OPINION: Reduce Costs at Pharmacies

Patients like me who rely on prescription drugs to manage a range of symptoms and health care conditions are tired of getting gouged by increasingly high out-of-pocket costs at the pharmacy. Our elected officials in Congress must do something this year to help reduce these burdensome costs and protect patients in Louisiana and throughout the nation.

The most effective thing Congress could do to help bring out-of-pocket prescription costs down would be to reform the harmful practices and policies enforced by Pharmacy Benefit Managers (PBMs). These insurer-owned groups have proved time and time again that they do not have the best interests of patients in mind as they only care about boosting their profits whenever and however they can.

Sadly, that even includes an all-too-common practice in which PBMs will negotiate with drug manufacturers to secure significant discounts or rebates on certain medications. However, instead of passing those discounts down to patients to help them lower their out-of-pocket expenses, PBMs will generally just absorb the savings to inflate their already massive profit margins.

That is why Congress must pass PBM reform legislation before the end of the year. Senators Cassidy and Kennedy can do their part by supporting and helping to advance both the Delinking Revenue from Unfair Gouging (DRUG) Act as well as the Modernizing and Ensuring PBM Accountability Act. Vulnerable patients shouldn’t have to pay more out of pocket just so these greedy PBMs can keep raking in the profits.

Shayne Benedetto

LANDRY: The Opioid Crisis

AG Jeff Landry with Iberia Parish Sheriff Tommy Romero with a Drug Take Back Box.

On January 10, 1980, the New England Journal of Medicine published a letter claiming that prescription opioids rarely lead to addiction. It would go on to be “heavily” and “uncritically” cited to support the prescription practices that followed. Fast forward forty years, and we’ve got popular shows like Hulu’s Dopesick and Netflix’s Painkiller highlighting the damage this has done to communities across our Nation.  

For too long, there were more opioid prescriptions than people in Louisiana; and it is estimated that 120 Americans die of an overdose every day — a rate that has tripled since 1999. For reference, Purdue Pharma’s “miracle drug” OxyContin was released in 1995.  

Targeting blue collar workers susceptible to work-related injuries, the Big Pharma giant encouraged physicians to prescribe these time-released doses of oxycodone — a cousin of heroin twice as powerful as morphine — for pain ranging from arthritis and back injuries to fibromyalgia and headaches. Sales reps claimed that, despite preconceptions about opioids, “fewer than 1% of patients who took OxyContin became addicted.”  

This was proven absolutely untrue as a surge of addiction soon fed a wave of armed robbery, violent crime, prostitution, and theft as job and child abandonment rates increased. At the same time, sales of OxyContin in the United States outpaced those of Viagra while more than 30,000 coupons for the addictive drug were used. And by 2011, the CDC had declared an opioid epidemic.  

That, however, did not stop production of other pain relievers. Fentanyl, which is 50 to 100 times more powerful than morphine, soon became a household name — though most people are unaware that they are even consuming fentanyl, until it’s far too late. Today, opioids account for 69% of drug overdose deaths, a rate that has doubled since 2010. And most synthetic opioids are far stronger and more dangerous than the drugs used ten years ago. That is why this has become an international crisis over the past two decades, one that has certainly affected our State.  

When I became Attorney General, I made the opioid epidemic a priority of my office. Knowing that roughly 60% of addicts start their addiction with someone else’s prescription, we set out to educate on the dangers of opioids and counterfeit drugs, then collaborated with law enforcement to provide drug take back boxes across our State. We also leveraged a legal settlement to provide our first responders with free vouchers for Naloxone. Then, we pushed Congress to repeal the shielding of manufacturers and distributors from accountability. 

My Consumer Protection Division also reached a settlement with the consulting firm who advised Purdue Pharma on how to maximize their profits by targeting high-volume prescribers, encouraging doctors to increase prescriptions, and circumventing pharmacy restrictions. When states began to sue Purdue, the firm advised deleting documents to hide the truth; yet in collaboration with 47 other states, we held them accountable.  

Furthermore, our office led negotiations alongside other attorneys general to reach an historic agreement with CVS and Walgreens for their role in this crisis, resulting in $10.7 billion in opioid relief funds to be paid over the next decade. Monies will be allocated to local governments and parishes and used to remediate this crisis, from prevention and harm reduction to treatment and recovery services.  

