UP­DAT­ED: New Kaiser analy­sis shows how lim­it­ing price ne­go­ti­a­tions to tar­get­ed drugs may bet­ter fo­cus up­com­ing leg­is­la­tion

As Con­gress con­sid­ers whether to adopt sweep­ing new leg­is­la­tion to low­er pre­scrip­tion drug prices across the board, the Kaiser Fam­i­ly Foun­da­tion is out with a new re­port on Mon­day show­ing how a more tar­get­ed ap­proach on a sub­set of drugs might be a more ef­fi­cient way to save gov­ern­ment funds.

“This analy­sis shows that Medicare Part D and Part B spend­ing is high­ly con­cen­trat­ed among a rel­a­tive­ly small share of cov­ered drugs, main­ly those with­out gener­ic or biosim­i­lar com­peti­tors,” wrote Juli­ette Cuban­s­ki, deputy di­rec­tor of the pro­gram on Medicare pol­i­cy at KFF, and Tri­cia Neu­man, SVP of KFF. “Fo­cus­ing drug price ne­go­ti­a­tion or ref­er­ence pric­ing on a sub­set of drugs that ac­count for a dis­pro­por­tion­ate share of spend­ing would be an ef­fi­cient use of ad­min­is­tra­tive re­sources, though it would al­so leave some po­ten­tial sav­ings on the ta­ble.”

The re­port found that in 2019, 60% of net to­tal Part D spend­ing came from 250 top-sell­ing drugs in Medicare’s Part D pro­gram with one man­u­fac­tur­er and no gener­ic or biosim­i­lar com­pe­ti­tion, which was 7% of all Part D cov­ered drugs.

“For the top 250 drugs, the av­er­age net cost per claim was $5,750, more than twice as much as the av­er­age net cost per claim for the re­main­ing 2,208 drugs with one man­u­fac­tur­er ($2,555), and more than 13 times greater than the av­er­age net cost per claim for all oth­er cov­ered Part D drugs ($422) (pri­mar­i­ly gener­ic drugs),” the analy­sis shows.

In ad­di­tion, the top 50 drugs cov­ered un­der Medicare Part B, rep­re­sent­ing just 8.5% of all Part B cov­ered drugs, ac­count­ed for 80% of to­tal spend­ing in the pro­gram.

“In con­sid­er­ing whether to broad­en these pro­pos­als to fo­cus on all pre­scrip­tion drugs, pol­i­cy­mak­ers may want to con­sid­er whether do­ing so would achieve suf­fi­cient sav­ings to jus­ti­fy the added ad­min­is­tra­tive bur­den and as­so­ci­at­ed costs,” Cuban­s­ki and Neu­man wrote.

De­moc­rats are hop­ing to use sav­ings from ma­jor drug pric­ing re­forms to help pay for an in­fra­struc­ture bill lat­er this year, rather than try to work through stand­alone pric­ing leg­is­la­tion, which would re­quire 60 votes in the Sen­ate.

“I would look for leg­is­la­tion com­ing out of the Sen­ate to be more along the lines of what Sen­a­tor Wyden pro­posed with Sen­a­tor Grass­ley in 2019, which was more mod­est if on­ly in that it didn’t in­clude the ne­go­ti­a­tion pro­vi­sion in HR 3,” Cuban­s­ki told End­points.

Health­care Dis­par­i­ties and Sick­le Cell Dis­ease

In the complicated U.S. healthcare system, navigating a serious illness such as cancer or heart disease can be remarkably challenging for patients and caregivers. When that illness is classified as a rare disease, those challenges can become even more acute. And when that rare disease occurs in a population that experiences health disparities, such as people with sickle cell disease (SCD) who are primarily Black and Latino, challenges can become almost insurmountable.

The End­points 11: They've got mad mon­ey and huge am­bi­tions. It's time to go big or go home

These days, selecting a group of private biotechs for the Endpoints 11 spotlight begins with a sprint to get ahead of IPOs and the M&A teams at Big Pharma. I’ve had a couple of faceplants earlier this year, watching some of the biotechs on my short list choose a quick leap onto Nasdaq or into the arms of a buyer.

Vividion, you would have been a great pick for the Endpoints 11. I’m sorry I missed you.

