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Drugmakers Hike Prices on Hundreds of Brand-Name Drugs

Drugmakers Hike Prices on Hundreds of Brand-Name Drugs

Starting Thursday, the government will begin negotiations on 10 drugs covered by Medicare this week. But those new prices won’t go into effect until 2026.

Drugmakers raised the prices on 775 brand-name medicines, including Ozempic, through mid-January. Put together, the median is 4.5%, which is higher than the inflation rate.

However, the government will begin negotiations on 10 drugs covered by Medicare this week. But those new prices won’t go into effect until 2026.

Pfizer boosted the prices on “124 unique drug brands” and 22 “at its Hospira arm.” The drugmaker had the most increases in January for the second year in a row.

Ozempic went up 3.5% to $970 for a month’s supply. Mounjaro, another diabetes drug also used for weight loss, increased 4.5% to about $1,070 a month.

Here are a few of the drugs that increased by more than 4.5%:

  • Trikafta, a cystic fibrosis treatment: 5.9% to $26,546 for 28 days.
  • Dupixent, an anti-inflammatory drug: 6% to $3,800 for a month supply.
  • Biktarvy, popular HIV treatment: 4.9% to $3,980.
  • Skyrizi, a psoriasis therapy: 5.8% to $21,017 for a dose.
  • Eliquis, a blood-thinner: 6% to $594 for a month supply.

Bristol attributed inflation, research investment, and innovation to the rise in prices:

The price paid to the company will “remain nearly flat” this year because of rebates and discounts, she said, and half of patients pay $40 or less a month.

Pfizer referred questions about Eliquis to Bristol. A company spokeswoman speaking generally said the amount of money Pfizer receives for its drugs and vaccines has dropped for the past five years because of climbing rebates and discounts to health insurers and pharmacy-benefit managers.

I remember those rebates and discounts when I took Humira and Simponi for rheumatoid arthritis. I couldn’t believe the amount for one dose, but when I signed up for the company’s savings program, it dropped to $5. I don’t remember the exact number because I haven’t taken those in a long time. I’m now on Rinvoq.

Starting Thursday, the Medicare program can negotiate drug prices due to President Joe Biden’s Inflation Reduction Act (IRA).

HHS published in October:

The new law requires the federal government to negotiate prices for selected high expenditure drugs covered under Medicare, and provides enhanced financial protection against out-of-pocket drug costs for Medicare beneficiaries. Other provisions require drug manufacturers to pay rebates to Medicare if they implement price increases for certain prescription drugs utilized by Medicare beneficiaries that exceed the rate of inflation. Manufacturers must pay rebates to Medicare if the Annual Manufacturer Price (AnMP) increases for certain covered Part D drugs and either the Average Sales Price (ASP) or Wholesale Acquisition Cost (WAC) increases for certain covered Part B drugs exceed the rate of inflation.

The first 10 drugs on the list, according to NBC News:

  • Eliquis, a blood thinner from Bristol Myers Squibb and Pfizer;
  • Xarelto, a blood thinner from Johnson & Johnson;
  • Januvia, a diabetes drug from Merck;
  • Jardiance, a diabetes drug from Boehringer Ingelheim and Eli Lilly;
  • Enbrel, a rheumatoid arthritis drug from Amgen;
  • Imbruvica, a drug for blood cancers from AbbVie and J&J;
  • Farxiga, a drug for diabetes, heart failure and chronic kidney disease from AstraZeneca;
  • Entresto, a heart failure drug from Novartis;
  • Stelara, a drug for psoriasis and Crohn’s disease from J&J;
  • Fiasp and NovoLog, diabetes drugs from Novo Nordisk.

These negotiations will go through August 1. The Biden admin will publish final prices on September 1.

But don’t expect relief right away. The prices won’t go into effect until 2026.

HHS also reminded off-site outpatient hospital facilities about the 340B Drug Pricing Program, which “requires drug manufacturers that participate in the Medicaid Program to offer certain outpatient drugs to ‘covered entities’ at discounted prices.”

HHS loosened many of its programs, including the 340B Program, due to COVID-19.

These facilities had to be:

  • Listed as reimbursable on the hospital’s Medicare Cost Report prior to participating in the 340B Program
  • Registered and listed in 340B Office of Pharmacy Affairs Information System (OPAIS) prior to participating in the 340B Program.

However, the expansion led to complications concerning compliance. The facilities have to fill out more forms for one of the two:

  • Be listed on the hospital’s most recently filed Medicare Cost Report and registered in OPAIS by the next 340B Program quarterly registration period
  • The covered entity must notify HRSA [Health Resources and Services Administration] within 90 days of the publication of the Notice that they have initiated the process of listing the offsite, outpatient facility on the hospital’s Medicare Cost Report and registering it in OPAIS [Office of Pharmacy Affairs].

