House com­mit­tee weighs drug pric­ing pro­pos­als

The House Ways and Means Com­mit­tee on Tues­day heard tes­ti­mo­ny on ways the US could ad­dress the ris­ing cost of pre­scrip­tion drugs.

The hear­ing fol­lows two re­cent Con­gres­sion­al hear­ings on drug pric­ing held by the House Over­sight Com­mit­tee and Sen­ate Fi­nance Com­mit­tee late last month and pre­cedes a much-an­tic­i­pat­ed Sen­ate Fi­nance Com­mit­tee hear­ing on 26 Feb­ru­ary where the CEOs of drug­mak­ers Ab­b­Vie, Bris­tol-My­ers Squibb, John­son & John­son, Mer­ck, Pfiz­er and Sanofi are ex­pect­ed to tes­ti­fy.

Ris­ing pre­scrip­tion drug prices have been a fierce­ly de­bat­ed po­lit­i­cal is­sue in re­cent years, with both De­moc­rats and Re­pub­li­cans in Con­gress and the Trump ad­min­is­tra­tion all pitch­ing their own so­lu­tions, in­clud­ing al­low­ing pre­scrip­tion drug im­por­ta­tion from Cana­da, fur­ther Medicare Part D ne­go­ti­a­tions, set­ting in­ter­na­tion­al ref­er­ence pric­ing and re­duc­ing bar­ri­ers to com­pe­ti­tion.

The De­part­ment of Health and Hu­man Ser­vices al­so re­cent­ly pro­posed a rule to elim­i­nate pro­tec­tions for re­bates paid to phar­ma­cy ben­e­fit man­agers (PBMs), which the ad­min­is­tra­tion says would low­er costs for con­sumers.

While drug­mak­ers, in­clud­ing Eli Lil­ly and No­var­tis, have backed the pro­pos­al, the Phar­ma­ceu­ti­cal Care Man­age­ment As­so­ci­a­tion, the trade group rep­re­sent­ing PBMs, has ar­gued that PBMs help low­er costs by ne­go­ti­at­ing re­bates.

Dur­ing the hear­ing, Ways and Means Com­mit­tee Chair­man Richard Neal (D-MA) cit­ed the fin­ger point­ing be­tween the var­i­ous ac­tors in­volved in pre­scrip­tion drug spend­ing.

Rep. Richard Neal

“Drug com­pa­nies point to the PBMs, who point to the in­sur­ance com­pa­nies, who point to the hos­pi­tals. The one group that is not the prob­lem but is the biggest vic­tim is in­deed the pa­tients,” he said, adding that Con­gress will need to take a “mul­ti-pronged” ap­proach to ad­dress high pre­scrip­tion drug spend­ing in­volv­ing changes at the US Food and Drug Ad­min­is­tra­tion, Cen­ters for Medicare & Med­ic­aid Ser­vices (CMS) and po­ten­tial­ly changes to the tax code.

Neal, along with rank­ing mem­ber Kevin Brady (R-TX), said they are com­mit­ted to work­ing to­geth­er “to take mean­ing­ful ac­tion to low­er the cost of pre­scrip­tion drugs in the US health care sys­tem.”

How­ev­er, de­spite the promise to work to­geth­er, mem­bers of the two par­ties are not ful­ly aligned on what steps to take.

One area of dis­agree­ment is over whether Medicare should be al­lowed to ne­go­ti­ate drug prices in its Part B and Part D pro­grams.

While ad­vo­cat­ing for Medicare Part B and Part D re­forms, Brady dis­missed the no­tion that the gov­ern­ment should ne­go­ti­ate drug prices.

Rep. Kevin Brady

“When Wash­ing­ton ne­go­ti­ates in gov­ern­ment-run health­care pro­grams, tax­pay­ers of­ten end up bear­ing the cost while Amer­i­cans can be de­nied ac­cess to the most in­no­v­a­tive break­through med­i­cines avail­able to oth­ers in the pri­vate mar­ket,” he said.

