Bal­loon­ing 340B mar­ket reach­es al­most 15% of 2021 US phar­ma sales, IQVIA finds

The tale of a boom­ing fed­er­al drug dis­count pro­gram, which phar­ma com­pa­nies have sought to cur­tail, has of­ten been told but rarely with new num­bers.

Now, the drug pric­ing gu­rus at IQVIA say their lat­est da­ta shows that the pro­gram, known as 340B and once de­signed to give mas­sive dis­counts to on­ly a se­lect num­ber of out­pa­tient drugs for on­ly a se­lect few health care providers, has bal­looned to $93.6 bil­lion in sales in 2021, which is about 15% of the to­tal $668.3 bil­lion in phar­ma sales for the year.

What’s more, is that the 340B sales to­tal has near­ly dou­bled in just three years.

The da­ta ar­rive as at least 16 phar­ma com­pa­nies have now re­worked their 340B op­er­a­tions over the last sev­er­al years to work around a ris­ing num­ber of hos­pi­tals’ con­tract phar­ma­cies, even as law­suits have sought to con­strain the firms, some of which have tilt­ed to in­dus­try’s fa­vor.

Phar­ma com­pa­nies’ re­stric­tions on the pro­gram are work­ing, too, as IQVIA found that for 9 of these man­u­fac­tur­ers with re­stric­tions in place for some or all of 2021, re­tail and mail 340B sales fell 32% and 20%, re­spec­tive­ly. But for all oth­er phar­ma man­u­fac­tur­ers’ sales, re­tail and mail 340B sales grew 16% and 44%, re­spec­tive­ly.

An­oth­er sign the re­stric­tions are work­ing: 340B sales of di­a­betes drugs de­clined 7.4% year-on-year in 2021 ver­sus 22% growth seen in 2020.

Com­pli­cat­ing the mat­ter fur­ther is the fact that in­sulin jug­ger­naut Eli Lil­ly de­feat­ed in court the Biden ad­min­is­tra­tion’s Health Re­sources and Ser­vices Ad­min­is­tra­tion, the fed­er­al de­part­ment that runs the 340B pro­gram.

The judge, in that case, made clear that Con­gress may need to act in this sit­u­a­tion:

The de­mand for 340B drugs and the preva­lence of con­tract phar­ma­cies has ex­plod­ed in a way that Con­gress like­ly did not imag­ine ei­ther when the statute was first en­act­ed in 1992.

Still, HRSA con­tin­ues to go af­ter the phar­ma man­u­fac­tur­ers re­strict­ing 340B sales, as it re­ferred to Boehringer In­gel­heim’s con­tract phar­ma­cy changes for mon­e­tary penal­ties, ac­cord­ing to a re­cent let­ter to the com­pa­ny pres­i­dent.

HRSA said in a state­ment re­gard­ing the over­ar­ch­ing le­gal sit­u­a­tion:

We are pleased that two of three re­cent U.S. Dis­trict Court opin­ions in­volv­ing the 340B Pro­gram agree with HRSA that three phar­ma­ceu­ti­cal man­u­fac­tur­ers have un­law­ful­ly re­strict­ed ac­cess to 340B dis­count­ed drugs by cov­ered en­ti­ties that dis­pense med­ica­tions through con­tract phar­ma­cy arrange­ments – the core find­ing of HRSA’s May 17, 2021, Vi­o­la­tion Let­ters.  HRSA re­spect­ful­ly dis­agrees with the re­cent Dis­trict Court opin­ion find­ing that two oth­er man­u­fac­tur­ers had not vi­o­lat­ed the statute, and con­tin­ues to eval­u­ate its op­tions.

Pi­o­neer­ing Click Chem­istry in Hu­mans

Reimagining cancer treatments

Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, which is nearly one in six deaths. Recently, we have seen incredible advances in novel cancer therapies such as immune checkpoint inhibitors, cell therapies, and antibody-drug conjugates that have revamped cancer care and improved survival rates for patients.

Despite this significant progress in therapeutic targeting, why are we still seeing such a high mortality rate? The reason is that promising therapies are often limited by their therapeutic index, which is a measure of the effective dose of a drug, relative to its safety. If we could broaden the therapeutic indices of currently available medicines, it would revolutionize cancer treatments. We are still on the quest to find the ultimate cancer medicine – highly effective in several cancer types, safe, and precisely targeted to the tumor site.

Justin Klee (L) and Joshua Cohen, Amylyx co-CEOs (Cody O'Loughlin/The New York Times; courtesy Amylyx)

Ad­vo­cates, ex­perts cry foul over Amy­lyx's new ALS drug, cit­ing is­sues with price, PhI­II com­mit­ment

Not 24 hours after earning the first ALS drug approval in five years, Amylyx Pharmaceuticals’ Relyvrio is already drawing scrutiny. And it’s coming from multiple fronts.

In an investor call Friday morning, Amylyx revealed that it would charge about $158,000 per year, a price point that immediately drew backlash from ALS advocates and some outside observers. The cost reveal had been highly anticipated in the immediate hours after Thursday evening’s approval, though Amylyx only teased Relyvrio would cost less than previously approved drugs.