Unfortunately, after Purdue reformulated OxyContin to reduce drug abuse — namely by preventing abusers from snorting and injecting the ground up pill — addicts turned to heroin. This created a new market for drug cartels in Mexico, who have since abused our border crisis to further feed crime, drug addiction, and overdose deaths in our communities.  

This why my office has been relentless in fighting open border policies that benefit human traffickers and drug dealers. As Attorney General, I defended ICE, fought Sanctuary Cities, pushed for Title 42 to remain in place, and sued the Biden Administration in federal court to keep our asylum process fair rather than issue blank checks of citizenship to criminals. We also continue to call for the resignation of DHS Secretary Alejandro Mayorkas, who has made a bad situation far worse.  

Sadly, none of that offers much comfort to those who have lost their loved ones to the opioid crisis. No law, policy, or lawsuit will ever bring their family members back from a fatal overdose. But what we can do is prevent someone else from succumbing to this horrible situation, and that is what I will continue to fight for as long as I remain in office. The great people of our State are not alone; and together, we will turn the tide. 

Jeff Landry
Louisiana Attorney General

Prescription drug pricing reform must rein in pharmacy benefit managers

This month, President Biden signed an executive order directing federal health departments to create plans within 90 days to lower prescription drug costs that are burdening so many Americans. Any robust program to meaningfully bring financial relief to patients at the prescription counter must address the root cause of skyrocketing drug prices — pharmacy benefit managers (PBMs).

A new report by one of us (Rep. Buddy Carter) reveals the outsized role PBMs play in making medications unaffordable and inaccessible. Federal health departments can achieve the bipartisan goal of reducing medication prices by taking this opportunity to rein in PBMs’ predatory practices.

Read more: Prescription drug pricing reform must rein in pharmacy benefit managers

WSJ: Biden’s Cancer ‘Moonshot’ Contradiction

By the Editorial Board

President Biden this week gave a speech promoting his Cancer Moonshot initiative and a new government health agency that he says will drive treatment breakthroughs. As usual, he gave no credit to drug makers that are producing game-changing treatments such as Amgen’s Lumakras for lung cancer. 

Lung cancer kills more Americans than any other cancer. The five-year survival rate is a mere 18.6% and 5% for advanced forms. Treatments targeting particular protein or gene mutations have improved survival odds for breast, melanoma and some other cancers. But cancers driven by a mutation in the KRAS gene have eluded these breakthroughs, and lung cancer is one of them.

The KRAS gene regulates cell growth and division, and mutations are found in many tumors, including 32% of lung and 90% of pancreatic cancers. Yet the KRAS protein has long been considered “undruggable” because its small size and smooth surface are difficult for drug molecules to block. Amgen’s Lumakras pill proves it can be done.

The Food and Drug Administration last May approved Lumakras under its accelerated approval pathway for patients with advanced non-small lung cancer bearing a particular KRAS gene mutation. Results from early trials showed promise and this week were borne out by a late-stage trial that showed more than twice as many patients responded to the drug than they did to chemotherapy.

A quarter of patients receiving Lumakras lived at least a year without their cancer getting worse compared to 10% who received chemotherapy. Survival benefits were hard to assess since a third of the chemotherapy patients received Lumakras after their disease progressed. Amgen also announced results from a separate small trial this week showing Lumakras may help patients with metastatic colorectal cancer. 

The drug is by no means a cure, but progress occurs at the margin and some patients who had what amounted to a death sentence now have hope to live. Lumakras is also much less brutal than chemotherapy. 

Yet the drug might not have been developed had the Medicare take-it-or-leave-it negotiations that Democrats recently enacted been in effect earlier. Their price controls will penalize in particular small-molecule drugs like Lumakras that have the potential to help large numbers of patients. Within six years, Lumakras could be targeted by bureaucrats for price controls and the payoff on Amgen’s investment could vanish. 

Mr. Biden’s price-control policy contradicts his desire to promote faster cancer cures. The damage will come in slower therapies and patients who might have been saved. 

