Donald Trump (AP Images)

Trump ups the stakes with 'grand­dad­dy of them al­l' drug pric­ing ex­ec­u­tive or­der. But he could be run­ning out of time

When Pres­i­dent Don­ald Trump signed four ex­ec­u­tive or­ders in late Ju­ly aim­ing at low­er­ing drug prices, de­tails of the most con­tro­ver­sial — “the grand­dad­dy of them all,” ac­cord­ing to Trump — were con­spic­u­ous­ly miss­ing.

Al­most two months lat­er, the text is fi­nal­ly here. And it’s al­ready been ex­pand­ed.

The EO in­structs Health and Hu­man Ser­vices Sec­re­tary Alex Azar to test a pay­ment mod­el in which Medicare would pay no more than the “most-fa­vored-na­tion price” for doc­tor and out­pa­tient ser­vices (Part B) as well as pre­scrip­tion drugs (Part D). While rule-mak­ing plans were al­ready in place for the for­mer, reg­u­la­tions for the lat­ter re­quire a sep­a­rate, new process.

Which means it may not be im­ple­ment­ed any time soon. But that doesn’t stop in­dus­try ad­vo­cates from blast­ing the or­der with ur­gency.

PhRMA had re­port­ed­ly sub­mit­ted a coun­terof­fer in Au­gust to the White House af­ter Trump asked them to pro­pose an al­ter­na­tive. It would have ef­fec­tive­ly cut Part B prices by 10%, ver­sus 30% as the ad­min­is­tra­tion was shoot­ing for, per Politi­co.

Stephen Ubl

Echo­ing his pre­vi­ous com­ments, PhRMA pres­i­dent Stephen Ubl calls the most-fa­vored na­tion pol­i­cy “ir­re­spon­si­ble and un­work­able,” as it dou­bles down on “a reck­less at­tack on the very com­pa­nies work­ing around the clock to beat Covid-19.”

“What’s worse is that they are now ex­pand­ing the pol­i­cy to in­clude med­i­cines in both Medicare Part B and Part D, an over­reach that fur­ther threat­ens Amer­i­ca’s in­no­va­tion lead­er­ship and puts ac­cess to med­i­cines for tens of mil­lions of se­niors at risk,” its state­ment reads. “Rather than em­u­lat­ing coun­tries that al­low politi­cians to ar­bi­trar­i­ly de­cide what med­i­cines are worth and what dis­eases are worth in­vest­ing in, we should use ex­ist­ing trade en­force­ment tools to pre­vent them from free­load­ing off Amer­i­can in­no­va­tion.”

Sim­i­lar­ly, BIO’s Michelle Mc­Mur­ry-Heath de­scribed the move to move for­ward with the plans to es­sen­tial­ly “im­port for­eign price con­trols” as “dumb­found­ing.”

Michelle Mc­Mur­ry-Heath

“That is why we will use every tool avail­able — in­clud­ing le­gal ac­tion if nec­es­sary — to fight this risky for­eign price con­trol scheme,” she said.

Al­though dif­fer­ent in name, the idea of ref­er­enc­ing what oth­er coun­tries, many of whom have sin­gle-pay­er health­care sys­tems and ag­gres­sive ne­go­ti­a­tion tac­tics, pay in or­der to bring down Amer­i­can drug prices dates back at least to 2018. The Cen­ters for Medicare & Med­ic­aid Ser­vices be­gan work­ing on a pro­posed mod­el dubbed the in­ter­na­tion­al pric­ing in­dex fo­cused around Medicare Part B. A sub­se­quent health­care bill passed by the De­mo­c­rat-con­trolled House in­clud­ed a pro­vi­sion that would em­pow­er HHS to ne­go­ti­ate prices for 250 pre­scrip­tion drugs based on the same in­dex. The prices would ap­ply to gov­ern­ment and com­mer­cial mar­kets alike.

Big Phar­ma lead­ers and small biotech in­vestors alike have long op­posed the pro­pos­al in its var­i­ous in­car­na­tions, cit­ing a fore­cast re­duc­tion in new med­i­cines. They were joined by Sen­ate Re­pub­li­cans, who had draft­ed their own pric­ing bill fo­cused on out-of-pock­et costs.

They may not be alone in this par­tic­u­lar fight, Michael Ganio, the se­nior di­rec­tor of phar­ma­cy prac­tice and qual­i­ty at the Amer­i­can So­ci­ety of Health-Sys­tem Phar­ma­cists, said on Twit­ter.

Yet again, with just a few months left in his first term, Trump’s last-ditch ef­fort to tack­le drug prices still faces sig­nif­i­cant hur­dles that can stretch be­yond the cur­rent term, not­ed Rachel Sachs, as­so­ciate pro­fes­sor of law at Wash­ing­ton Uni­ver­si­ty in St. Louis.

The top 100 bio­phar­ma VCs, Bob Brad­way places $2B bet in can­cer, gene edit­ing pi­o­neer's new big idea, 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.

Before diving in, we had some news to share: Endpoints is launching a premium weekly report focusing on all things regulatory. Coverage will be led by our new senior editor, Zachary Brennan, who joins us from POLITICO. Arsalan Arif has more details in his Publisher’s Note.

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Robert Bradway (Photographer: Scott Eisen/Bloomberg via Getty Images)

UP­DAT­ED: Am­gen snaps up can­cer drug play­er Five Prime, adding PhI­II-ready FGFR2b drug in $2B M&A play

Amgen is making a long-awaited move on the M&A side, buying South San Francisco-based Five Prime $FPRX for close to $2 billion and adding a slate of new cancer drugs to the pipeline.

