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Pbms Were on Capitol Hill, but Pharma Still Took Some Heat “ - Scrip, 9 Apr, 2019.) 18 April 2019 No. 3951 Scripscrip.pharmaintelligence.informa.com Pharma intelligence | informa guard their operations with greater se- crecy than HBO is guarding the ending of Game of Thrones.” Nonetheless, pharma still took a lot of heat. As Senator Sheldon Whitehouse, D-RI, spelled out, only $23bn of the $480bn the US spends on drugs, or 5%, goes to PBMs, while $323bn goes to phar- maceutical companies. “It has to be interesting to you all to wit- ness how the pharmaceutical industry has been able to take pressure on their pricing and turn it into, with political jiu-jitzu of almost magical variety, pressure on their greatest adversary, the most powerful force for pushing prices down,” White- house said. “I hope you at least respect what they have been able to pull off here.” Indeed, industry has been quite suc- cessful turning attention to PBMs in the debate over drug pricing and highlighting PBMs Were On Capitol Hill, the growing rebates drug makers pay off list prices to negotiate formulary access But Pharma Still Took Some Heat with payers. One of the pivotal changes being proposed by the Trump Administra- JESSICA MERRILL [email protected] tion to lower drug prices is a proposal to eliminate rebates or pass them on directly harmacy benefit managers had their officer Steve Miller and Prime Therapeu- to consumers at the point of sale. Drug turn on Capitol Hill, called into testify tics Interim CEO Mike Kolar. makers are broadly supportive of the plan, Pon drug pricing before the Senate Fi- The hearing went off without any big but payers argue that the proposal will re- nance Committee April 9, but drug makers surprises, with the PBMs pushing back sult in higher insurance premiums. got a lot of the blame for high drug prices. on pharma’s main lobbying message, Leaders from five PBMs testified in that high list prices are powered by PBMs, MAKING THE CASE FOR REBATES the third hearing held by the Senate who benefit financially through rebates That sentiment was one echoed by the Finance Committee on drug pricing, charged as a percent of list price. PBM representatives during the roughly about six weeks after seven pharmaceu- Senators appeared to be going through three hours of testimony at the hearing. tical leaders similarly testified. Among the motions, pressing the pharmacy dis- Humana’s Fleming gave some of the the PBM participants were United tributors on the role of rebates and fees more powerful testimony against the De- Healthcare Services Inc.’s OptumRx and how they relate to drug costs, but partment of Health and Human Services’s CEO John Prince, CVS Health Corp. Exec without a lot of specificity. Perhaps con- rebate proposal, pointing to the potential VP and CVS Caremark President Derica gressional leaders were as befuddled by impact on overall health care costs. Rice, Humana Inc. Healthcare Services the pharmacy middleman as the general “All beneficiaries will pay higher premi- Segment President William Fleming, public. As Ranking Member Ron Wyden, ums, while 12% will see savings of greater Cigna Corp. Exec VP and Chief Clinical D-OR, quipped, “I’m of the view that PBMs CONTINUED ON PAGE 4 BROUGHT TO YOU BY THE EDITORS OF PHARMASIA NEWS, START-UP AND SCRIP INTELLIGENCE Liver Disease Fervor Glimins In Diabetes Coming Soon Finding A Winning Strategy (p13-15) New Drug Class Approaches (p19) Key R&D Catalysts In Second Quarter (p11-12) IN THIS ISSUE from the executive editor [email protected] US drug pricing is once again to the fore in this week’s Celgene. The next big step will be the combination of issue, with the Senate Finance Committee’s third hear- their commercial product portfolios and drug develop- ing on the thorny subject, and this time it was the phar- ment pipelines, with the new Bristol-Myers Squibb mak- macy benefit managers in the spotlight. It was no sur- ing a claim to have the top biopharma oncology and car- prise that they pushed back on pharma’s main lobbying diovascular franchises. See p4 for all the details. message, that high list prices are powered by PBMs, who Other deal developments saw Alnylam team up with benefit financially through rebates charged as a percent Regeneron in a $800m multi-disease deal on the same of list price. Jessica Merrill has the full story on p1, and day the RNAi specialist and Sanofi announced that the also reports on how HHS, the Centers for Medicare and research portion of their longstanding R&D collabora- Medcaid Services and others who are working to elimi- tion had ended, but development work continues. Joe nate rebates will try to lessen the impact on Medicare Haas has all the details on p6. Part D insurance premiums (see p3). Meanwhile, we take a look at the