Read more: Biden’s Cancer ‘Moonshot’ Contradiction

States Shouldn’t Repeat Maine’s Drug Importation Mistake

When children, out of natural curiosity, touch a hot stove burner, they learn very quickly never to do that again. As I see several states contemplating prescription drug importation plans and having conversations with the Food and Drug Administration about how they can arrange wholesale drug imports from Canada, I find myself wishing that these state officials had a child’s capacity for self-protection and a determination to prevent themselves — and, more important, their citizens — from getting repeatedly burned.

Read more: States Shouldn’t Repeat Maine’s Drug Importation Mistake

U.S. Senate candidate from Louisiana smokes marijuana in campaign ad

Photo source: YouTube

Gary Chambers, a Democrat running for the U.S. Senate from Louisiana, unveiled a new ad Tuesday in which he is shown smoking marijuana.

In the spot, Chambers, who is seeking to unseat Sen. John Neely Kennedy (R-La.), is shown seated in an open field, lighting up a rolled blunt of marijuana and taking multiple puffs. In a voice-over, he rattles off statistics about the drug, including that Black people are four times as likely as White people to be arrested for its use.

Read more: U.S. Senate candidate from Louisiana smokes marijuana in campaign ad

Socialist Drug Price Controls Have No Place in America

Pssst…  Want to turn American healthcare into the equivalent of this week’s Iowa Democratic caucus fiasco? 

Just import foreign drug price controls to the United States, and voila. 

The same types of people who couldn’t manage to introduce a new app in a caucus involving a few thousand people on a single night in a single state expect us to trust them to control healthcare with metronomic precision for 330 million people?  Mark me skeptical. 

For his part, President Trump offered reassurance in his State of the Union speech this week when he said, “To those watching at home tonight, I want you to know we will never let socialism destroy American healthcare.” 

Read more: Socialist Drug Price Controls Have No Place in America

H.R. 3 is the wrong path to lower drug costs

Photo source: Wall Street Journal

Americans want health care to be less expensive. We also want our health care to be the most innovative in the world. The key to simultaneously achieving both of these goals is good public policy.

Back in September, House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.) introduced H.R. 3, also known as the Lower Drug Costs Now Act of 2019, into the House of Representatives with 105 co-sponsors, all Democrats. The House is set to vote on the bill this week.

H.R. 3 would adopt international reference pricing for the Medicare program in an effort to lower drug costs. In other words, it would impose foreign price controls on the U.S. market. This would indeed reduce prices, but at what cost to innovation?

Read more: H.R. 3 is the wrong path to lower drug costs

Drug Pricing Proposals Would Import Foreign 'Death Panels'

The left loves to pooh-pooh "death panels" as some kind of right-wing phantom, but that’s what’s happening elsewhere in the world as countries find “free” to be more expensive than believed and try to make their budget numbers work.

In the United Kingdom, the problem became so acute the government was forced to set up an entire new program just to fund health care costs for people who were likely to die soon.

Read more: Drug Pricing Proposals Would Import Foreign 'Death Panels'

At What Cost?

Photo source: Washington Examiner

The U.S. House of Representatives is racing to pass a bill designed to address prescription drug pricing, but its confiscatory taxes would decimate innovation and undoubtedly reduce the supply of today’s medicines.

Two House committees—Energy & Commerce and Education & Labor—voted largely along party lines yesterday to advance H.R. 3, which is expected to be named after the late Rep. Elijah Cummings who died on Thursday at age 68. 

Economist Doug Holtz-Eakin, a former CBO Director and now president of the American Action Forum, took a look at the CBO’s cost estimates of the Pelosi drug bill—which is only a partial estimate but which shows savings of $345 billion to Medicare Part D. That’s a big “savings” number that definitely gets the attention of members always on the prowl for new money to spend. 

But at what price? “Now, if you do a little price-fixing…followed by a little extortion…you can save some money,” Holtz-Eakin wrote, adding, “it is easy to save budget dollars — just don’t pay for things.” 

Read more: At What Cost?

DEA issues warning over counterfeit prescription pills from Mexico

The Drug Enforcement Administration, New Orleans Division, is alerting the public of dangerous counterfeit pills killing Americans.