In­stead, Brady ar­gued that “em­pow­er­ing pa­tients to choose the most af­ford­able med­i­cines for them and elim­i­nat­ing the in­cen­tives in Medicare that re­ward bad ac­tors and lead to high prices” would be a more ef­fec­tive so­lu­tion, re­fer­ring Medicare’s per­cent­age-based re­im­burse­ment struc­ture which some ar­gue in­cen­tivizes pre­scrib­ing more ex­pen­sive drugs.

Rachel Sachs

Mark Miller, ex­ec­u­tive vice pres­i­dent of health care at Arnold Ven­tures, told the com­mit­tee that mov­ing to a flat fee-per-pre­scrip­tion mod­el for Medicare Part B could help to curb some spend­ing.

Both Miller and Rachel Sachs, as­so­ciate pro­fes­sor of law at Wash­ing­ton Uni­ver­si­ty in St. Louis, al­so said that the US could save mon­ey on pre­scrip­tion drugs by ty­ing their prices to an in­ter­na­tion­al ref­er­ence list, as the Trump ad­min­is­tra­tion re­cent­ly pro­posed.


First pub­lished here and syn­di­cat­ed in part­ner­ship with RAPS.

Martin Shkreli [via Getty]

Pris­on­er #87850-053 does not get to add drug de­vel­op­er to his list of cred­its

Just days after Retrophin shed its last ties to founder Martin Shkreli, the biotech is reporting that the lead drug he co-invented flopped in a pivotal trial. Fosmetpantotenate flunked both the primary and key secondary endpoints in a placebo-controlled trial for a rare disease called pantothenate kinase-associated neurodegeneration, or PKAN.

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We­bi­nar: Re­al World End­points — the brave new world com­ing in build­ing fran­chise ther­a­pies

Several biopharma companies have been working on expanding drug labels through the use of real world endpoints, combing through the data to find evidence of a drug’s efficacy for particular indications. But we’ve just begun. Real World Evidence is becoming an important part of every clinical development plan, in the soup-through-nuts approach used in building franchises.

I’ve recruited a panel of 3 top experts in the field — the first in a series of premium webinars — to look at the practical realities governing what can be done today, and where this is headed over the next few years, at the prodding of the FDA.

ZHEN SU — Merck Serono’s Senior Vice President and Global Head of Oncology
ELLIOTT LEVY — Amgen’s Senior Vice President of Global Development
CHRIS BOSHOFF — Pfizer Oncology’s Chief Development Officer

A premium subscription to Endpoints News is required to attend this webinar. Please upgrade to either an Insider or Enterprise plan for access. Already have Endpoints Premium? Please sign-in below. You can contact our Subscriptions team at help@endpointsnews.com with any issues.

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Hal Barron. GSK

GSK's Hal Bar­ron her­alds their sec­ond pos­i­tive piv­otal for cru­cial an­ti-BC­MA ther­a­py, point­ing to a push for quick OKs in a crowd­ed field

Hal Barron has his second positive round of Phase III data in hand for his anti-BCMA antibody drug conjugate belantamab mafodotin (GSK2857916). And GSK’s research chief says the data paves the way for their drive in search of an FDA approval for treating multiple myeloma.

It’s hard to overestimate the importance of this drug for GSK, a cornerstone of Barron’s campaign to make a dramatic impact on the oncology market and provide some long-lost excitement for the pharma giant’s pipeline. They’re putting this BCMA program at the front of that charge — looking to lead a host of rivals all aimed at the same target.

We don’t know what the data are yet, but DREAMM-2 falls on the heels of a promising set of data delivered 5 months ago for DREAMM-1. There investigators noted that complete responses among treatment-resistant patients rose to 15% in the extra year’s worth of data to look over, with a median progression-free survival rate of 12 months, up from 7.9 months reported earlier. The median duration of response was 14.3 months.