But the 340B program helps rural hospitals survive. A great example is Golden Valley Memorial Healthcare in Missouri:

At GVMH, for example, 80% of our patients access their healthcare coverage through Medicare and Medicaid, with only 20% being covered by commercial insurance plans. While we are proud to provide care to beneficiaries of these vital safety-net programs, the fact is that Medicare and Medicaid reimburse hospitals at a lower rate than commercial insurers—and far less than the true cost of providing care and services. That makes the savings we see through the 340B program all the more essential in helping to sustain our operations.

“Without the 340B program, it would be extremely challenging, if not impossible, to continue providing oncology services at scale—which could force GVMH to reduce these services, threatening access to critical care for many rural cancer patients,” wrote Craig Thompson, CEO of GVMH.

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Comments

Ozempic has gone nuts since it was released on second label for obesity and not just diabetes. The stocks are pretty much gone everywhere.

Mounjaro may be in the same boat as it is a similar drug.

    The Gentle Grizzly in reply to healthguyfsu. | January 31, 2024 at 4:56 pm

    I managed to keep a 60 or so day backlog of my Ozempic so my pharmacy can get it. And, yes, I take it for its original purpose: diabetes therapy.

      BierceAmbrose in reply to The Gentle Grizzly. | February 1, 2024 at 12:06 am

      Talked the doc into prescribing me a buffer 90 days on my sustaining meds. The new PA / doc in training wrote me a years’ worth at a mere suggestion.

      First time I asked, docs office told me “they won’t fill it.” Got past that, and the pharmacy, indeed wouldn’t, telling me “insurance won’t cover another round so soon.” ‘I pay cash for regular expenses — coverage is only involved with reimbursing me, so it’s my problem.” I eventually got my extra meds, and paid for them. The dirty looks were complementary.

    Just Al in reply to healthguyfsu. | January 31, 2024 at 5:32 pm

    My wife takes Mounjaro for her diabetes and we pay completely out of pocket because our insurance thinks they know what she needs better than a doctor and refuses to pay for it. They insist she needs to take a less expensive medication my wife can’t take because she’s allergic to it. Luckily Mounjaro has a coupons so it’s only $550 a month.

    P.S. United Health is garbage insurance

      BierceAmbrose in reply to Just Al. | February 1, 2024 at 12:10 am

      Garbage, but no doubt an approved, officially sufficient program.

      it’s like what makes a plan acceptable to The Overlords doesn’t have to with how it takes care of people.

      Mandatory pre-paynent of regular predictable services though only sanctioned providers is a prescription for graft and capture. it’s like the graft and capture is the point.

    BierceAmbrose in reply to healthguyfsu. | February 1, 2024 at 12:02 am

    Drug substitution and pricing shenanigans are pretty spectacular, especially in the diabetes and sugar management domains.

    Insulin prices started steadily climbing some years ago, for no apparent reason. Interesting substitution, the Lantus slow-release injectable kept increasing. Then came a “substitution”, not an otherwise identical generic but a similar “alternative” production, deemed “the same” by the FDA, so it could be declared safe. (Any of this sounding familiar?)

    Lantus prescriptions got substituted with this “substitutable alternative” by the prescription-wrangling intermediaries. I know, because I noticed when the other stuff showed up on a Lantus prescription. Turns out the pharmacy didn’t know the substitution, neither did the prescribing doctor — they didn’t have to be notified. Took nearly a week to unwind the “script processors did the substitution” story. About another week doing my own research, initially looking for the simple “That’s just the generic name for the same stuff.” Not thrilled to unwind the much more complicated story.

    We don’t have 3rd-party payers, we have nth-party intermediaries. Nobody who needs or directs treatments really knows what is going on.

    We don’t need more organizations and policies around this, we need less, putting the people impacted or served in the loop.

      artichoke in reply to BierceAmbrose. | February 1, 2024 at 7:52 pm

      There’s something the doc can add to the prescription so that it cannot be substituted with a generic. I don’t remember what it’s called, but I suppose you can ask the doc to do it and tell him this story why.

        drsamherman in reply to artichoke. | February 1, 2024 at 9:21 pm

        It is called “Dispense as Written” or “Do Not Substitute”, and it varies on how it is done from state to state. It can be a real bear with insurance companies though. Just my $0.02 as a doc.

        BierceAmbrose in reply to artichoke. | February 4, 2024 at 12:43 am

        “There’s something the doc can add to the prescription so that it cannot be substituted with a generic.”

        Yeah, this doc uses the leeway he has. As part of an ever-expanding, ever-more administratively encumbered “network”, he’s ever-more personally constrained.

        The small shops keep getting absorbed into larger systems. The larger systems keep getting more bureaucratic, more administratively driven. The admins keep moving to more “standard of care” from an external authoritah — see ‘rona jabs and other treatment. The “service delivery” keeps generating more failure demand.

        It’s like that was the plan. Farms aren’t run for the benefit of the livestock.

        Also, this substitutions wasn’t an actual “generic”; rather a differently-branded, “mostly the same” product with gamed approval under the approval of the other name-brand stuff. “Cheaper” but neither the same, nor priced like a commodity.

        Not chemically, or production identical to the approved product.

