Allergan CEO Brent Saunders (via AP images)

The list gets longer: Mer­ck, Al­ler­gan, No­var­tis is­sue 2020 drug price hikes — re­port

The price train con­tin­ues chug­ging in one di­rec­tion.

On Fri­day, a trio of drug­mak­ers — US-based Mer­ck, Ire­land-head­quar­tered Al­ler­gan and Swiss drug­mak­er No­var­tis — is­sued a round of hikes on more than 100 med­i­cines, vault­ing the to­tal num­ber of price rais­es on 445 drugs in 2020, Reuters re­port­ed, cit­ing health­care re­search firm 3 Ax­is Ad­vi­sors.

These spikes fol­low those by a cadre of drug­mak­ers in­clud­ing GSK, Pfiz­er, Gilead, Bris­tol-My­ers, Bio­gen, Lil­ly, and Te­va ear­li­er in the first week of 2020. In most cas­es, the stick­er price in­creas­es have been lim­it­ed to the mid-sin­gle-dig­it per­cent­ages. As the spot­light on drug pric­ing in­ten­si­fied, with pa­tients, pol­i­cy­mak­ers, and politi­cians de­cry­ing the mag­ni­tude and fre­quen­cy of hikes, a raft of drug­mak­ers — led by Al­ler­gan CEO Brent Saun­ders — pre­vi­ous­ly pledged to not raise their prices by more than 10% an­nu­al­ly.

“We don’t have all the da­ta yet,” 3 Ax­is Ad­vi­sors’ co-founder An­to­nio Ciac­cia not­ed in an in­ter­view with End­points News. His­tor­i­cal­ly, the bulk of the price in­creas­es for the year are typ­i­cal­ly is­sued by the sec­ond week of Jan­u­ary.

The biggest of­fend­er in terms of price in­creas­es is hard to iso­late not just be­cause all the price in­creas­es not been rev­e­lat­ed yet, but be­cause list prices are not re­li­able in­di­ca­tors of re­al, av­er­age, out-of-pock­et costs for in­sured Amer­i­cans.

“The amount of in­creas­es that we’ve seen so far are pret­ty well in line with pri­or years, at least over the last five years. It’s im­pos­si­ble to tell who the bad guy is,” Ciac­cia said. “Like if they raised the price by 7%, where that 7% is go­ing — is it go­ing back to…share­hold­ers or is it flowed back to the sup­ply chain in terms of a pro­pri­etary dis­count that’s go­ing to the in­sur­ers and the PBMs.”

In the lat­est round of hikes on Fri­day, both No­var­tis and Al­ler­gen (which is the process of be­ing swal­lowed by Ab­b­Vie) said the net prices on their price boost­ed med­i­cines would be ei­ther flat or low­er in 2020.

No­var­tis is lift­ing the prices of 7% of its US med­i­cines — but the drug­mak­er told Reuters that af­ter dis­counts and re­bates those net prices will de­crease by 2.5%. Mean­while, Al­ler­gan is boost­ing prices on 25 drugs by 5%, and on two more med­i­cines by 2-3%, but fol­low­ing dis­counts and re­bates, its net prices will work out flat-to-low­er in 2020, the com­pa­ny claimed to the wire ser­vice.

In ad­di­tion, Mer­ck el­e­vat­ed the stick­er price on 15 drugs — in­clud­ing its di­a­betes drugs Janu­via and Janu­met — by an av­er­age of 5%. The price of the drug­mak­er’s flag­ship im­munother­a­py, Keytru­da — which gen­er­at­ed near­ly $8 bil­lion in the first nine months of 2019 and is on track to be­come the world’s best sell­ing med­i­cine by 2024 — is go­ing up by 1.5%. Mer­ck’s hikes are “con­sis­tent with its com­mit­ment to not raise US net prices by more than in­fla­tion an­nu­al­ly,” the com­pa­ny told Reuters.

“I think over the last three, four years man­u­fac­tur­ers have rel­a­tive­ly speak­ing, tak­en their foot off the gas,” Ciac­cia said. “They’re lay­ing low, they’re keep­ing the in­creas­es un­der 10%. But for the most part, I feel like they’re keep­ing things with­in the realm that hope­ful­ly keeps them out of the news­pa­pers.”

As of Fri­day, Ciac­cia said there was one small drug­mak­er that boost­ed the price of its med­i­cine by more than 10%: Neos Ther­a­peu­tics lift­ed the price of its at­ten­tion deficit dis­or­der drug, Con­tem­pla XR, by 13.24%.

Some­times, drug­mak­ers don’t just take an­nu­al hikes — they al­so take ad­di­tion­al mid-year in­creas­es, al­though the prac­tice has grad­u­al­ly wilt­ed as the scruti­ny in­to pric­ing in­ten­si­fies.

“His­tor­i­cal­ly speak­ing, mid-year price heights have re­al­ly erod­ed…we’re not see­ing the amount of fig­ure price in­creas­es that we used to,” Ciac­cia said. “It’s hard to have a crys­tal ball, but if we’re, just judg­ing on past ex­pe­ri­ence, maybe price in­creas­es will like­ly go down again.

Surg­ing drug prices in the Unit­ed States are a thorny yet key bi­par­ti­san is­sue as an­oth­er pres­i­den­tial elec­tion beck­ons. While US Pres­i­dent Trump strug­gles to make good on his promise to low­er drug prices, the in­dus­try, which has long thrived pric­ing its prod­ucts with­out gov­ern­ment in­ter­fer­ence, per­sis­tent­ly ar­gues that any kind of in­ter­fer­ence will sti­fle in­no­va­tion.

Law­mak­ers left and right all ar­gue drug prices in the Unit­ed States are too high — and the in­dus­try holds the crown for the least fa­vored sec­tor by Amer­i­cans, falling be­hind the fed­er­al gov­ern­ment it­self — but so far no­body can agree on just how to make the US health care sys­tem great again. Last month, the HHS opened the door to a pol­i­cy that al­lows for the im­por­ta­tion of drugs from Cana­da.

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Fast forward four more years and the startup, AveXis, is now a subsidiary of Novartis marketing the second-ever gene therapy to be approved in the US.

For its part, Deerfield has also grown more comfortable and ambitious about the nascent field. And the investment firm is now putting down its biggest bet yet: a $1.1 billion contract development and manufacturing facility to produce everything one needs for cell and gene therapy — faster and better than how it’s currently done.

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He went on to assure everyone that he hadn’t misrepresented the CRL.

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