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n case the pharmaceutical industry is unclear what some federal officials think about drug prices, Andy Slavitt has offered a pointed and sobering reminder. In remarks before the BioPharma Congress, an industry conference that was held last Thursday, the acting administrator for the Centers for Medicare & Medicaid Services slammed drug makers — all of them.

“Cost increases are pervasive,” he lamented. “Despite all the attention it has generated this year, Mylan’s Epipen is not even on our top 20 list for either high price increases or spending overall in 2015. Many of these have been ongoing for a while with real patient impact, and some are big stories waiting to happen.”

“You know, last year when I spoke here, the price increases at Turing [Pharmaceuticals] were making news, and I told you I didn’t want this industry to be defined by its worst actors,” he said, referring to the company that was headed by Martin Shkreli at the time. “I defended the industry then, but the more data that’s revealed, the more bad actors you find, and I’m telling you now: it’s too many.”

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And Slavitt offered some data to illustrate his concerns: Total prescription drug spending in 2015 was about $457 billion, or 16.7 percent of health care spending. Based on recent trends, Slavitt said CMS is projecting average annual increases of 6.7 percent through 2025. Medicare Part B drug spending, meanwhile, doubled from 2007 to 2015, and Part D costs increased 8.4 percent between 2013 and 2015

“Specialty drugs are a big part of the equation,” he explained. “In 2014, they accounted for 31.8 percent or spending despite representing only 1 percent of prescriptions. However, of the 20 drugs with the highest per-unit cost increases in Medicaid, seven were generic drugs. Those products had increases in price ranging from 140 percent to nearly 500 percent between 2014 and 2015.”

“These numbers don’t give us the full picture, but they do help to draw attention to a problem that is an increasing source of worry for families across the country,” he said. “Drug costs have become the health policy issue Americans are most anxious to see us act on, and we have a responsibility to them to explore all the options available us to make their medications more affordable.”

His remarks, which were subsequently posted on his CMS blog, come at a time of high anxiety over prescription drug prices. A recent Kaiser Family Foundation poll found that reducing costs should be the biggest priority for the next President and Congress when it comes to lowering overall health costs, and 63 percent want government to take action.

Indeed, Californians will vote tomorrow on a ballot measure that would require state agencies to pay no more than the US Department of Veterans Affairs. And a dozen state legislatures, including California, have pursued bills that would require drug makers to either justify certain prices or disclose costs in hopes of gaining transparency into pricing decisions. Only Vermont has passed such a law, though.

To what extent the federal government will take action remains to be seen. A bill similar to the state bills was recently introduced in Congress. CMS is trying to launch what it calls a project to lower Medicare Part B costs. And an increasing number of Congressional lawmakers are calling for probes into various drug makers that have raised prices. Mylan Pharmaceuticals is the latest example.

For its part, the pharmaceutical industry argues innovation will dry up if price caps are enacted. Mostly, though, companies are responding defensively. Drug makers are spending $109 million to fight the California ballot measure and will pay another $100 million to their industry trade group to battle other pricing initiatives and dissuade Congress from passing unfavorable legislation.

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Another argument industry makes is about the value of medicines. But Slavitt dismissed that.

“I hear occasionally from some that life sciences needs to tell its ‘value story’ better. Perhaps,” he said, “but it also needs to do the math. If something is growing by 11 percent, unless it’s causing something else to decrease by 12 percent, it’s not going to last forever. The reality is that in the next few years these costs will put unsustainable pressure on the Medicare program, and action is going to be necessary to address them. For my successor, this will likely be a big priority as well.”

Slavitt tried to end his talk on a more conciliatory note, though.

“What you choose to do as an industry will help define the next several years. So the question is: can we have both innovation and the affordability necessary to make it accessible? I think the answer is yes,” he said. “These two goals shouldn’t be in opposition.”

“In every-forward looking industry outside of health care, we see that competition actually fuels innovation, and affordability improves alongside the development of new technologies,” he said. “There are plenty of policy options and certainly a number of ways innovators like you can choose to respond – from disputing the math and fighting it, to looking for win-wins.”

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  • My family Dr. Is mal and I love him to death a GREAT DR. BUT IN GENERAL I PREFER A FEMALE DR. THEY SEEM TO BE MORE COMPASJONANTAND CARING AND THE SEEM TO LISTEN TO YOU MMORE THAN A MALE DR. MALE DR.’so seem to not have time to listen to your complaints.
    My choice would be a Female Dr. Excel my Dr. Who is female but he does have companion and time for you. Not just trying to run them in & out so they can see more patients. More patients more money. I’m glad I can say that my Dr. Is NOT THAT WAY AT ALL…

  • I’m retired and 67. For 2016 I am with Aetna prescription plan. I am taking Questran. During this time I paid $41 for the first month, followed by $98 for February and March then back down to $17 and this month I paid $7. I planned to change to Silver Script for 2017 until I learned I would be charged a monthly rate of $75. I’m disgusted! This may be legal but definitely not moral. When I questioned the Pharmacy they said that the pharmaceutical company raised the rate. This is so wrong!

  • Can you think of an instance, even one, when the companies in an industry, without legal coercion, restrained themselves from pricing their products as high as the market would bear?

  • How long did it take CMS to come around to finally comprehend and yell out to Big Pharma like Howard Beale in Network, “I’m mad as hell, and I’m not going to take this anymore!”?

    As we already know how drug pricing has not been sustainable as it makes even pirates envious, when does CMS act in the public’s interest and request the U.S. Attorney to charge the individual monopolists who make-up Big Pharma with conspiracy and willful violation of the RICO act? How can Big Pharma continue in its path of market concentration to set prices and not be construed as a racketeer force, best personified by its chief lobbying group, PhRMA? This Washington-based lobbying group makes Putin blush, and is best remembered as paying back Congressman Billy Tauzin (R-LA) for his superb support as chair of the House Committee on Energy and Commerce ramming through Congress the Medicare Part D Act of 2002, known as the “open spigot at full retail pricing,” by also denying Medicare any opportunity to negotiate pricing. Note how Tauzin received a multi-million dollar job at PhRMA right after doing their bidding.

    CMS must step-up, although belatedly, to now protect the public from Big Pharma’s price gouging that no longer even is claimed to be based upon the cost of R&D, but rather, “whatever the market will bear.”

    • We’re basically like OPEC. Despite being an oligopoly market forces eventually brought the price of oil down and America no has the cheapest gasoline in the world. Also, people that deliberately forgo mandatory health insurance have no right to complain as do people with such high drug deductibles they not as well have coverage at all.

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