Cut RO payments every year? SURE! Cut drug payments? HOLD ON PARTNER!!!

[Gfunk6]

I'm surprised that this hasn't been discussed yet.

Merck sues US govt to prevent price negotiation

The money quote:

"Merck & Co (MRK.N) sued the U.S. government on Tuesday, seeking to halt the Medicare drug price negotiation program contained in the Inflation Reduction Act (IRA), which it argues violates the Fifth and First Amendments to the U.S. Constitution."

Just like the Founding Fathers intended - pharma companies who manufacture PD-L1 inhibitors should be able to charge whatever they want for it as it is a matter of free speech and free expression. Any type of negotiation is considered a fascist assault on freedom. 'MURICA!!!

Also,

"Merck said it plans to litigate the matter all the way to the U.S. Supreme Court if necessary."

Uh oh. I'm glad that we have an ironclad 6-3 conservative majority who would never allow socialism to infiltrate America. We ought to be forced to pay 300x for a drug that we can get far cheaper a couple of miles north and south of our national borders. As we all know, the only thing worse than "price-negotiated" Keytruda is Mexican Keytruda or Canadian Keytruda.

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[fiji128]

I'm surprised that this hasn't been discussed yet.

Merck sues US govt to prevent price negotiation

The money quote:

"Merck & Co (MRK.N) sued the U.S. government on Tuesday, seeking to halt the Medicare drug price negotiation program contained in the Inflation Reduction Act (IRA), which it argues violates the Fifth and First Amendments to the U.S. Constitution."

Just like the Founding Fathers intended - pharma companies who manufacture PD-L1 inhibitors should be able to charge whatever they want for it as it is a matter of free speech and free expression. Any type of negotiation is considered a fascist assault on freedom. 'MURICA!!!

Also,

"Merck said it plans to litigate the matter all the way to the U.S. Supreme Court if necessary."

Uh oh. I'm glad that we have an ironclad 6-3 conservative majority who would never allow socialism to infiltrate America. We ought to be forced to pay 300x for a drug that we can get far cheaper a couple of miles north and south of our national borders. As we all know, the only thing worse than "price-negotiated" Keytruda is Mexican Keytruda or Canadian Keytruda.

I don't think the arguments that Merck make are unreasonable and the courts will sort it out at any rate. Keytruda patent protection expires in 5 years (just like our job market projections). The US consumer subsidizes so much drug development for the rest of the world and all of these new drugs go generic fairly quickly at any rate. If you want to slow or see little innovation in this space paying Mexican Keytruda prices would be a good start. Yes I realize these are general statements and there are many examples of pricing abuse.

 

[madchemist89]

Will hospitals and med onc practices lose a lot of revenue when keytruda goes generic?

 

[RickyScott]

Will hospitals and med onc practices lose a lot of revenue when keytruda goes generic?

No. Antibodies (made in a bioreactor) can’t actually go “generic”. Can have a bio similar that would still need to be trialed in patients.

 

[Fpg1245]

From what I understand biologics are far more costly to produce and the price differential between “generic” and brand name isn’t all that great. They are more costly and likely have stringent quality and production regs.

It will be interesting to see how the fight between Merck and HHS goes. I mean is there a chance that Medicare holders won’t have access to this drug? I doubt it.

 

[RadOncDoc21]

Merck, during a transition year, doled out nearly $30M to its pair of CEOs

With Merck taking the reins from retiring CEO Ken Frazier and handing them to Robert Davis at the exact midway point of 2021, how would the New Jersey-based drugmaker divvy up their pay for the yea | With Merck taking the reins from retiring CEO Ken Frazier and handing them to Robert Davis at...

www.fiercepharma.com

Merck's CEO is Rob Davis, appointed in Apr 2021, he has a tenure of 2.17 years. His total yearly compensation is $18.65M , comprised of 8.2% salary and 91.8% bonuses, including company stock and options. He directly owns 0.011% of the company's shares, worth $29.71M.

 

[medgator]

I don't think the arguments that Merck make are unreasonable and the courts will sort it out at any rate. Keytruda patent protection expires in 5 years (just like our job market projections). The US consumer subsidizes so much drug development for the rest of the world and all of these new drugs go generic fairly quickly at any rate. If you want to slow or see little innovation in this space paying Mexican Keytruda prices would be a good start. Yes I realize these are general statements and there are many examples of pricing abuse.

