DRUG PRICES
Could this drama over QALYS muck with Medicare negotiation?
Congressional Republicans are scrambling to limit federal agencies from using certain metrics to calculate drugs' values. And while the bill once had Democrats' support, they're balking at broad language that they argue could hobble Medicare's efforts to negotiate prices before its even begun.
Most everyone has agreed that the agency shouldn't use a controversial value metric known as quality-adjusted life years, or QALYs — not even Medicare officials have signaled they want to use that approach, which disability rights advocates argue devalues the lives of disabled people. But it's one other little phrase in the bill, H.R. 485, that has Democrats pumping the brakes: "Similar measures."
House legislative aides and drug pricing advocates told D.C. Diagnosis that the sweeping little phrase could spell litigation and barriers for Medicare to use other metrics that they say don't discriminate based on disabilities, like the equal value life year gained metric (I know, rolls off the tongue.) Supporters of H.R. 485 meanwhile argue that the bill is simply extending already-existing Obamacare language that limited the mandate of a little-known initiative, the Patient Centered Research Outcomes Institute, right from the start. More on that from me here.
RESEARCH
Bernie's big drug pricing idea
Sen. Bernie Sanders (I-Vt.) hasn't been bashful about calling for aggressive health care reforms like Medicare for All. But my colleague Matt Herper writes in a new column that maybe, just maybe, Sanders isn't being ambitious enough on prescription drug pricing.
In Matt's view, Sanders' quick reference in a recent hearing with Moderna's CEO to the idea that the federal government could fund more drug research could be a winning idea. He's got more about the history of government-funded medical research, other industries where similar models work, and how the government could absorb some risk in a space where 90% of medicines that start clinical trials don't reach the market. Read it here.
ADDICTION
How fentanyl panic fueled a naloxone boom
With fentanyl overdoses and deaths spiking across the U.S., the pharmaceutical industry sprung into motion, churning out what STAT's Lev Facher calls a dizzying array of new naloxone products. But what may seem like an obvious answer — flood the market with antidotes to dangerous opioids — is not so altruistic, Lev writes.
The range of new products (like a mechanized injector with audio commands, a prefilled syringe pen, and an ultra-high dose nasal spray) also come with high price tags. That's despite substance use researchers and recovery advocates saying the solution could be much simpler: An abundant supply of cheap naloxone in easy packaging and standardized doses.
Instead, the advent of new and high-priced naloxone products has schools, nonprofits, policy departments and public health agencies diverting resources to the next-big-thing and not vast supplies of the cheaper options, advocates argue. It's a "fear-based market," as one said. Read more from Lev here.
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