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Here are six reasons drugs in the United States cost so much:1. In the United States, negotiations with drug makers are split among tens of thousands of health plans, resulting in far less bargaining muscle for the buyers. Other nations also conduct careful analyses of how much additional benefit a new drug presents over drugs already on the market — and at what cost. If the cost is too high and the benefit too small, those countries are more willing to say no to a new drug. Health policy analysts say that is a start, but much broader negotiating authority is needed to make a dent in drug prices overall.

Persons: ”, Stacie Dusetzina Organizations: Vanderbilt University School of Medicine, Pharmaceutical, Industry Locations: United States

☆ Insight: What happens when a $2 million gene therapy is not enough
▼ + stars: | 2023-08-12 | by ( Deena Beasley | ) www.reuters.com time to read: +13 min

Their experience raises broader questions around other high-cost gene therapies coming to market, sometimes after accelerated regulatory approvals, drug pricing experts said. Gene therapies work by replacing genes – the body's blueprint for its development. The gene Zolgensma delivers instructs the body to make a protein vital for muscle control. If gene therapies do fall short, it becomes harder to justify prices that researchers have argued are already poor value. More recently, the first hemophilia gene therapy approved by the U.S. Food and Drug Administration was priced by CSL Behring at $3.5 million; 26 more gene therapies are in late-stage development, according to IQVIA.

Persons: Elizabeth Kutschke, Ben, Zolgensma, Ben Kutschke, neurologists, Sitra Tauscher, Wisniewski, Ben's, Roger Hajjar, Brigham Gene, Kutschke, Vasant Narasimhan, Stacie Dusetzina, Roche's, Biogen, Roche, Maha Radhakrishnan, Steven Pearson, It's, Sree Chaguturu, Amanda Cook, Weston, Jackson, Cook, Elizabeth, Jerry Mendell, Russell Butterfield, –, Biogen's, Mendell, UMR, Spinraza, Eric Cox, Caroline Humer, Sara Ledwith Organizations: Reuters, U.S, Novartis, IQVIA Institute, Human Data, Novartis Gene Therapies, Mass, Cell Therapy, U.S . Food, Drug Administration, CSL Behring, CSL, Nashville's Vanderbilt University School of Medicine, Clinical, Economic, CVS Health, Aetna, SMA, Nationwide Children's Hospital, University of Utah Health, Children's, UnitedHealth, Thomson Locations: Oak Park, Berwyn , Illinois, Swiss, U.S, Lebanon , Virginia, United States, Columbus , Ohio, Russia, Kazakhstan, Chicago

☆ Obesity drug data could boost companies' case for US coverage, analysts say
▼ + stars: | 2023-08-10 | by ( Patrick Wingrove | ) www.reuters.com time to read: +5 min

Wegovy prescriptions were up 300% at their peak, according to data from Barclays, before supply issues began to hamper sales. A COMPELLING CASEAnalysts said the data made a compelling case for long-term health benefits of the drug. Analysts were divided on whether Medicare could potentially cover Wegovy as a cardiovascular treatment without a new law passing. Three doctors specializing in obesity treatment, including a cardiologist, were not sure whether such an indication would allow for Medicare coverage. Companies that provide healthcare insurance have begun pulling back on coverage of weight loss drugs because of the high cost of the medicines.

Persons: Read, Eli Lilly, Stacie Dusetzina, Wegovy, Eli Lilly's Mounjaro, Evan Seigerman, Eugene Yang, Morningstar, Damien Conover, Tom Carper, Eli Lilly's, Dusetzina, Patrick Wingrove, Elissa Welle, Ahmed Aboulenein, Caroline Humer Organizations: Novo Nordisk, U.S, Vanderbilt University, Medicare, Barclays, University of Washington Medicine, Companies, Democratic, Novo, Reuters, Democrat, Republican, Thomson Locations: New York, Danish, Washington

Although insulin list prices are high in the U.S., drugmakers typically pay substantial rebates to private insurers and government programs, resulting in lower prices for most Americans with insurance. U.S.-listed Novo Nordisk shares rose as much as 1.7% to $142.95, while Denmark-listed shares closed marginally higher on Tuesday. Eli Lilly shares were down slightly. "I think it is a relatively natural consequence of what we have seen their competitor Eli Lilly do. Eli Lilly, Sanofi and Novo Nordisk make up 90% of the U.S. market for insulin.

The Mark Cuban Cost Plus Drug Company negotiates directly with drugmakers. So far, that's been the strategy for the Mark Cuban Cost Plus Drug Company. In October, Cost Plus Drug Company announced a partnership with Capital Blue Cross. Cuban said he wanted Cost Plus Drug Company to be as transparent as possible on pricing. Cost Plus Drug Company is considering a test program for insulin that would offer a 90-day supply of insulin, or a total of 12 vials, for $170.

☆ New U.S. cancer drug prices rise 53% in five years -report
▼ + stars: | 2022-11-02 | by ( Deena Beasley | ) www.reuters.com time to read: +4 min

"I do think there is a possibility we see launch prices go up," she said. Reuters GraphicsPorter, who championed inflation-based caps on drug prices, is calling for additional national legislation to link launch prices to how well a drug works. The report found that the average launch price of a self-administered cancer drug, after adjusting for inflation, rose by nearly 26% to $238,000 between 2017 and 2021. By 2022, six out of the eight newly-launched oral cancer drugs had prices over $200,000 per year. Based on current trends, the report calculated that by 2026, when Medicare will first be able to negotiate drug prices, the average self-administered cancer drug launch price will be nearly $325,000 per year and over $525,000 for pills and biologics.

☆ The Inflation Reduction Act aims to lower drug costs — but here’s how Big Pharma could get around it
▼ + stars: | 2022-09-20 | by ( Https | Media-Cldnry.S-Nbcnews.Com Image Upload Newscms Berkeley-Lovelace-Jr.Jpg | Berkeley Lovelace Jr. | ) www.nbcnews.com time to read: +7 min

The Inflation Reduction Act is set to lower drug prices for millions of people in the United States — but experts fear pharmaceutical companies could exploit loopholes in the bill, ultimately keeping prescription costs high for many. The tactics may ultimately threaten the law’s ability to lower drug costs for consumers. Higher prices for new drugsOther experts are concerned about how companies might abuse the inflation rebate rule in the health law. The provision, which takes effect next year, imposes a rebate on drug manufacturers that raise the prices of their medications faster than inflation. By releasing new drugs at higher prices, drug companies will be able to make up for any lost revenue that they would normally receive from steadily raising prices each year, she said.

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