There was more activity on Capitol Hill last week aimed at lowering Americans' costs for prescription medicines.
Getting generic medicines to the U.S. market quicker was the sole topic at a March 13 hearing of the House Energy and Commerce Health Subcommittee. During three other hearings, Health and Human Services Secretary Alex Azar also promoted the administration's efforts to lower drug prices as part of its fiscal 2020 budget plan.
Among the administration's proposals is a plan to eliminate the safe harbor protections that allow pharmacy benefit managers — often called middlemen — to secure lucrative rebates from biopharmaceutical companies under secret deals.
Now, Sens. Chuck Grassley, R-Iowa, chairman of the Senate Finance Committee, and Ron Wyden, D-Ore., want five PBMs to testify at an April 3 hearing: Cigna Corp., CVS Health Corp., Humana Inc., Prime Therapeutics LLC and UnitedHealth Group Inc.'s OptumRx.
In February, the lawmakers heard from executives from seven biopharmaceutical companies.
"It's only fair that the committee has the opportunity to ask questions of other players in the healthcare supply chain," Grassley and Wyden said in a March 12 statement.
New importation proposal
Meanwhile, Grassley partnered with Republican Sen. Mike Lee of Utah and Democratic Sens. Dick Durbin of Illinois and Amy Klobuchar of Minnesota on bipartisan legislation that would permit the temporary importation of medicines when there is a drug shortage or if there are few competitors.
The bill is also intended to prevent situations like when Turing Pharmaceuticals LLC, now Vyera Pharmaceuticals LLC, was the sole manufacturer of the toxoplasmosis medicine Daraprim and it hiked the drug's price by more than 5,000%.
The Trump administration has been mulling over a similar idea and ordered U.S. Food and Drug Administration Commissioner Scott Gottlieb, who is soon departing the agency, to find a pathway to make it work.
Last week, Durbin also blasted Takeda Pharmaceutical Co. Ltd., Eisai Co. Ltd., Merck & Co. Inc. and Roche Holding AG's Genentech for selling their cancer medicines in the U.S. in what he said were "excessively large vials that contain dramatically more medicine than the average patient needs," which results in wasted money when the leftover products are thrown out.
During a March 14 speech on the Senate floor, Durbin noted that at least $3 billion worth of cancer medicines is thrown away every year because of the large vials.
The Illinois senator teamed up with Republican Sen. Rob Portman of Ohio on a bipartisan bill that would enable Medicare to recoup money from drugmakers for medications wasted because of larger-than-needed packaging.
Meanwhile, a bipartisan cadre of more than 40 House members sent a letter last week to Azar urging him to withdraw the administration's proposal that would give private insurers that sell drug plans under the government's Medicare Part D program for seniors and disabled Americans the power to restrict coverage of medicines in the so-called six protected classes — anticonvulsants, antidepressants, antineoplastics, antipsychotics, antiretrovirals and immunosuppressants.
Medicare Part D covers beneficiaries' medicines that are picked up at the pharmacy counter.
The proposal would have "reverberating effects for patients suffering from multiple conditions" and would "exacerbate health disparities among poor and minority communities," the lawmakers wrote.
On Twitter, Rep. Barbara Lee , D-Calif., said the proposal would be particularly devastating for communities of color.
The administration said beneficiaries in the Part D program could save as much as $692 million in out-of-pocket costs over 10 years under the proposal, which was unveiled in November 2018.
CMS updates drug spending dashboard
Last week, the Centers for Medicare and Medicaid Services updated its drug spending dashboard with 2017 details.
The lobbing group for the brand-name biopharmaceutical industry, however, has urged caution on the figures, noting the annual report does not include the discounts and rebates offered by drugmakers.
The Trump administration updated the dashboard for the first time in May 2018 with 2016 spending figures, well behind the anticipated November 2017 anticipated date.
In its new report, CMS said the Medicare Part D program spent $154.9 billion in 2017. The Medicare Part B program, which covers injectable medicines administered in a doctor's office or clinic, spent $30.4 billion in 2017. Medicaid, the government's insurance program for low-income Americans, spent $67.6 billion.
Infectious diseases a perpetual threat
Also last week, top U.S. health officials updated lawmakers on the nation's role in trying to stop the spread of Ebola in the Democratic Republic of the Congo, or DRC — the second largest outbreak of the virus in known history. More than 130 U.S. public health workers have been deployed to respond to the DRC outbreak.
As of March 16, 943 people in the DRC had been infected with Ebola, with 594 of them dying of the virus.
More than 88,500 people in the DRC have received Merck's experimental Ebola vaccine since vaccination started in August 2018.
Emerging infectious diseases "have been with us forever," Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told members of the Senate Appropriations Subcommittee on Labor, HHS, Education and Related Agencies. "They are not going to go away, and that's the reason why we have to be perpetually prepared for them."