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Brian Kaspar. AveXis via Twitter

AveX­is sci­en­tif­ic founder fires back at No­var­tis CEO Vas Narasimhan, 'cat­e­gor­i­cal­ly de­nies any wrong­do­ing'

Brian Kaspar’s head was among the first to roll at Novartis after company execs became aware of the fact that manipulated data had been included in its application for Zolgensma, now the world’s most expensive therapy.

But in his first public response, the scientific founder at AveXis — acquired by Novartis for $8.7 billion — is firing back. And he says that not only was he not involved in any wrongdoing, he’s ready to defend his name as needed.

I reached out to Brian Kaspar after Novartis put out word that he and his brother Allen had been axed in mid-May, two months after the company became aware of the allegations related to manipulated data. His response came back through his attorneys.

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Why would Am­gen want to buy Alex­ion? An­a­lysts call hot­ly ru­mored takeover un­like­ly, but seize the mo­ment

A rumor that Amgen is closing in on buyout deal for Alexion has sparked a guessing game on just what kind of M&A strategy Amgen is pursuing and how much Alexion is worth.

Mizuho analyst Salim Syed first lent credence to the report out of the Spanish news outlet Intereconomía, which said Amgen is bidding as much as $200 per share. While the source may be questionable, “the concept of this happening doesn’t sound too crazy to me,” he wrote.

FDA asks why No­var­tis took two months to launch for­mal in­ter­nal probe, af­ter AveX­is flagged da­ta ma­nip­u­la­tion

And the plot thickens. Novartis $NVS officials are reportedly now scrambling to explain to the FDA why it took them two months to open an internal investigation into data discrepancies for their $2.1 million gene-therapy for spinal muscular dystrophy — the world’s most expensive drug.

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Build­ing on suc­cess­ful PD-1 pact, Eli Lil­ly li­cens­es di­a­betes drug to Chi­nese part­ners at In­novent

Eli Lilly is expanding its partnership with China’s Innovent in a deal involving a diabetes drug sitting in its Phase I reserves.

The two companies had jointly developed one of China’s first homegrown PD-1 agents, scoring an approval for Tyvyt (sintilimab) late last year for relapsed/refractory classical Hodgkin’s lymphoma. This time around, Lilly is out-licensing a piece of its diabetes pipeline, a leading franchise that has historically produced the top-selling Trulicity and Humalog.

Am­gen, Al­ler­gan biosim­i­lar of Roche's block­buster Rit­ux­an clears an­oth­er US piv­otal study 

Novartis $NVS may have given up, but Amgen $AMGN and Allergan $AGN are plowing ahead with their knockoff of Roche’s blockbuster biologic Rituxan in the United States.

Their copycat, ABP 798, was found to have a clinically equivalent impact as Rituxan — meeting the main goal of the study involving CD20-positive B-cell non-Hodgkin’s lymphoma patients. This is the second trial supporting the profile of the biosimilar. In January, it came through with positive PK results in patients with rheumatoid arthritis.

Trump ad­min­is­tra­tion re­vives bid to get drug list prices on TV ads

The Trump administration is not giving up just yet. On Wednesday, the HHS filed an appeal against a judge’s decision in July to overturn a ruling obligating drug manufacturers to disclose the list price of their therapies in television adverts — hours before it was stipulated to go into effect.

In May, the HHS published a final ruling requiring drugmakers to divulge the wholesale acquisition cost— of a 30-day supply of the drug — in tv ads in a bid to enhance price transparency in the United States. The pharmaceutical industry has vehemently opposed the rule, asserting that list prices are not what a typical patient in the United States pays for treatment — that number is typically determined by the type of (or lack thereof) insurance coverage, deductibles and out-of-pocket costs. Although there is truth to that claim, the move was considered symbolic in the Trump administration’s healthcare agenda to hold drugmakers accountable in a climate where skyrocketing drug prices have incensed Americans on both sides of the aisle.