upcoming catalysts M&A news was dominated by the shareholder go- for this quarter; turn to p11 to see what you can expect ahead for Bristol-Myers Squibb’s $74bn acquisition of to happen in the next few months. LEADERSHIP ADVERTISING DESIGN Phil Jarvis, Mike Ward, Christopher Keeling Paul Wilkinson Karen Coleman DESIGN SUPERVISOR SUBSCRIPTIONS Gayle Rembold Furbert Scrip Dan Simmons, Shinbo Hidenaga EDITORS IN CHIEF Andrea Charles EDITORIAL OFFICE Ian Haydock (Asia) John Davis Christchurch Court Eleanor Malone (Europe) Kevin Grogan 10-15 Newgate Street Denise Peterson (US) Ian Schofield London, EC1A 7AZ Vibha Sharma CUSTOMER SERVICES Joanne Shorthouse EXECUTIVE EDITORS US Toll-Free: +1 888 670 8900 COMMERCIAL Sten Stovall US Toll: +1 908 547 2200 Alexandra Shimmings (Europe) UK & Europe: +44 (20) 337 73737 Mary Jo Laffler (US) US Australia: +61 2 8705 6907 Michael Cipriano POLICY AND REGULATORY Japan: +81 3 6273 4260 Derrick Gingery Maureen Kenny (Europe) Email: clientservices@ Joseph Haas Nielsen Hobbs (US) pharma.informa.com Mandy Jackson ASIA Cathy Kelly Jessica Merrill TO SUBSCRIBE, VISIT Anju Ghangurde scrip.pharmaintelligence.informa.com Jung Won Shin Brenda Sandburg TO ADVERTISE, CONTACT Brian Yang Bridget Silverman Sue Sutter [email protected] EUROPE All stock images in this publication Neena Brizmohun courtesy of www.shutterstock.com Francesca Bruce unless otherwise stated Scrip is published by Informa UK Limited. ©Informa UK Ltd 2019: All rights reserved. ISSN 0143 7690. 2 | Scrip | 18 April 2019 © Informa UK Ltd 2019 Cheaper Drug Plans 20 8 HIV Two-Drug Combos 12 Manufacturing Agility 21 exclusive online content inside: COVER / PBMs Were On Capitol Hill, But Pharma Still Took Rebate Reshuffle: Could Pharma Foot Some Heat The Bill To Offset Higher Premiums? 3 Rebate Reshuffle: Could Pharma Foot The Bill To Offset JESSICA MERRILL [email protected] Higher Premiums? 4 As Expected: Shareholders Back Bristol’s $74bn Celgene Buy 6 Alnylam Replaces Sanofi Partnership With Second Regeneron Tie-Up For RNAi Drugs 7 South Korea’s ADEL Innovates With Anti-Tau Antibody For Alzheimer’s Disease 8 Insulin Assistance Programs: Big Help Or Just A Band-Aid? 10 Dainippon Pursues Organ Generation In New Alliance With Japan Partners 11 ‘Pharma Fireworks’: Pipeline Catalysts To Watch Out For In Q2 12 ViiV’s Dovato: Treatment-Naive HIV Is Earmarked For The A big challenge facing HHS, the Centers for Medicare and “Complete Regimen” Medicaid Services (CMS) and other stakeholders working to eliminate rebates from the drug distribution system is how 13 Intercept’s OCA Data Bolster NASH Efficacy, But Pruritus to blunt the impact on Medicare Part D insurance premi- Worries Worsen ums, which are expected to increase as a result of changes. Some industry watchers expect pharma could be asked 15 Novartis’s NASH Chief: Our Strategy Is Combos With to step in and pick up the tab, or some of it, given that drug Tropifexor As ‘Backbone’ makers are poised to benefit financially from the proposal 16 Defusing US Opioid Crisis Offers Orexo “Strong Growth that’s in development. Potential” Says CEO Bernstein Research analysts Luke Wilkes and Ronny Gal speculated in an April 8 research note that one solution to 18 Cyclerion Readies For Readouts In Sickle Cell, Other Rare, the issue would be for the Administration to charge the Serious Diseases This Year drug industry a fee and use it to “buy down” premiums. “The fee could be a direct payment to the plan spon- 19 Positive Phase III Data Set Stage For Japan Imeglimin Filing sor, or it could be a reduction in prices or take some other 20 GSK Forms New Commercial Trade Channel Team In India form,” Wilkes and Gal speculated. “The intent would be to utilize some of the drug companies’ benefits from the plan 21 Cipla COO On Joining The Revolution In Manufacturing to reduce net cost for the plan sponsors back toward the original net cost.” 22 Pipeline Watch There is still a lot to work out about how rebates will be removed from the system or given directly at point-of- 23 Appointments sale. The industry is still awaiting a final rule from HHS. A proposed rule was issued by the HHS Office of Inspector General in January with an effective date of Jan. 1, 2020. @PharmaScrip /scripintelligence Published online 8 April 2019 To read the rest of this story go to: https://bit.ly/2IFOgR4 /scripintelligence /scripintelligence scrip.pharmaintelligence.informa.com 18 April 2019 | Scrip | 3 HEADLINE NEWS/M&A CONTINUED FROM PAGE 1 The PBM representatives generally He advocated in favor of more target- than $70 per year; 5% will see savings of highlighted other areas where improve- ed approaches that could address spe- less than $70 per year,” he said. Meanwhile, ments could be made, with a focus on cific groups of patients.
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