According to the DEA, Mexican drug cartels are manufacturing mass quantities of counterfeit prescription pills containing fentanyl, a dangerous synthetic opioid that is lethal in minute doses, for distribution throughout North America.

Based on a sampling of tablets seized nationwide between January and March 2019, DEA found that 27 percent contained potentially lethal doses of fentanyl.

Read more: DEA issues warning over counterfeit prescription pills from Mexico

White House distances itself from Pelosi plan to lower drug prices

Photo source: Piper Report

The White House has been in talks with Pelosi’s office for months on drug prices, a rare shared priority, but the effort always faced tough odds given the partisan divide and the impeachment inquiry into President Trump. 

Now the Trump administration is downplaying the chances it will endorse Pelosi’s bill, instead pointing to a somewhat more modest bill in the Senate from Sens.Chuck Grassley(R-Iowa) andRon Wyden(D-Ore.), the chairman and ranking member, respectively, of the Senate Finance Committee.

“Lines of communication remain open with the Speaker’s office, but the Grassley-Wyden proposal is the most likely solution that could advance on a bipartisan basis and achieve the President’s priority of lowering drug prices even further for all Americans,” White House spokesman Judd Deere wrote in an email. 

Read more: White House distances itself from Pelosi plan to lower drug prices

Pelosi’s drug pricing plan puts medical innovation at risk

Photo source: Stat News

Speaker of the House Nancy Pelosi recently unveiled her drug pricing proposal (HR 3, also known as the Lower Drug Costs Now Act of 2019), which is being debated in key congressional committees this week. It is unprecedented in size and scope, dramatically expanding the role of the federal government in health care decision-making. It also opens the door for bureaucrats in the United States and in foreign countries to determine the type of research companies should pursue and how and when patients can access new treatments and cures.

The speaker claims that her plan to lower drug costs allows the government to “negotiate” prices for 250 medicines, but that is not how it would work. The legislation creates a “ceiling price” based on the average price a medicine is sold in six foreign countries with government-run health care systems — countries that limit patient access to innovative treatments. The legislation also sets a “target price,” which equals the lowest price of the medicine in any of the six countries.

Biopharmaceutical companies can accept the target price or attempt to convince the government they should be paid closer to the ceiling price. But unlike a negotiation in which both parties have leverage, if a company does not accept the price the government is willing to pay for a medicine, it is forced to pay a tax of up to 95% of sales of the medicine. That is not negotiation.

Read more: Pelosi’s drug pricing plan puts medical innovation at risk

Pelosi’s Expensive Drug Bill

Many distortions in drug prices are due to mandatory Medicaid rebates that include an inflation adjustment and require that states receive the “best” price of any private plan. Drug makers have been reluctant to let private insurers make installment payments on CAR T-cell cancer therapies based on their efficacy because they could be forced to provide steep discounts to Medicaid that are lower than the treatment costs.

Drug makers get a bad rap because they sometimes raise prices for no apparent reason, and consumers are facing sticker shock because of rising deductibles and co-payments. But net prices after rebates paid to insurers and the government have been falling amid faster generic-drug approvals and more competition from branded drugs.

Price controls would hamper competition by slowing new drug development. The U.S. accounts for most of the world’s pharmaceutical research and development, so there would be fewer breakthrough therapies for rare pediatric genetic disorders, cancers or hearing loss.

Read more: Pelosi’s Expensive Drug Bill

Pelosi’s Price-Control Prescription Would Cost American Lives

Under Pelosi’s “Lower Drug Costs Now Act,” the federal government would identify the 250 most expensive drugs every year and “negotiate” prices for at least the top 25. The negotiations, however, would be rigged. The bill forces a pharmaceutical company to accept a price for its drug that is no more than 1.2 times the average price of that drug in the countries of Australia, Canada, France, Germany, Japan, and the United Kingdom. If a company refuses to enter into negotiations for its drug, the federal government will impose a punitive excise tax of 65 percent on the gross sales of the drug. That tax will increase by 10 percent every quarter until it reaches a maximum of 95 percent.