I think the idea should be to make the rest of the (developed) world pay their fair share

 

[Gfunk6]

I think the idea should be to make the rest of the (developed) world pay their fair share

LOL, good luck with that. I'm sure every other country will give them the middle finger. Those countries are happy with their socialized medicine and are content to let us suffer with our (relatively) terrible life expectancy and infant mortality - all at a very high price!

 

[Mandelin Rain]

LOL, good luck with that. I'm sure every other country will give them the middle finger. Those countries are happy with their socialized medicine and are content to let us suffer with our (relatively) terrible life expectancy and infant mortality - all at a very high price!

At what point of drug development do we become healthier? Feels very much like the question of how many more guns do we need before we're safer from gun violence?

Feels like we've passed both.

 

[Gfunk6]

IRA Update: HHS Names First Ten Drugs for Medicare Negotiations

Today, The Biden Administration named the first ten Part D drugs selected for negotiation under the Medicare Drug Price Negotiation Program pursuant to the Inflation Reduction Act (IRA). The list of selected drugs is as follows: Eliquis Jardiance Xarelto Januvia Farxiga Entresto Enbrel Imbruvica Stelara Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill The reduced list prices are scheduled to go into effect on January 1, 2026; however, the pending outcomes of several lawsuits challenging the constitutionality of the IRA could impact this timeline. AstraZeneca is the latest company to file a lawsuit against the Administration with respect to the IRA’s drug price negotiation program bringing the total suits filed against the program to eight. Drug manufacturers with drugs selected for negotiation will have until October 1, 2023 to decide whether to participate in negotiation talks. If they decline, they could face an excise tax of up to 95 percent on product sales. After a series of meetings with each manufacturer, the negotiation period is set to end on August 1, 2024, with the final price released one month later.

Interestingly Imbruvica appears to be the only anti-cancer drug on the list.

 

[NotMattSpraker]

​

Interestingly Imbruvica appears to be the only anti-cancer drug on the list.

I was surprised not to see Revlimid. It's a little discouraging. Still early, but I was hoping this would reign in oncology pharma a bit.

 

[grenz]

​

Interestingly Imbruvica appears to be the only anti-cancer drug on the list.

Immunotherapy is probably too much of a hot potato. My guess is they want to see how these go first

 

[Fpg1245]

Immunotherapy is probably too much of a hot potato. My guess is they want to see how these go first

The whole thing seems sort of rigged. I was surprised at the lack of cancer drugs on the list.

I doubt any of these purported savings will mean anything for rad oncs which is why I don’t really

I laughed at the consequences of not participating You can pay 95% excise tax and also you will not be able to sell any other drug to a Medicare patient if you don’t negotiate . - it’s actually somewhat like the “you’re in or you’re out” approach they have to physicians who opt out of Medicare - seen how well those negotiations are going or have gone. It’s clear they are bringing to coercive power of the state into this. If anyone has insight into how this is done in other countries

Ofcourse now the courts are involved, I think the results will be mixed (pharma money CNS still buy results) but I can’t see the courts getting too much in the way of this. The govt hate pharma almost as much as they can’t stand a doctor making any real money.

At any rate, pharma will and has had time to work out the contingencies for this and have probably worked every angle

 

[Chartreuse Wombat]

Immunotherapy is probably too much of a hot potato. My guess is they want to see how these go first

The criteria used to define the list gives the answer.

The Centers for Medicare & Medicaid Services selected the drugs through a process that prioritized ones that account for the highest Medicare spending, have been on the market for years and do not yet face competition from rivals.

 

[Fpg1245]

The criteria used to define the list gives the answer.

The Centers for Medicare & Medicaid Services selected the drugs through a process that prioritized ones that account for the highest Medicare spending, have been on the market for years and do not yet face competition from rivals.

Aren’t there a ton of NOACs on the market?
Same with the gliptins

Also didn’t they listed two SGLT2 inhibitors? doesn’t that constitute a rival product?

 

[HemeOncHopeful19]

All of the drugs on the list that I recognize are outpatient/oral (or self injection).

There are like 4-5 DOACs on the market but I would say Eliquis/Xarelto represent 95+% of the them. I don’t think I’ve ever seen someone on Edoxaban, I’m not even sure it is available in the US.

I think infusional drugs fall under a different category and were not part of the Inflation Reduction Act but I could be misremembering.