        (FWIW, my sustaining meds are all generics. And I’m off injected insulin for several years now based on BG, with my BG management continuing to improve. Yes, I’m bragging.)

There’s a 3rd generation drug, adding an additional ingredient, that is reportedly even more effective than Mounjaro at causing weight loss, (reported AVERAGE weight loss in testing exceeds 70 lbs) that’s going to be introduced soon.

The price of alzheimer drugs are going up too. But Dr Jill says she’s not concerned. “Joe will not be as dependent on drugs after the successful implant of Musk’s brain chip last week. Heck, he might even be able to use the tall stairs on Air Force One.”

    alaskabob in reply to Peabody. | January 31, 2024 at 5:15 pm

    Hard to parse the reasons for the down thumbs on that.

      AF_Chief_Master_Sgt in reply to alaskabob. | January 31, 2024 at 5:47 pm

      Because he committed the sin of talking badly about King J Robinette I, and Queen “Doc Tor” Jill.

      That ruffled the panties of the “vapors” crowd here.

      Azathoth in reply to alaskabob. | February 1, 2024 at 9:26 am

      There are Democrats among us.

      artichoke in reply to alaskabob. | February 1, 2024 at 7:59 pm

      I wouldn’t downvote a good joke like that. But I don’t think Biden is senile. He’s elderly, frail, short term memory getting worse and worse, these are all normal symptoms of getting very old but they aren’t dementia.

      It’s impressive that Trump doesn’t seem to have any of these symptoms. I’d expect the age to get to him more because of his weight, but he seems stronger for the same age (i.e. compared with Biden a few years ago.)

      Biden’s strong debate performances against Trump (they were outstanding but he had a worse position to defend) are puzzling, as are his blue eyes being black for those debates.

    BierceAmbrose in reply to Peabody. | February 1, 2024 at 12:11 am

    Are they really going to find enough functioning brain left to plug into?

Joe is so far gone that he could not use an implant. He should be in a nursing home, the way Jill and others have used him is criminal. Is there a RICO case to be made against his puppet masters?

Some of that is Bidenomics and some making $$$ with additional donations to The Big Guy or his successor… The Big Guy..er..Gal …My Belle Michael… er Michelle….

The diabetes and blood thinners are not niche drugs and this is just bad news.

Someone has to pay for all those spiffy commercials with the great songs and dancing.

AF_Chief_Master_Sgt | January 31, 2024 at 6:26 pm

The revenge of the Government Pharmaceutical Industry. When the rubes decided they didn’t need the clot shot every other week, it ate into the profits of BIG Pharma.

So this is a Yuge F U to the infidels.

    BierceAmbrose in reply to AF_Chief_Master_Sgt. | February 4, 2024 at 12:47 am

    Hey, when pharma threw in to push ObamaCare over the line, their cut was a swath of mandated high-margin business for the rest of time.

    They’re learning that all those particular opportunists’ promises have an expiration date.

    That bunch aren’t an actual criminal conspiracy. Not organized enough, no ops plan. Just opportunists, gonna locust off to the next con, as soon as they pocket this one.

You can pt use pharmaceutical rebates if your on Medicare. No $5 dollar top tier new drugs

Believe me I’ve tried. I use Good Rx or other discount programs cause my Medicare drug insurance pretty much sucks outside of a few tier 1&2 drugs

FJB! I take Farxiga and it finally hit my insurance formulary last year. With insurance it is still $60 a month. I am retired and on a fixed income. Farxiga should go generic in about 4 years.

Getting red pilled is now expensive.

destroycommunism | January 31, 2024 at 10:23 pm

of course b/c red tape lovers are already adding more and more regs which cost money anddddddd

the companies know that the left will take over so they raise the prices and then the gov “negotiates” lower prices and everyone wins

UHHHH ….EXCEPT THE USUAL CREW>>>>THE MIDDLE CLASS

destroycommunism | January 31, 2024 at 10:25 pm

Like everything else in a socialist economy

the elites will do as the please and allll others will be dictated to

and of course the msm pr machines will tout the governments “wisdom” and any opposition will be seen as traitorous

“Put together, the median is 4.5%, which is higher than the inflation rate.“

Well, inflation is understated. Government statistics are lies.

As for the median price increase – it is a list price. The net price may be flat or even go down for some of these drugs – the net price as paid to the pharma mfr.

The big beneficiary of the higher prices is the PBM that benefits from higher rebates on the negotiated spread.

The loser is the patient whose plan covers drug on a co-insurance (% of list price) versus fixed co-pay plan since they pay more on a higher list price even if the insurance company doesn’t.

And don’t forget Congress created the absolute mess of a healthcare system and its regulations that we have.

They ultimately are responsible for most of the craziness in our system.

E Howard Hunt | February 1, 2024 at 9:25 am

If things get bad enough people will start eating right and exercising.

I’m on Eliquis. Only med I take and I’ll be on it for life

Cigna just jumped my Part D premium by $16 / mo

Just read that they just sold to Healthcare Service Corporation for, $3.7 million

Looks like I’ll be shopping again, but I doubt I’ll find a better deal