Tag: biden
Patients See Drug Savings From Biden Law -- As Pharma Prepares To Sue

Patients See Drug Savings From Biden Law -- As Pharma Prepares To Sue

Last year alone, David Mitchell paid $16,525 for 12 little bottles of Pomalyst, one of the pricey medications that treat his multiple myeloma, a blood cancer he was diagnosed with in 2010.

The drugs have kept his cancer at bay. But their rapidly increasing costs so infuriated Mitchell that he was inspired to create an advocacy movement.

Patients for Affordable Drugs, which he founded in 2016, was instrumental in getting drug price reforms into the 2022 Inflation Reduction Act. Those changes are kicking in now, and Mitchell, 73, is an early beneficiary.

In January, he plunked down $3,308 for a Pomalyst refill “and that’s it,” he said. Under the law, he has no further responsibility for his drug costs this year — a savings of more than $13,000.

The law caps out-of-pocket spending on brand-name drugs for Medicare beneficiaries at about $3,500 in 2024. The patient cap for all drugs drops to $2,000 next year.

“From a selfish perspective, I feel great about it,” he said. But the payment cap will be “truly life-changing” for hundreds of thousands of other Medicare patients, Mitchell said.

President Joe Biden’s battle against high drug prices is mostly embodied in the IRA, as the law is known — a grab bag of measures intended to give Medicare patients immediate relief and, in the long term, to impose government controls on what pharmaceutical companies charge for their products. The law represents the most significant overhaul for the U.S. drug marketplace in decades.

With Election Day on the horizon, the president is trying to make sure voters know who was responsible. This month, the White House began a campaign to get the word out to seniors.

“The days where Americans pay two to three times what they pay for prescription drugs in other countries are ending,” Biden said in a February 1 statement.

KFF polling indicates Biden has work to do. Just a quarter of adults were aware that the IRA includes provisions on drug prices in July, nearly a year after the president signed it. He isn’t helped by the name of the law, the “Inflation Reduction Act,” which says nothing about health care or drug costs.

Biden’s own estimate of drug price inflation is quite conservative: U.S. patients sometimes pay more than 10 times as much for their drugs compared with people in other countries. The popular weight loss drug Wegovy lists for $936 a month in the U.S., for example — and $83 in France.

Additional sections of the law provide free vaccines and $35-a-month insulin and federal subsidies to patients earning up to 150% of the federal poverty level, and require drugmakers to pay the government rebates for medicines whose prices rise faster than inflation. But the most controversial provision enables Medicare to negotiate prices for certain expensive drugs that have been on the market for at least nine years. It’s key to Biden’s attempt to weaken the drug industry’s grip.

Responding to Pressure

The impact of Medicare’s bargaining over drug prices for privately insured Americans remains unclear. States have taken additional steps, such as cutting copays for insulin for the privately insured.

However, insurers are increasing premiums in response to their higher costs under the IRA. Monthly premiums on traditional Medicare drug plans jumped to $48 from $40 this year, on average.

On Feb. 1, the Centers for Medicare & Medicaid Services sent pharmaceutical makers opening bids for the first 10 expensive drugs it selected for negotiation. The companies are responding to the bids — while filing nine lawsuits that aim to kill the negotiations altogether, arguing that limiting their profits will strangle the pipeline of lifesaving drugs. A federal court in Texas dismissed one of the suits on Feb. 12, without taking up the substantive legal issue over constitutionality.

The nonpartisan Congressional Budget Office predicted the IRA’s drug pricing elements would save the federal government $237 billion over 10 years while reducing the number of drugs coming to market in that period by about two.

If the government prevails in the courts, new prices for those 10 drugs will be announced by September and take effect in 2026. The government will negotiate an additional 15 drugs for 2027, another 15 for 2028, and 20 more each year thereafter. CMS has been mum about the size of its offers, but AstraZeneca CEO Pascal Soriot on Feb. 8 called the opening bid for his company’s drug Farxiga (which earned $2.8 billion in U.S. sales in fiscal year 2023) “relatively encouraging.”

Related Biden administration efforts, as well as legislation with bipartisan support, could complement the Inflation Reduction Act’s swing at drug prices.

The House and Senate have passed bills that require greater transparency and less self-serving behavior by pharmacy benefit managers, the secretive intermediaries that decide which drugs go on patients’ formularies, the lists detailing which prescriptions are available to health plan enrollees. The Federal Trade Commission is investigating anti-competitive action by leading PBMs, as well as drug company patenting tricks that slow the entry of cheaper drugs to the market.

