This Week in Managed Care: May 17, 2019

Fourty-four states accuse drug makers of price fixing, Gilead’s pledge to donate pre-exposure prophylaxis (PrEP) gets a mixed response, and researchers say the Philadelphia soda tax has cut consumption of sugary drinks 38%.

Welcome to This Week in Managed Care, I’m Samantha DiGrande.

States Accuse Drug Makers of Price Fixing

Forty-four states sued 20 drug makers last week, saying the group illegally collaborated to divide up the market to drive up the cost of generic drugs, sometimes by as much as 1000%. Teva was singled out in the lawsuit and accused of raising prices on 86 drugs between July 2013 and January 2015. Company officials deny the charges.

Drug pricing expert Stacie Dusetzina, PhD, associate professor, Health Policy, Vanderbilt University, told NPR the charges are disappointing and, if true, harm patients even if they have insurance.

She said, “More people than ever before are paying based on the price of the drugs...They pay full price until they reach a certain level of spending, or they pay a percentage of the drug's price—we call that a coinsurance.”

Gilead Announces PrEP Donations, Early Generic Launch

Gilead quietly announced last week that a generic version of its PrEP, Truvada, would be marketed in 2020, a year ahead of schedule. But that news was eclipsed by reports that Gilead will donate Truvada for up to 200,000 people for up to 11 years. The agreement will last at least through 2025 and possibly through 2030.

HHS said that eligible recipients will be those at risk for HIV who are uninsured, as part of the Trump administration’s plan to end the HIV epidemic. Up to 1.2 million people could benefit from Truvada, but only 100,000 take it.

Said HHS Secretary Alex Azar, JD, “The majority of Americans who are at risk and who could protect themselves with PrEP are still not receiving the medication.”

Activists were not as impressed with the announcement, because they had been calling for CDC to reach a deal with Gilead on Truvada. HIV advocates said taxpayers funded research for the drug and patients should have access to it.

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Philadelphia Soda Tax Cut Consumption of Sugary Drinks

Does a soda tax cause people to cut back on sugary drinks? A study published in JAMA this week asked that question, and the answer is a resounding yes. Researchers from Penn Medicine tracked the effects of a 2017 excise tax that added 1.5 cents per ounce to the cost of sugary drinks, which are linked to higher rates of diabetes, obesity, and cardiovascular disease.

Using data from a company that tracked information from retailers in Philadelphia, they concluded that sugary beverage sales fell 38% in the city. However, they did track an uptick in sales in nearby ZIP codes.

Noting that the beverage tax went to fund education programs, lead researcher Christina Roberto, PhD, assistant professor of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, said: "Philadelphia's tax on sweetened drinks led to a huge reduction in sales of these unhealthy drinks one year after it was implemented and generated revenue for thousands of pre-K slots. That's great news for the well-being of the people of Philly."

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Demand for Chemotherapy Expected to Grow Significantly

Demand for chemotherapy will rise significantly by the year 2040, and more trained staff will be needed to administer treatment. The GLOBOCAN 2018 study, which drew data from 183 countries, found that the number of patients needing first-line chemotherapy worldwide each year will rise 53% to 15 million by 2040, if all patients are treated according to evidence-based guidelines.

The study also found:

• By 2040, 67% of patients needing chemotherapy will live in low- or middle-income countries.
• The increase in demand will be largely a result of population growth and changes in cancer distribution.
• Today, there are 65,000 cancer physicians administering chemotherapy, but projections show 100,000 will be needed by 2040.

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Upcoming Conference Coverage

AJMC^® will be on the road again this weekend, with our teams covering developments in health outcomes research and psychiatry. First, our team will travel to New Orleans for the meeting of the International Society for Pharmacoeconomics and Outcomes Research. Besides our conference coverage and interviews, you can catch us live by signing up here.

Our second team will be in San Francisco for the 175th meeting of the American Psychiatric Association, with coverage starting Sunday.

Sign up for all our conference coverage for these meetings and more.

For all of us at the Managed Markets News Network, I’m Samantha DiGrande.