Read more: Pelosi’s Price-Control Prescription Would Cost American Lives

Again, Thank You Jeff Landry for Your Fight Against Opioids

My regular job is oilfield related and many do not know that I was once a paramedic with Acadian Ambulance. Just giving this bit of personal information to put into context what I have to say next. This is from my personal Facebook page

What a way to start the weekend. Stopped for gas in Houma on the way back to New Iberia after work and walked in to the store and onto a guy overdosing on drugs in the Subway next door. Houma PD was already on scene and administered Narcan and the guy had an open airway by the time AASI arrived.

This is just another reason why I am proud of our Attorney General. Jeff was able to get Narcan for first responders to use and this saved this guy’s life.

The opioid problem is very prevalent here in our state. Talk to your kids!!!!

Read more: New Opioid Fighting Initiative Announced By Attorney General Jeff Landry

It Costs What!? Why Prices Rise and Fall - and Why We Don’t Need Pharma Price Controls

Photo source: PJ Media

Recently we've been hearing politicians such as Sen. Ron Wyden (D-Ore.) chomping at the bit to put price controls on pharmaceutical drugs, with almost no sense of economics or history about how prices change over time.

In 1926, a nice radio cost $7,175 (in 2019 dollars), and it took up more space than the giant flat screen you probably have in the family room. Speaking of TVs, in 2007, a 50-inch HDTV cost $7,046 (models of the same size and with much better quality go for about $250 today). In the "golden age" of airplane travel, tickets cost at least double today's prices. In 1975, buying and selling stock cost $100 per transaction (it's now less than $5). And calling your aunt in Los Angeles from New York for ten minutes cost $27.75. The same call now is practically free -- 2.3 cents per minute -- or actually free, with a service like Skype. One measly megabyte of computer memory cost $411 million in 1957 -- now the same amount costs less than a single penny.

Read more: It Costs What!? Why Prices Rise and Fall - and Why We Don’t Need Pharma Price Controls

The Right’s Left Turn on Drug Prices

Republicans are worried about their re-election prospects in 2020, and one result is a frenzy to “do something” on high drug prices. Yet two of the latest ideas are standbys of the left: foreign importation and pricing penalties, which are more about politics than results for patients.

Read more: The Right’s Left Turn on Drug Prices

Citizens Against Government Waste Rejects HHS Plan on Foreign Drug Importation

Photo source: CAGW

“No HHS Secretary or Commissioner of the Food and Drug Administration (FDA) under either party has ever confirmed that importing pharmaceuticals would keep Americans safe from dangerous counterfeit drugs, including the opioids that have caused so much destruction across our country. Indeed, both President Trump and HHS Secretary Alex Azar expressed their objections to this concept in 2018. The President said in October that ‘we don’t like getting [drugs] from other countries’ because ‘we don’t know … how they’re being made.’ Secretary Azar said in May 2018 that ‘importing drugs from other countries, such as Canada … is a gimmick,’ citing the miniscule savings calculated by the Congressional Budget Office. The HHS proposal would expose Americans to potentially adulterated drugs and encourage unscrupulous actors to get more involved in drug importation. It would hurt U.S. biopharmaceutical research and development. The plan also ignores Canadian warnings that the country has no interest in supplying Americans with their drugs, citing concerns over shortages. Instead of pursuing this ineffective and potentially dangerous policy, the administration should work with Congress to increase free market incentives and competition in public-sector drug benefit plans, speed up generic drug approvals, modernize clinical trial designs to encourage competition, and write better trade deals to ensure foreign countries pay a fair share of U.S.-funded biopharmaceutical research and development, rather than free-riding on our discoveries.”

Read more: Citizens Against Government Waste Rejects HHS Plan on Foreign Drug Importation

CCAGW Thanks Chairman Grassley for Opposing Foreign Price-Controlled Drugs

Dear Senator Grassley,

On behalf of the more than 1 million members and supporters of Council for Citizens Against Government Waste (CCAGW), I am writing to thank you for opposing the Trump administration’s proposed International Pricing Index (IPI) model, an ill-advised regulatory effort that would base Medicare Part B pricing on foreign price-controlled drugs.  CCAGW agrees with your statement, “I don’t think that this administration's approach on international pricing is going to be to the benefit of the adoption of and research for modern drugs.”

Read more: CCAGW Thanks Chairman Grassley for Opposing Foreign Price-Controlled Drugs