Ian Read, Len Schleifer Hug-It-Out Following Drug Price Scuffle

APRIL FOOLS’!  No, the CEOs of Pfizer and Regeneron are not shaking hands and working it out following their heightened rhetoric about drug prices two years ago. It may be April 2nd, but we couldn’t let April Fool’s pass without The Week That Was team having a little fun. Just sayin, it would make a good Oprah reunion episode!

But don’t let yesterday’s pranks fool you, the following updates are no joke:

• You could catch Bingo Night and an urgent care clinic at Walmart if the rumors that a partnership with the retailer and Humana come true. The move may be a bid to expand their health care coverage offerings to the 65+ segment. Now, the only thing missing from your neighborhood Walmart may be an early bird special!
• The faith has found pharma! No, this is not a revival. Rather, many pharmaco annual shareholder meetings this spring will hold votes seeking to examine connections between executive compensation and drug pricing. The votes are part of an effort by the Interfaith Center on Corporate Responsibility, a group that posits that CEOs should be rewarded for new drugs developed -- not short-term tactics to maximize revenue and stock price, such as raising drug prices.
• Did you know you’ve got an extra organ? And it’s the largest one in your body? Some researchers recently discovered interstitial tissue (the main component of fluid found between cells in the body), which they argue qualifies as an organ. If accepted, it would become the new, largest organ in the body – beating the skin, which is 16% of an individual’s body mass. Our question: how long has it been hiding there?
• Grindr (a male-only dating app) will begin to send its users reminders to get tested every four months, in a proactive public health effort to combat the AIDS epidemic.

If you’re still in a Cadbury egg sugar coma, these headlines will bring you back into focus. Read on for The Week That Was...

►A CONGRESSIONAL TRADITION UNLIKE ANY OTHER GOES UNUTILIZED

Hauling CEOs before Congress has been a favorite tactic for lawmakers looking to score free points by taking out America’s frustration on the corporate villain du` jour. But the pharmaceutical industry hasn’t been the subject of these inquiries in more than a year, and STAT News explored the reasons why. A few possibilities: effective work by industry trade associations, CEOs investing time to meet with members of Congress individually, and a lack of Congressional consensus on what they would do to address high prices. The industry’s leading trade association PhRMA has spent ~$25 million on lobbying last year, and 2018 is sure to be another record. Advocates for lower prices are not satisfied and asking for meaningful legislative action.

►OUR TAKE

Don’t confuse the lack of ‘blame and shame’ hearings on Capitol Hill as a lack of interest in drug pricing. While not as public as hearings, Congress has maintained a steady flow of letters to companies, demands for further information, and constituent communications that bash the industry or individual companies for drug pricing and marketing. If individual companies don’t want to be the one to end the “streak”, then successful media and stakeholder communications about the price of your medicines is imperative...particularly with Presidential policy on drug pricing looming in the weeks ahead.

►VERMONT'S JOURNEY TO PRICE TRANSPARENCY HITS OPAQUE END

In 2016, Vermont broke the mold as the first state in the country to require that drug makers justify the price increases of medicines. And the industry held its breath about what the law would mean. Two years later, not much has happened. A report issued by Vermont’s Attorney General in February found: 6,500 medicines raised their list prices by more than 50% over five years, and ~1,900 drugs took price increases greater than 15% in the past year. Despite all this, the state law only required the state agencies focus on price increases for 10 drugs, which carried the highest costs to the state and which had taken the dramatic increases noted above. With no clear “teeth” in the law, some drug makers refused to share proprietary information, leading Vermont policymakers to question the value of what law is yielding. Lawmakers are going back to the drawing board to examine ways to strengthen the policy such as importing drugs from Canada and preventing generics from “price gouging” among other measures.

►OUR TAKE

Many pharmacos have been asking themselves this question for the last two years following the law’s implementation: “Why would we submit so much proprietary data to the state when there are few negative consequences?” Some have even feared proprietary data would fall into competitor hands. So while Vermont vs. pharma may have hit a stalemate, the bigger question is whether other states will take note of Vermont’s shortcomings and craft bills with more bite. Only time will tell!

►NEW APPROACHES TO AN INTRACTABLE OPIOID PROBLEM

Every day that passes brings new reporting on the opioid epidemic and seemingly all sectors of society are trying to find solutions to the problem. Here’s the latest:

• Cigna reported that it has reduced the use of prescription opioids among its members by 25%, a year ahead of schedule. How did it happen? The insurer worked with physicians and dentists to review concerns about prescribing practices, notified them of possible cases of misuse and abuse, applied closer utilization management of opioids; and offered more support for opioid use disorder. While the effort aims to reduce the risk of addiction, some experts say it could exacerbate the problem. If the Cigna mandate isn’t applied carefully, some subpopulations used to high dosing may be at risk for opioid withdrawal. In turn, this could increase their search for alternative options such as heroin, creating a vicious, worsening cycle.
• Congressman Elijah Cummings (D-MD) and Senator Elizabeth Warren (D-MA) penned a strongly-worded opinion editorial in USA Today calling for legislative solutions to the opioid epidemic. Beseeching Congress to recall the playbook it used to battle the HIV/AIDS epidemic 30 years ago, the legislators asked their peers apply the same proactive leadership for tackling today’s public health crisis.  While Warren and Cummings pledged to introduce legislation, they didn’t miss the opportunity to blast the ‘drug-pushing’ pharmacos, claiming the crisis that ‘didn’t happen on its own.’

►OUR TAKE

In the effort to untangle the web that is the opioid epidemic, too often policymakers and press run the risk of oversimplifying the actors involved into a binary characterization of “good or bad.” Similarly, blunt tactics are often proffered as the “solutions” for a multi-faceted problem. Cigna’s effort is an important start, but what is missing is more active engagement with manufacturers and pain management advocacy groups. This problem started as part of a complex ecosystem, where each sector missed warning signs, and it won’t be unwound without every stakeholder at the table.

Until next week,

-  The Reputation & Risk Management Practice @ Syneos Health Communications