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Dave Lennon, former president of Novartis Gene Therapies

So what hap­pened with No­var­tis Gene Ther­a­pies? Here's your an­swer

Over the last couple of days it’s become clear that the gene therapy division at Novartis has quietly undergone a major reorganization. We learned on Monday that Dave Lennon, who had pursued a high-profile role as president of the unit with 1,500 people, had left the pharma giant to take over as CEO of a startup.

Like a lot of the majors, Novartis is an open highway for head hunters, or anyone looking to staff a startup. So that was news but not completely unexpected.

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Who are the women su­per­charg­ing bio­phar­ma R&D? Nom­i­nate them for this year's spe­cial re­port

The biotech industry has faced repeated calls to diversify its workforce — and in the last year, those calls got a lot louder. Though women account for just under half of all biotech employees around the world, they occupy very few places in C-suites, and even fewer make it to the helm.

Some companies are listening, according to a recent BIO survey which showed that this year’s companies were 2.5 times more likely to have a diversity and inclusion program compared to last year’s sample. But we still have a long way to go. Women represent just 31% of biotech executives, BIO reported. And those numbers are even more stark for women of color.

Emma Walmsley, GlaxoSmithKline CEO (Credit: Fang Zhe/Xinhua/Alamy Live News)

The fire un­der Glax­o­SmithK­line's Em­ma Walm­s­ley grows as an­oth­er well-known ac­tivist in­vestor grabs its pitch­fork — re­port

Bluebell Capital Partners, a proxy brawler fresh off a campaign to oust global food giant Danone’s CEO and most of its board of directors, has bought a stake in UK drugmaker GlaxoSmithKline with its eyes trained directly on Emma Walmsley, the Financial Times reported Wednesday.

The London-based hedge fund joins another notorious activist firm in Paul Singer’s Elliott Management, which earlier this year called for a shakeup in leadership at GSK to handle what the company described as a wealth of riches across the drug giant’s portfolio hindered by limited vision from top staff.

FDA au­tho­rizes Pfiz­er's vac­cine boost­er for se­niors, those at high risk for se­vere Covid-19

The Biden administration’s goal of kicking off its booster shot drive for the entire US population this week is not quite going as planned.

First, Pfizer applied for approval of a supplemental application for the booster shots, but since last Friday’s adcomm reviewing them, the plan has devolved into an EUA, which the FDA issued late Thursday evening.

The population that is now eligible for the booster, six months after receiving the first pair of Pfizer-BioNTech vaccines, also narrowed from what Pfizer applied for (everyone who’s eligible for the initial Pfizer shots) to just those who are 65 or older, or at high-risk of a Covid infection, including health care workers and others with occupational hazards.

Stéphane Bancel, AP Images

Fi­nal analy­sis of US-fund­ed Mod­er­na Covid vac­cine tri­al shows 98% ef­fi­ca­cy against se­vere dis­ease

A final look at the results of the placebo-controlled Moderna trial in the New England Journal of Medicine, published Thursday afternoon, shows how the vaccine continues to prevent Covid-19 and severe cases after more than five months following the second shot.

Of the more than 30,000 enrolled in the trial that ultimately led to the vaccine’s EUA, only two people in the vaccine group got a severe form of the disease, compared to 106 in the placebo group — leading to an efficacy of 98%.

FDA+ roundup: Bs­U­FA III ready for show­time, court tells FDA to re-work com­pound­ing plan, new guid­ance up­dates and more

The FDA has now spelled out what exactly will be included in the third iteration of Biosimilar User Fee Act (BsUFA) from 2023 through 2027, which similarly to the prescription drug deal, sets fees that industry has to pay for submitting applications, in exchange for firm timelines that the agency must meet.

This latest deal includes several sweeteners for the biosimilar industry, which has yet to make great strides in the US market, with shorter review timelines for safety labeling updates and updates to add or remove an indication that does not contain efficacy data.

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Joshua Liang, Clover Biopharmaceuticals CEO

With world still in sore need of dos­es, Clover says its Covid-19 vac­cine is 67% ef­fec­tive in Phase III

With concerns about the Delta variant rising and much of the world still in desperate need of vaccine doses, a Chinese biotech announced Wednesday that a new shot has shown positive results in a large trial against Covid-19, including new variants.

Clover Biopharmaceuticals announced Wednesday that its vaccine candidate showed 79% efficacy against the Delta variant in a Phase II/III trial dubbed Spectra, and 67% effective against Covid-19 overall.