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An unlikely crusader for lower hospital prices, insurers’ turn for transparency, and pharma lobbying under the microscope

   

 

D.C. Diagnosis

Good morning, D.C. Diagnosis readers! Good morning, D.C. Diagnosis readers! This morning, I recommend reading the Washington Post’s scoop on Democrats' latest efforts to include prescription drug pricing in reconciliation talks. We’re following developments on this front closely, so pass any tips and/or questions to rachel.cohrs@statnews.com.

The unlikely crusader who’s winning the fight to lower hospital prices

Al Hubbard (LEE KLAFCZYNSKI FOR STAT)

Al Hubbard isn’t your typical health care activist. 

He’s a Republican through and through. He went to Harvard Business School with George W. Bush and served in his White House, and he golfs with Condoleezza Rice. He’s a businessman who made his millions buying and growing companies in sectors as diverse as specialty chemicals, gluten-free baked goods, and camper van rentals, and has used his funds as a prolific political donor. 

He’s also been driving a remarkably successful campaign to lower extraordinarily high hospital prices in Indiana. He’s notched some victories against the powerful hospital lobby on transparency measures, and helped secure commitments from two profitable systems to moderate their prices. 

“One hospital CEO actually said, ‘Who gives you standing to take this on?’” Hubbard told me in an interview in his downtown Indianapolis office. “Nobody gives me standing. I’m a citizen. We’re in America. And it’s important that someone challenge hospitals on their high prices because it’s hurting the standard of living of every single person who lives in Indiana.”

Read more about how Hubbard has built a successful advocacy model that could potentially translate to other red states, and the grueling lobbying fight to come next year in my new story out this morning

It’s insurers’ and employers’ turn in the hot seat on prices

More than a year after hospitals were required to publicly post their prices (the compliance has been somewhat lackluster), it’s time to see if insurers and employers will do any better, my colleague Bob Herman reports. New transparency rules kick in for them on Friday. 

The fines for noncompliance will be heftier than what hospitals face — companies that don’t publish their data face a fine of $100 per day, per covered person, so a company that provides health insurance to at least 10,000 people would rack up $1 million in penalties in just one day.

Insurers are saying they’re ready to go. Get all the details about what data will be released, and who it will be useful for, in Bob’s story.

Pharma lobbying spending under the microscope

The team over at OpenSecrets put together a massive report on 2021 lobbying spending, and it's jam-packed with insights about the pharmaceutical industry’s strategy and about which lobbying firms benefit the most. 

One interesting takeaway: when it came to state-level lobbying firms, the ones that focused on a single state brought in the highest paychecks from drugmakers. The top firms in that category were based almost entirely in California, Massachusetts, and New York — all blue states that tend to experiment with innovative health policy ideas. The top three firms were Massachusetts-based Bay State Strategies Group, Capitol Advocacy based in California, and Tress Capitol Advisors in New York. 

Another eyebrow-raising point – while drugmakers tripled hospitals’ lobbying spend at the federal level, hospitals were dominant in state spending, with a $53 million spend compared with pharma’s $32 million.

An ~interestingly~ timed insulin coupon program

Just as insulin makers’ pricing practices are in the spotlight on Capitol Hill, Sanofi released a plan Wednesday to lower uninsured patients’ cost for insulin.

Starting tomorrow, patients without insurance can get Sanofi insulins for $35 per month — the same threshold under consideration for patients with insurance in several bills in Congress. Previously, the unfortunately named “Insulins Valyou Savings Program” had a threshold at $99 per month. Eli Lilly has a similar program that pegs costs at $35 per month as well. 

What we're reading

  • In a doctor’s suspicion after a miscarriage, a glimpse of expanding medical mistrust, STAT

  • Democrats’ ACA Jam, Punchbowl News

  • 100 lawmakers ask HHS to use controversial federal laws to combat high drug prices, STAT

  • Abortion pill maker plans multistate legal action to preserve drug access, Politico

  • This clinical trial wanted to end breast cancer disparities. But first it needed to enroll Black women, STAT

Thanks for reading! More next Thursday — we'll be taking a short hiatus on Tuesday after the holiday weekend,

@rachelcohrs
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Thursday, June 30, 2022

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