{"id":926,"date":"2015-12-17T16:00:02","date_gmt":"2015-12-17T16:00:02","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=926"},"modified":"2017-08-21T11:13:24","modified_gmt":"2017-08-21T11:13:24","slug":"primary-care-corner-with-geoffrey-modest-md-senate-investigation-exposes-gileads-greed-while-kaiser-fam-foundation-report-shows-part-d-impact","status":"publish","type":"post","link":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2015\/12\/17\/primary-care-corner-with-geoffrey-modest-md-senate-investigation-exposes-gileads-greed-while-kaiser-fam-foundation-report-shows-part-d-impact\/","title":{"rendered":"Primary Care Corner with Geoffrey Modest MD: Senate Investigation Exposes Gilead’s Greed While Kaiser Fam Foundation Report Shows Part D Impact"},"content":{"rendered":"

By Dr. Geoffrey Modest<\/strong><\/p>\n

This if from Ken Saffier, wanting to add it to the ever-growing\u00a0Big Pharma Shenanigans\u00a0blogs on\u00a0drug company malfeasance and greed. Per the NY Times, at the time of the release of these extraordinarily expensive Hep C drugs,\u00a0Gilead\u00a0admitted that the pricing was totally divorced from their costs but that the drugs were “worth it” because the costs of Hep C care was even more.\u00a0This\u00a0extensive\u00a0Senate Committee investigation, led by a conservative Republican, confirms this.<\/p>\n

_________________________________________________________________________<\/p>\n

Senator Ron Wyden<\/em><\/p>\n

Press Release<\/em><\/p>\n

December 1, 2015<\/em><\/p>\n

 <\/p>\n

Wyden-Grassley Sovaldi Investigation Finds Revenue-Driven Pricing Strategy Behind $84,000 Hepatitis Drug<\/em><\/p>\n

 <\/p>\n

18-Month Investigation Reveals a Pricing and Marketing Strategy Designed to Maximize Revenue with Little Concern for Access or Affordability<\/em><\/p>\n

 <\/p>\n

Senate Finance Committee Ranking Member Ron Wyden, D-Ore., and senior committee member Chuck Grassley, R-Iowa, today released the results of an 18-month investigation into the pricing and marketing of Gilead Sciences\u2019 Hepatitis C drug Sovaldi and its second-wave successor, Harvoni. Drawing from 20,000 pages of internal company documents, dozens of interviews with health care experts, and a trove of data from Medicaid programs in 50 states and the District of Columbia, the investigation found that the company pursued a marketing strategy and final wholesale price of Sovaldi \u2013 $1,000 per pill, or $84,000 for a single course of treatment \u2013 that it believed would maximize revenue. Building on that price, Harvoni was later introduced at $94,500. Fostering broad, affordable access was not a key consideration in the process of setting the wholesale prices.<\/em><\/p>\n

 <\/p>\n

\u201cGilead pursued a calculated scheme for pricing and marketing its Hepatitis C drug based on one primary goal, maximizing revenue, regardless of the human consequences. There was no concrete evidence in emails, meeting minutes or presentations that basic financial matters such as R&D costs or the multi-billion dollar acquisition of Pharmasset, the drug\u2019s first developer, factored into how Gilead set the price. Gilead knew these prices would put treatment out of the reach of millions and cause extraordinary problems for Medicare and Medicaid, but still the company went ahead. If Gilead\u2019s approach to pricing is the future of how blockbuster drugs are launched, it will cost billions and billions of dollars to treat just a fraction of patients,\u201d Senator Wyden said.<\/em><\/p>\n

 <\/p>\n

\u201cThe Finance Committee has tremendous responsibility in overseeing the federal programs paying for prescription drug coverage,\u201d Senator Grassley said. \u00a0\u201cWith that responsibility, the committee should know how the costs to the public programs and private insurance companies of a single innovative drug entering the market without competition can have major effects on which patients get the new drug and when.\u00a0 This report sheds light on one example of the pricing decisions made by one company with a new prescription medicine that entered the market without competition in high demand.\u201d<\/em><\/p>\n

 <\/p>\n

Additional major findings from the investigation include:<\/em><\/p>\n

 <\/p>\n

* \u00a0Gilead justified Sovaldi\u2019s high price point based on price-per-cure<\/em><\/p>\n

 <\/p>\n

* \u00a0Gilead set a high price for Sovaldi with an eye toward ensuring a future high price for Harvoni<\/em><\/p>\n

 <\/p>\n

* \u00a0Gilead underestimated the degree of access restrictions that it expected would result from its pricing decision<\/em><\/p>\n

 <\/p>\n

* \u00a0Despite significant access restrictions, Gilead refused to significantly lower the net price<\/em><\/p>\n

 <\/p>\n

* \u00a0The burdens on Medicare, Medicaid, and the Bureau of Prisons were significant<\/em><\/p>\n

 <\/p>\n

The press release includes links to the Executive Summary and 144 page report:<\/em><\/p>\n

https:\/\/www.wyden.senate.gov\/news\/press-releases\/wyden-grassley-sovaldi-investigation-finds-revenue-driven-pricing-strategy-behind-84000-hepatitis-drug<\/a><\/em><\/p>\n

 <\/p>\n

***<\/em><\/p>\n

 <\/p>\n

Kaiser Family Foundation<\/em><\/p>\n

December 2, 2015<\/em><\/p>\n

It Pays to Shop: Variation in Out-of-Pocket Costs for Medicare Part D Enrollees in 2016<\/em><\/p>\n

By Jack Hoadley, Juliette Cubanski, and Tricia Neuman<\/em><\/p>\n

 <\/p>\n

Medicare Part D drug plans differ considerably in the drugs they list on their formularies, their use of formulary tiers, and the level and structure of cost sharing applied to those tiers. Plan premiums and the use of deductibles also vary widely. Plan decisions affect different beneficiaries in different ways, depending on the drugs they use. The financial consequences for Part D plan enrollees can be substantial. In this brief, we focus on out-of-pocket drug costs for Part D enrollees in 2016 for specialty, brand, and generic drugs.<\/em><\/p>\n

 <\/p>\n

Part D enrollees can expect to pay thousands of dollars out of pocket for a single specialty drug in 2016, even after their drug costs exceed the catastrophic coverage threshold<\/em><\/p>\n

 <\/p>\n

From Figure 1:<\/em><\/p>\n

 <\/p>\n

Median on-formulary out-of-pocket costs in 2016:<\/em><\/p>\n

 <\/p>\n

Sovaldi \u00a0$6,608<\/em><\/p>\n

 <\/p>\n

Harvoni \u00a0$7,153<\/em><\/p>\n

 <\/p>\n

Part D enrollees\u2019 out-of-pocket costs for many specialty drugs are substantial at the start of the year, and continue even after spending exceeds the catastrophic coverage threshold<\/em><\/p>\n

 <\/p>\n

Out-of-pocket costs are substantially higher\u2014often ten times higher or more\u2014for specialty drugs when they are not listed on formulary by a Part D plan<\/em><\/p>\n

 <\/p>\n

http:\/\/kff.org\/medicare\/issue-brief\/it-pays-to-shop-variation-in-out-of-pocket-costs-for-medicare-part-d-enrollees-in-2016\/<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Primary Care Corner with Geoffrey Modest MD: Senate Investigation Exposes Gilead’s Greed While Kaiser Fam Foundation Report Shows Part D Impact […]<\/p>\n

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