Endpoints News

Keep reading Endpoints with a free subscription

Unlock this story instantly and join 151,400+ biopharma pros reading Endpoints daily — and it's free.

Land­mark Amy­lyx OK spurs de­bate; Some... pos­i­tive? Alzheimer's da­ta; Can­cer tri­al bot­tle­neck; Sanofi's CRISPR bet; and more

Welcome back to Endpoints Weekly, your review of the week’s top biopharma headlines. Want this in your inbox every Saturday morning? Current Endpoints readers can visit their reader profile to add Endpoints Weekly. New to Endpoints? Sign up here.

After brief stops in Paris and Boston, John Carroll and the Endpoints crew are staying on the road in October with their return for a live/streaming EUBIO22 in London. The hybrid event fireside chats and panels on mRNA, oncology and the crazy public market. We hope you can join him there.

Endpoints News

Keep reading Endpoints with a free subscription

Unlock this story instantly and join 151,400+ biopharma pros reading Endpoints daily — and it's free.

Joshua Cohen (L) and Justin Klee, Amylyx co-CEOs

Up­dat­ed: Af­ter long and wind­ing road, FDA ap­proves Amy­lyx's ALS drug in vic­to­ry for pa­tients and ad­vo­ca­cy groups

For just the third time in its 116-year history, the FDA has approved a new treatment for Lou Gehrig’s disease, or ALS.

US regulators gave the thumbs-up to the drug, known as Relyvrio, in a massive win for patients and their families. The approval, given to Boston-area biotech Amylyx Pharmaceuticals, comes after two years of long and contentious debates over the drug’s effectiveness between advocacy groups and FDA scientists, following the readout of a mid-stage clinical trial in September 2020.

Endpoints News

Keep reading Endpoints with a free subscription

Unlock this story instantly and join 151,400+ biopharma pros reading Endpoints daily — and it's free.

#AAO22: J&J’s first look at com­mon eye dis­ease port­fo­lio pads the case for PhII of gene ther­a­py

CHICAGO — While the later-stage drug developers in the geographic atrophy field are near the finish line, Johnson & Johnson’s Janssen is taking a more deliberate route, with a treatment that it hopes to be a one-time fix.

The Big Pharma will take its Hemera Biosciences-acquired gene therapy into a Phase II study later this year in patients with GA, a common form of age-related macular degeneration that impacts about five million people worldwide. To get there, Janssen touted early-stage safety data at the American Academy of Ophthalmology annual conference Saturday morning, half a day after competitors Apellis and Iveric Bio revealed their own more-detailed Phase III analyses.

Endpoints News

Keep reading Endpoints with a free subscription

Unlock this story instantly and join 151,400+ biopharma pros reading Endpoints daily — and it's free.

Nooman Haque, head of life sciences and healthcare at Silicon Valley Bank, and John Carroll

I’m head­ed to Lon­don soon for #EU­BIO22. Care to join me?

It was great getting back to a live ESMO conference/webinar in Paris followed by a live pop-up event for the Endpoints 11 in Boston. We’re staying on the road in October with our return for a live/streaming EUBIO22 in London.

Silicon Valley Bank’s Nooman Haque and I are once again jumping back into the thick of it with a slate of virtual and live events on October 12. I’ll get the ball rolling with a virtual fireside chat with Novo Nordisk R&D chief Marcus Schindler, covering their pipeline plans and BD work.

Some­one old, some­one new: Mod­er­na pro­motes CTO, raids No­var­tis for re­place­ment amid pipeline push

Moderna CEO Stéphane Bancel made clear on the last quarterly call that “now is not the time to slow down.” On Thursday, he made a bit more room in the cockpit.

The company unveiled a new executive role on Thursday, promoting former chief technical operations and quality officer Juan Andres to president of strategic partnerships and enterprise expansion, and poaching a former Novartis exec to take his place.

Gilead names 'k­ing­pin­s' in coun­ter­feit HIV med law­suit

Gilead is mounting its counterfeit drug lawsuit, naming two “kingpins” and a complex network of conspirators who allegedly sold imitation bottles of its HIV meds, some of which ended up in US pharmacies.

The pharma giant on Wednesday provided an update on what it called a “large-scale, sophisticated counterfeiting conspiracy,” accusing two new defendants of “leading and orchestrating” a scheme to sell hundreds of millions of dollars in illegitimate drugs posing as meds such as Biktarvy and Descovy.

Tar­sus looks to raise aware­ness of eye­lid mite dis­ease in cam­paign aimed at eye­care spe­cial­ists

Eyelid mite disease may be “gross” but it’s also fairly common, affecting about 25 million people in the US.

Called demodex blepharitis, it’s a well-known condition among eyecare professionals, but they often don’t always realize how common it is. Tarsus Pharmaceuticals wants to change that with a new awareness campaign called “Look at the Lids.”

The campaign and website debut Thursday — just three weeks after Tarsus filed for FDA approval for a drug that treats the disease.

Endpoints News

Keep reading Endpoints with a free subscription

Unlock this story instantly and join 151,400+ biopharma pros reading Endpoints daily — and it's free.