‘Sending a Message’

Months after drug companies began suing to stop price negotiations, the Biden administration released a framework describing when it could “march in” and essentially seize drugs created through research funded by the National Institutes of Health if they are unreasonably priced.

The timing of the march-in announcement “suggests that it’s about sending a message” to the drug industry, said Robin Feldman, who leads the Center for Innovation at the University of California Law-San Francisco. And so, in a way, does the Inflation Reduction Act itself, she said.

“I have always thought that the IRA would reverberate well beyond the unlucky 10 and others that get pulled into the net later,” Feldman said. “Companies are likely to try to moderate their behavior to stay out of negotiations. I think of all the things going on as attempts to corral the market into more reasonable pathways.”

The IRA issues did not appear to be top of mind to most executives and investors as they gathered to make deals at the annual J.P. Morgan Healthcare Conference in San Francisco last month.

“I think the industry is navigating its way beyond this,” said Matthew Price, chief operating officer of Promontory Therapeutics, a cancer drug startup, in an interview there. The drugs up for negotiation “look to be assets that were already nearing the end of their patent life. So maybe the impact on revenues is less than feared. There’s alarm around this, but it was probably inevitable that a negotiation mechanism of some kind would have to come in.”

Investors generally appear sanguine about the impact of the law. A recent S&P Global report suggests “healthy revenue growth through 2027” for the pharmaceutical industry.

Back in Washington, many of the changes await action by the courts and Congress and could be shelved depending on the results of the fall election.

The restructuring of Medicare Part D, which covers most retail prescription drugs, is already lowering costs for many Medicare patients who spent more than $3,500 a year on their Part D drugs. In 2020 that was about 1.3 million patients, 200,000 of whom spent $5,000 or more out-of-pocket, according to KFF research.

“That’s real savings,” said Tricia Neuman, executive director of KFF’s Medicare policy program, “and it’s targeted to people who are really sick.”

Although the drug industry is spending millions to fight the IRA, the Part D portion of the bill could end up boosting their sales. While it forces the industry to further discount the highest-grossing drugs, the bill makes it easier for Medicare patients to pick up their medicines because they’ll be able to afford them, said Stacie Dusetzina, a Vanderbilt University School of Medicine researcher. She was the lead author of a 2022 study showing that cancer patients who didn’t get income subsidies were about half as likely to fill prescriptions.

States and foundations that help patients pay for their drugs will save money, enabling them to procure more drugs for more patients, said Gina Upchurch, the executive director of Senior PharmAssist, a Durham, North Carolina-based drug assistance program, and a member of the Medicare Payment Advisory Commission. “This is good news for the drug companies,” she said.

Relief for Patients

Lynn Scarfuto, 73, a retired nurse who lives on a fixed income in upstate New York, spent $1,157 for drugs last year, while most of her share of the $205,000 annual cost for the leukemia drug Imbruvica was paid by a charity, the Patient Access Network Foundation. This year, through the IRA, she’ll pay nothing because the foundation’s first monthly Imbruvica payment covered her entire responsibility. Imbruvica, marketed jointly by AbbVie and Janssen, a subsidiary of Johnson & Johnson, is one of the 10 drugs subject to Medicare negotiations.

“For Medicare patients, the Inflation Reduction Act is a great, wonderful thing,” Scarfuto said. “I hope the negotiation continues as they have promised, adding more drugs every year.”

Mitchell, a PR specialist who had worked with such clients as the Campaign for Tobacco-Free Kids and pharmaceutical giant J&J, went to an emergency room with severe back pain in November 2010 and discovered he had a cancer that had broken a vertebra and five ribs and left holes in his pelvis, skull, and forearm bones. He responded well to surgery and treatment but was shocked at the price of his drugs.

His Patients for Affordable Drugs group has become a powerful voice in Washington, engaging tens of thousands of patients, including Scarfuto, to tell their stories and lobby legislatures. The work is supported in part by millions in grants from Arnold Ventures, a philanthropy that has supported health care policies like lower drug prices, access to contraception, and solutions to the opioid epidemic.

“What got the IRA over the finish line in part was angry people who said we want something done with this,” Mitchell said. “Our patients gave voice to that.”

Arnold Ventures has provided funding for KFF Health News.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.


Reprinted with permission from Alternet.

