls

Well, we don’t know the who, but we know the when.

Politico reported yesterday that the White House would announce the first ten medicines to be price-controlled on Tuesday morning, well ahead of the Sept. 1 deadline. That’s good news for those looking to take a long Labor Day weekend and lousy news for those, like, um, me, who moved their long weekend up to make sure they were available on Sept. 1.

So we know the date.* And we know that the administration is going to bang pots and pans together to bring attention to the event. All that’s left is the guest list. * At least, we think we know the date. The Politico reporting has been out there for 18 hours or so, and I haven’t seen any other outlet match it.

So far as I can tell, no one knows exactly which ten medicines will be selected. There are probably six, maybe seven, slam-dunks, but the bottom of the list is a big question mark.

Some of the uncertainty comes from the fact that no one is quite sure how the government will assess which medicines might be facing generic competition in two-plus years, when the “negotiated” prices kick in. And no one has the 2022 spending numbers that Medicare is using to make the call, adding to the drama.

If you want to peep some lists of possible , here is the Journal of Managed Care and Specialty Pharmacy one that gets referenced a lot. Here’s the UBS guess, as reported by Yahoo. Bloomberg has their ten. Reuters has a slightly broader list, sourced from analyst notes. Pink Sheet, too, cheated by citing more than 10 candidates.

Don’t get so caught up in the “selected drugs” list that you take your eye off the ball of the ongoing legal battles.

Bloomberg has a strong look at all of the law firms massed for this particular war, and if you’re looking for an at-a-glance overview of which groups are making which legal claims, I’ve updated my clip-n-save overview (an annotated PDF, with links, etc. is here):

Interesting that, in six of the seven cases, the judge overseeing the case was appointed by a Democrat. (The one exception is the rapidly moving Chamber case.)

I’ll admit: I have no idea what to make of this CVS-to-make-biosimilars story, or the initial effort, which is to sell Sandoz’s Humira biosimilar for more than 80% below Humira’s list (which comes to somewhere just north of $1,000).

Like, what’s the advantage to CVS for “owning” a biosimilar? What’s Sandoz’s role here? Where’s the benefit for the customer?

I know that 46Brooklyn’s Antonio Ciaccia is skeptical. He called it, in his inimitable style “a perpetuation of fake, inflated prices all while introducing yet another conflict of interest in the drug channel.” But I don’t really see how the whole thing fits together.

A quick search shows that Coherus’ biosimilar is available through Mark Cuban at $584.25. The Sandoz product, according to GoodRx, can be mine for only $554.53. But not at CVS … Walgreens has the lowest price.

God help the consumer here.

Moving on:

• STAT covered mid-year price increases in a way that is not particularly illuminating. There were some mid-year price increases where a muckracking journalist might be able to make hay, but the way this story was told really makes it hard to understand what the real problem is, beyond the usual talking points.

• Florida’s plan to set up a drug importation program with the FDA is running into problems, though the reporting here doesn’t really get at what’s happening or what’s next.

• Last week, I flagged a Reuters event on Tuesday titled “Re-designing U.S. Health Insurance.” If you missed it, the video is up here.