Amgen is paying $38 a share, putting the deal value at $1.9 billion. The stock closed at $21.26 last night, giving investors a 78% premium.

The jewel in the crown of this deal is bemarituzumab, which Amgen describes as a first-in-class, Phase III-ready anti-FGFR2b antibody. Amgen was drawn to the bargaining table by Five Prime’s mid-stage data on gastric cancer, satisfied by PFS and OS data helping to validate FGFR2b as a target. Amgen researchers will now expand on the R&D program in other epithelial cancers, including lung, breast, ovarian and other cancers.

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David Liu (Casey Atkins Photography courtesy Broad Institute)

David Liu has a new big idea: pro­teome edit­ing. It could one day shred tau, RAS and some of the worst dis­ease-caus­ing pro­teins

Before David Liu became famous for inventing new forms of gene editing, he was known around academia in part for a more obscure innovation: a Rube Goldberg-esque system that uses bacteria-infecting viruses to take one protein and turn it into another.

Since 2011, Liu’s lab has used the system, called PACE, to dream up fantastical new proteins: DNA base editors far more powerful than the original; more versatile forms of the gene editor Cas9; insecticides that kill insecticide-resistant bugs; enzymes that slide synthetic amino acids into living organisms. But they struggled throughout to master one of the most common and powerful proteins in the biological world: proteases, a set of Swiss army knife enzymes that cut, cleave or shred other proteins in everything from viruses to humans.

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The 2021 top 100 bio­phar­ma in­vestors: As the pan­dem­ic hit and IPOs boomed, VCs swung in­to ac­tion like nev­er be­fore

The global pandemic may have roiled economies, killed hundreds of thousands and throttled entire industries, but the only effect it had on biopharma venture investing was to help turbocharge the field to giddy new heights.

Below you’ll find the new top 100 venture investors in the industry, ranked by the number of deals they were publicly involved in, as tracked by DealForma chief Chris Dokomajilar. The numbers master then calculated the estimated amount of money they put into each deal — divvying up the cash by the number of players — to indicate how they managed their syndicates.

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Bruce Cozadd, Jazz CEO (Jazz Pharmaceuticals)

Jazz CEO Bruce Cozadd cam­paigned for 6 months to buy GW Phar­ma. A 90% pre­mi­um sealed the deal — along with $17.6M in ‘re­ten­tion’ in­cen­tives

Jazz CEO Bruce Cozadd didn’t beat around the bush.

In his first video meeting with GW Pharma chief Justin Gover last July 8, he offered to pay $172 a share to get the company, which had beaten the odds in getting its remarkable cannabinoid drug Epidiolex across the regulatory finish line for epilepsy. GW’s stock closed at $129 that day.

Cozadd had already done his homework on the financing to make sure he could swing it the way he wanted. He just needed to do some due diligence before making the non-binding bid firm.

UP­DAT­ED: Not 3 weeks af­ter tak­ing Hu­ma­cyte pub­lic, Ra­jiv Shuk­la launch­es an­oth­er blank check com­pa­ny

One of biotech’s earliest SPAC investors is back with another blank-check company, less than a month after his last effort announced its intent to merge.

Rajiv Shukla is intending to take a third lucky winner public with Alpha Healthcare Acquisition III, filing to go public Thursday with a $150 million raise penciled in. The move comes just a couple of weeks after Shukla’s second SPAC said it would jump to Nasdaq in tandem with Laura Niklason’s Humacyte in a $255 million new investment.

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Paul Hudson, Getty Images

How does Paul Hud­son's $13.5M comp pack­age stack up against oth­er CEOs? He's in the 'first quar­tile'

Paul Hudson arrived at Sanofi like a hurricane, chopping off duds in the pipeline, shaking up the C-suite, striking big M&A deals and jumping into the Covid-19 vaccine race — all in an attempt to reboot a pharma giant notorious for its setbacks.

Now, we’re getting a look at what the CEO brought home in his first year on the job.

When all is said and done, Hudson will have made about $6.7 million in 2020, about $2.5 million of which has already been paid. The bigger figure includes a $2.3 million bonus that’s subject to approval at an April meeting, and another $1.8 million in variable compensation that has yet to be paid.

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CMO Levi Garraway (Genentech)

Fo­cus­ing on the bright side, FDA OKs Roche's Actem­ra for rare lung dis­ease de­spite PhI­II flop

Actemra’s failure to hit the primary endpoint in a Phase III study didn’t stop the FDA from granting Roche priority review. And it’s certainly not standing in the way of a sixth approval for Roche’s IL-6 drug.

Regulators have cleared Actemra, or tocilizumab, for systemic sclerosis-associated interstitial lung disease in adult patients. Roche’s big Genentech subsidiary notes that it is the first biologic approved for this rare disease.

Af­ter three years of courtship (and turn­downs), Mer­ck pounced on the first glance of clin­i­cal da­ta in $1.85B Pan­dion takeover

It’s almost become cliché for biotech executives to talk about the importance of keeping your options open and being prepared to go all the way. But when it comes to negotiating with a giant like Merck, a little patience can indeed go a long way.

Just ask Pandion Therapeutics.

Days ago we already learned that Merck is shelling out $1.85 billion to pick up the biotech and its slate of autoimmune hopefuls. What we didn’t know until the SEC disclosure dropped Thursday is that the deal comes after Pandion turned down two other proposals from Merck over the past three years and held out until the last minute for a sweetened deal.

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