 

[NotMattSpraker]

The whole thing seems sort of rigged.

Haha I mean its probably good as a US physician to grow comfortable with the fact that everything is at least a little rigged.

 

[Gfunk6]

If this particular issue goes to the Supreme Court and if they rule in favor of pharma, then my view is that Medicare reform is done in the United States. Congress will keep kicking the can down the road until it becomes frankly insolvent at which point draconian changes will be mandatory and everyone will suffer.

Remember to invest wisely and use compound interest to become financially independent.

 

[RadOncDoc21]

If this particular issue goes to the Supreme Court and if they rule in favor of pharma, then my view is that Medicare reform is done in the United States. Congress will keep kicking the can down the road until it becomes frankly insolvent at which point draconian changes will be mandatory and everyone will suffer.

Remember to invest wisely and use compound interest to become financially independent.

Invest all your money in the dumbest sounding crypto coin also!

Don’t believe me-

Dogelon Mars (ELON) Rockets 14% After Whale Acquires 1 Trillion ELON Tokens, Outperforms Shiba Inu, Dogecoin Gains

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www.benzinga.com

 

[Lamount]

If this particular issue goes to the Supreme Court and if they rule in favor of pharma, then my view is that Medicare reform is done in the United States. Congress will keep kicking the can down the road until it becomes frankly insolvent at which point draconian changes will be mandatory and everyone will suffer.

Remember to invest wisely and use compound interest to become financially independent.

I am actually surprised pharma doesn't take their lumps and "permit" negotiations. It seems like they are playing with fire... and if the system goes insolvent, they will stand to lose the most.

 

[medgator]

I am actually surprised pharma doesn't take their lumps and "permit" negotiations. It seems like they are playing with fire... and if the system goes insolvent, they will stand to lose the most.

Pharma needs to start negotiations with Medicare more and maybe start having the rest of the developed world pay their fair share for R&D rather than having US patients bear those costs mostly

 

[Fpg1245]

Pharma needs to start negotiations with Medicare more and maybe start having the rest of the developed world pay their fair share for R&D rather than having US patients bear those costs mostly

I doubt they will budge. They aren’t gonna take the heat for this because the US has decided it’s “sick and tired” all while being asked to ramp up their military spending for their fair share of nato. If anything they’ll start cutting.

Drug development was always a risky proposition. New drugs will come. But this just adds a new layer.

The more I look at this list the more arbitrary it looks. I mean insulin is on the list.

 

[Gfunk6]

USA circa 2030 on the streets of Houston outside of MDACC

 

[OTN]

I doubt they will budge. They aren’t gonna take the heat for this because the US has decided it’s “sick and tired” all while being asked to ramp up their military spending for their fair share of nato. If anything they’ll start cutting.

Drug development was always a risky proposition. New drugs will come. But this just adds a new layer.

The more I look at this list the more arbitrary it looks. I mean insulin is on the list.

Insulin was the least surprising - it's been a political punching bag for several years now

 

[Fpg1245]

Insulin was the least surprising - it's been a political punching bag for several years now

it’s whatever the politicians want to hammer at. So really there’s no actual criteria except when there is

Maybe they should just take a poll next time

 

[DireMoose]

Pharma needs to start negotiations with Medicare more and maybe start having the rest of the developed world pay their fair share for R&D rather than having US patients bear those costs mostly

Perhaps they could preempt cuts by coming to CMS with some type of novel payment model. Maybe like a flat fee for a single diagnosis. But be sure to have carve outs for things like immunotherapy. And make sure to have those representing pharma be mostly insulated from any changes to the fee structure.

 

[evilbooyaa]

Perhaps they could preempt cuts by coming to CMS with some type of novel payment model. Maybe like a flat fee for a single diagnosis. But be sure to have carve outs for things like immunotherapy. And make sure to have those representing pharma be mostly insulated from any changes to the fee structure.

IT is prescribed by I presume most adult med and heme/oncs in the country at this point.... can't say the same about protons and rad oncs.

Replace immunotherapy with CAR-T for any recurrent case literally ever (in absence of data showing any benefit for the patient) and maybe you have an analogy....

 

[elementaryschooleconomics]

Perhaps they could preempt cuts by coming to CMS with some type of novel payment model. Maybe like a flat fee for a single diagnosis. But be sure to have carve outs for things like immunotherapy. And make sure to have those representing pharma be mostly insulated from any changes to the fee structure.