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Alzheimer’s moment of truth, Novo Nordisk’s dining with docs, and a PBM ad deluge

July 6, 2023
Reporter, D.C. Diagnosis Writer

Hello and happy Thursday, D.C. Diagnosis readers! If you're interested in learning more about how uptake is going for some of the first biosimilars to Humira, be sure to sign up for a virtual conversation with my colleague Ed Silverman on July 18. It's free! Pass along news tips as usual to rachel.cohrs@statnews.com.

alzheimer's

Moment of truth for Alzheimer's drug

Today's the day — the deadline for the FDA to decide whether it will grant full, traditional approval to the Alzheimer's drug Leqembi, which is made by Biogen and Eisai. If they give the medicine the green light, it will be the first drug approved that alters the course of the disease.

Upon approval, the drug will immediately qualify for broader coverage under the Medicare program. However, Medicare requires doctors to submit patient data to a registry to get the drug covered, and nobody has seen what that registry will actually look like yet. Several neurologists I spoke with last week are scrambling to figure out their own prescribing practices, and have mixed feelings about what a registry could mean for patient care. 

Here are the big questions I'm watching for in the coming days:

  • Does the patient registry work? 
  • Does the registry collect specific enough data to actually tell us something useful?
  • Does the FDA require testing for amyloid plaques? How is that covered by Medicare?
  • Does the FDA require genotyping to identify potential safety issues? How is that covered?

drug costs

Deluged by PBM ads? You're not alone

As multiple congressional committees and federal agencies decide how to tackle regulating pharmacy benefit managers, industry players with a stake in the outcome have taken their battle to the airwaves

The ads come up if you're listening to NPR podcasts, reading the New York Times, streaming "Yellowstone," or watching the U.S. Open Golf Championships. It doesn't matter if it's 5 a.m., primetime, or 11 p.m. They also run ads on email newsletters that proliferate Washington. 

My colleague Simar Bajaj breaks down who's spending the most, and where the money is coming from.


influence

A meal a day keeps the doctor swayed?

stat_pharma_dinner_2000x1125_f2MIKE REDDY FOR STAT

My colleague Nick Florko, who's well-known around the newsroom as a lobbying disclosure whiz, took his talents to a new dataset and found that Novo Nordisk has showered prescribers with more than 450,000 meals and snacks to promote drugs like Ozempic.

The tab? $9 million just last year. Many physicians received meals on many different days, and more than two hundred recorded more than 50 meals and snacks paid for by the company.

It's common for pharmaceutical companies to meet with doctors — often over lunch or coffee — to discuss their drugs. But the volume of meals Novo Nordisk purchased last year raised concerns for both conflict-of-interest experts and advocates that were interviewed by STAT. Read Nick's full report here



biosimilars

Will Humira biosimilars actually save money?

Suddenly, the U.S. is awash with biosimilar versions of Humira. Over the past few days, seven companies launched their versions of the AbbVie drug, which is one of the world's best-selling medicines, my colleague Ed Silverman writes. The moment marks one of the most closely watched product rollouts by pharmaceutical companies in many years.

The question now is how much money these medicines will save the U.S. healthcare system. The list price for Humira, which generated billions of dollars in annual sales, is $6,922 a month. But not all of the new entrants are taking the same approach to pricing as they attempt to appeal to pharmacy benefit managers, which create formularies, or lists of medicines covered by insurance. 

Boehringer Ingelheim set a list price slightly lower than the AbbVie price, but also plans to market another version at a steeper discount next year. Organon and Samsung Bioepis set their price at 85% off the AbbVie price. Coherus BioSciences did the same. "Price is important," said Organon chief executive officer Kevin Ali. "You have to up the ante and have a certain price in order to be able to play in this field."


Congress

Bill Cassidy's theory of drug pricing

Plenty of ink has been spilled about Senate health committee chair Bernie Sanders' (I-Vt.) demands on drug pricing (he's holding up the White House's NIH pick over them). Now, ranking Republican Bill Cassidy is laying out his own agenda on the issue in STAT.

A few of his priorities include preventing generic drug manufacturers from gaming exclusivity protections, cracking down on providers that get 340B drug discounts but don't treat enough low-income patients, and reforming certain practices of pharmacy benefit managers. 

What he doesn't want: "price setting" or importation. Cassidy received a bunch of money from pharma donors earlier this year. Here's his full op-ed, where he also draws from his personal experience as a doctor. 


long Covid

Covid testing crunch poses long Covid research issues

The initial difficulty in getting enough Covid-19 tests produced and available is having long-reaching consequences for patients who believe they have long Covid, but never had an officially positive PCR test, patients told the FDA in comments on patient-centered drug development for long Covid. 

The Patient-Led Research Collaborative wants the FDA to ensure a positive PCR test isn't necessary to participate in drug research. One patient recommended that studies could include a cohort with patients who don't have positive PCR tests, instead of excluding them from studies entirely. 

The comments also included a couple patients who were fed up with the RECOVER initiative's progress. "The $1.15 billion dollars that had been given to the NIH RECOVER Initiative has been largely exhausted with almost nothing to show for it," one anonymous patient said. Another comment attributed to Richard Vallee called RECOVER "a shambolic disaster." More on that, here


More around STAT
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What we're reading

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  • More states legalize sales of unpasteurized milk, despite public health warnings, California Healthline
  • Biden promised a 'war on cancer' — but declared war on the cure instead, PhRMA CEO Steve Ubl writes, STAT

Thanks for reading! More next week,


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