Trump and Biden

Fox Tells Viewers Trump Is 'President,' Biden Is 'A Wannabe Dictator'

Americans tuning in to Fox News Tuesday night, hours after Donald Trump was arraigned on 37 federal criminal felony charges, had a big surprise: Donald Trump is the “President of the United States,” and Joe Biden, the man actually in the White House, is a “wannabe dictator.”

That’s what Rupert Murdoch’s right-wing “news” network decided to tell its shrinking band of viewers, rather than the truth.

Also not telling the truth was Trump himself, aided by Fox News which, unlike CNN and MSNBC (but exactly like Newsmax and C-SPAN) decided to run his post-arraignment speech live, with no anchor doing any fact checks or providing any context.

“These things are not true, but Fox News is doing their damnedest to help,” noted MSNBC’s Stephanie Ruhle on-air, one of many who noticed and were disgusted enough to speak out.

Axios national political correspondent Alex Thompson posted the video of Fox News host Brian Kilmeade announcing, “this is the president of the United States, about to address a crowd of supporters.”

The Recount posted the clip of Fox News’ chyron that reads: “Wannabe Dictator Speaks at the White House After Having His Political Rival Arrested” (in all-caps.)

And no, Donald Trump is not the President of the United States, Joe Biden is. And Joe Biden is not a “wannabe dictator,” nor did he have “his political rival arrested.”

Reprinted with permission from Alternet.

Biden Cuts Asian Trip Short To Deal With Republicans On Debt And Budget

Biden Cuts Asian Trip Short To Deal With Republicans On Debt And Budget

Washington (AFP) - President Joe Biden's departure Wednesday to the G7 in Japan was meant to launch a geostrategic masterclass on rallying the world's democracies against China. Instead, he will limp into an abruptly truncated journey facing concerns that the US debt ceiling row is about to tear up the global economy.

Biden arrives Thursday in Hiroshima, one of the two cities hit by US atomic bombs in 1945 -- a closing chapter to World War II and the start of an era of US leadership across the Pacific that Beijing now seeks to supplant.

He will meet leaders from the rest of the G7 club -- Britain, Canada, France, Germany, Italy, Japan -- that has been so crucial in the US-led drive to enforce unprecedented economic sanctions on China-ally Russia for invading Ukraine.

However, visits next week to Papua New Guinea and to a Sydney summit of the Quad, comprising Australia, India, Japan and the United States, were canceled so that Biden can rush back Sunday and negotiate with Republican opponents on the debt ceiling.

For a president who often warns that democracies are in an existential fight to prove their viability against the world's autocracies, it's a sobering moment.

"It's extraordinarily hard... to go to the G7 and talk about economic unity against Russia, economic unity against China, when the dysfunction is coming from inside the house," Josh Lipsky, at the Atlantic Council, said.

Biden downplayed the reshuffling of his schedule, saying, "the nature of the presidency is addressing many critical matters all at once."

But Evan Feigenbaum, a former US diplomat with the Carnegie Endowment, was brutal.

"It's tough to 'compete with China' in the Pacific when you're busy sinking your own boat," he tweeted. "How do we think we look to the rest of the world?"

Candidate Biden Enters Furnace

For Biden, 80, the trip and the debt ceiling mess come at a crucial time. He has just launched his re-election campaign and Americans wary about his age are watching how he copes in the furnace of the presidency at home and abroad.

National Security Council spokesman John Kirby said Biden can multi-task.

"He can travel overseas, and manage our foreign policy and our defense policy and look after our national security commitments in an important region like the Indo-Pacific, and also work with congressional leaders to do the right thing -- raise the debt ceiling, avoid default so that the United States credibility here at home and overseas is preserved," Kirby said.

The risks over the debt ceiling, however, are so huge -- global market panic would be just the beginning of the fallout from a default -- that Biden may spend much of his time trying to reassure fellow world leaders on the state of the US economy, rather than planning how to manage China.

Biden doesn't know whether the increasingly hard-right Republican Party will allow an increase to the debt in time to prevent default. And he also doesn't know whether the left of his own Democratic party will forgive him for the compromises he may have to make to save the situation.

Quad Consolation Prizes

Canceling the Papua New Guinea and Australia stops is a bitter pill for a president who has reinvigorated US diplomacy after the isolationist Trump years.

The Quad, an informal grouping of large democracies interested in restraining aggressive Chinese economic and military expansion across the Pacific, is one of Biden's priorities.

The White House was quick to point out that Biden will already be meeting in Japan on the sidelines of the G7 with his other Quad counterparts.

And a consolation prize for Australian Prime Minister Anthony Albanese was extended in the form of an invitation to a state visit at the White House. Indian Prime Minister Narendra Modi is already booked in for a state visit this June.

But Washington is likely to rue the missed opportunity in Papua New Guinea, where Biden would have been the first serving US president to visit. The symbolism, at a time when remote Pacific island territories and countries have become chess pieces in the geostrategic contest with China, would have been powerful

Joe Biden

Polls Show Strong Public Support For Biden To Increase Debt Ceiling

When President Joe Biden addressed the debt ceiling negotiations Wednesday at a union event in Maryland, he uncharacteristically took Republican House Speaker Kevin McCarthy to task, calling House GOP demands "wacko" and "really dangerous."

“We’ve never ever defaulted on a debt. It would destroy the economy,” Biden said while speaking at the International Union of Operating Engineers Local 77 in Accokeek. “America is not a dead-beat nation,” he added.

The White House and Democrats are on the right side of public opinion. New Navigator Research polling found that 64 percent of voters believe it would be worse to default on the nation's debt than to raise the debt ceiling, while 36 percent say that raising the ceiling is worse than defaulting.

Biden was responding to the House GOP's debt ceiling “plan,” which ties raising the ceiling (i.e., averting a global meltdown) to major budget cuts. For months, Biden has urged House Republicans to pass a "clean" debt ceiling increase while refusing to link the two matters.

The heightened sense of urgency demonstrated by Biden, who isn't usually inclined to mix it up with political adversaries, is twofold. First, House Republicans are just dumb enough to play with fire, and Biden specifically recalls the fallout from the last time a White House and congressional Republicans played a game of chicken on raising the debt ceiling. It was 2011, Biden was vice president, and the nation came just close enough to defaulting that the U.S. credit rating was downgraded, markets plummeted, and U.S. taxpayers bore the burden of the country's increased borrowing costs.

Second, House Republicans are also just dumb enough to intentionally tank the economy in the name of austerity. Such a move could precipitate an epic global meltdown, and the White House simply cannot afford for voters to blame that on the president heading into his reelection.

Voters support raising the debt ceiling by a 10-point margin, 48 percent - 38 percent, with 14 percent saying they weren't sure. Those findings are in keeping with a PBS/NPR/Marist poll in February that found a 52 percent majority of voters supported raising the debt ceiling.

The notion that roughly half the nation supports a debt ceiling increase while fewer oppose it may seem less than reassuring, but that's more than twice as much support for raising the limit than in 2011, when the same PBS/NPR/Marist poll found that just 24 percent of voters favored a ceiling hike.

Another way of looking at it is that having been to this rodeo before, more voters drew similar conclusions to Biden: Quit messing around and just raise the damn ceiling already. In other words, Biden's message on the topic should be one that resonates with most voters.

But recent polling on the matter reveals one other lesson: People need to understand that failure to raise the debt ceiling will result in default. While people steeped in the brinkmanship inherently understand that failing to raise the ceiling will trigger a default, many voters apparently don't and are also hesitant to greenlight more government spending.

When CBS News asked respondents simply whether Congress should raise the debt ceiling, a narrow majority said no, with 46 percent favoring it while 54 percent opposed it.

However, when respondents were asked if Congress should raise the debt ceiling to avoid defaulting on its current debt, fully 70 percent support increasing the ceiling.

Currently, the U.S. has already hit the ceiling on what it can borrow and the Treasury Department has implemented so-called "extraordinary measures" to avoid defaulting on our debt. But sometime in June those measures are expected to come up short, so the reckoning is fast approaching.

Right now, McCarthy is attempting to lure the White House to the table on spending cuts when he may not even have the 218 votes in his own caucus to pass his own debt limit bill. That's not a particularly strong starting point, especially when everyone knows that bill would be dead on arrival in the Democratic-controlled Senate even if McCarthy managed to finagle it through the House by some miracle.

Biden has spent months pressing House Republicans to decouple the debt ceiling increase from negotiations on spending.

"Take default off the table," Biden said on Wednesday.

As the deadline grows closer, Biden is also rightfully pinning the blame on House Republicans.

“Let’s be clear: If he fails, the American people will be devastated,” Biden said of McCarthy.

He's not wrong. The best outcome for everyone involved—particularly average Americans—would be for a deal to come together long before a potential default shakes the global financial markets.

But if, God forbid, it comes down to finger-pointing, the White House appears to be on solid ground with the public, and Biden isn't mincing words.

Reprinted with permission from Daily Kos.