Discover and read the best of Twitter Threads about #340b

Most recents (9)

🧵Great review of the #340B program, how it has veered away from its intent, and negative consequences for #DrugPrices. | ⁦@wasan_kumar⁩ ⁦@kevin_schulman

Some takeaways follow 👇 ImageImageImage
2/ “The 340B program was established in response to concerns among safety-net providers regarding the Medicaid Drug Rebate Program, which was enacted in 1990 and required manufacturers to offer their lowest prices to the Medicaid program.”
3/ “An inadvertent effect of [Medicaid Drug Rebate] policy was that safety-net providers lost access to the discounts they had previously received from drug manufacturers. The 340B program was intended to restore discounts to providers caring for low-income and uninsured people.”
Read 10 tweets
FYI: A clarification 🧵on a misleading new @medicarepayment chart of brand-name drugs in #Medicare Part D.

Many have misunderstood these data & misrepresented the findings, which say nothing about net drug prices.

Read on for my explanation of what’s really going on.

1/14
Background: MedPAC seemed to show that in Part D, brand-name drug prices “net of rebates” grew by 7.5% per year from 2010 to 2020

But this chart is not what it appears to be…

drugch.nl/3Kq5j5S

2/14
Summary: Contrary to some claims, we can't conclude anything about net prices from the chart above.

In fact, Medicare Part D's "net brand-name drug prices" (as defined by MedPAC) can be increasing, while net prices received by manufacturers can be decreasing.

Here's why.

3/14
Read 14 tweets
1/ New paper out w/ @bnrome @Beatrice__Brown @akesselheim @PORTAL_Research examines how top-performing hospitals mark up prices on clinician-administered drugs.

🧵 below.

jamanetwork.com/journals/jamai…
2/ As of January 1, 2021, hospitals must now post payer-specific prices for all goods and services, including clinician administered drugs.

nejm.org/doi/full/10.10…
3/ Early compliance with the rule has been sluggish. See great work from @suhas_gondi @AdamLBeckman @averyofoje @JMichaelMcW

jamanetwork.com/journals/jamai…
Read 30 tweets
Great thread here from @dmgorenstein on the some of the key facts from our story about Truvada and PrEP today. We talk about a lot more in the episode on online which you should def check out: tradeoffs.org/2021/04/22/pre…

I wanted to share a few of my own big picture takeaways... 🧵
The Truvada case is fascinating to me because it includes so many classic drug pricing issues (patents, pay-for-delay, product hopping), but it also has so many unique wrinkles that make it that much harder to draw simple conclusions about the impact of high prices on use.
There's this wild patchwork (see @CDCgov flow chart below) of public and private insurance, safety-net providers, public health depts and drugmaker payment assistance programs that make it so most people who want to be on PrEP can do so without significant out-of-pocket costs.
Read 14 tweets
I'm seeing a lot about Biden freezing the Trump EO on insulin so it's thread time:

This seems counterintuitive but this freeze is actually a GOOD thing for patients. The original EO was pharma backed, giving them a way to back out of the #340b program 1/

modernhealthcare.com/community-heal…
The #340b program, is a life-saving program that provides healthcare and medicine to the most vulnerable. 15.5% of #diabetics get their insulin from the program. Since the EO came out, many people have seen their monthly insulin rise from $15-> over $1000 2/
Why? The EO demands that #340b pharmacies pass on their discounts of insulin to the patient. At first note, that sounds great! However, #340b's have a small upcharge to help pay administrative fees, pharmacists, etc... This EO gave pharma a big out for a program that they HATE 3/
Read 8 tweets
“I’m so grateful for #Gleevec. It keeps me alive. But the price tag ($10k/month) constantly hangs over my head.”
"When I'm on Enbrel, I don't have symptoms... But I also have to carry the fear knowing all this could be ripped away." Enbrel is priced at $6k per month.
First up: autoimmune drug Enbrel. Even though the primary patent on Enbrel expired in 2010, $AMGN has filed more than 50 additional patents on the drug to thwart cheaper competition, according to analysis by @IMAKglobal (1/) statnews.com/2020/09/29/dru…
Read 45 tweets
Q: How much revenue and profit are safety-net hospitals participating in the #340B prescription drug program making dispensing #Medicare #PartB covered drugs?

A: NEW in @JAMANetworkOpen from @saynikpay, @MelindaBBuntin and @contirena1

jamanetwork.com/journals/jaman… Image
What does that mean in terms of profit? It, too, has grown in recent years. jamanetwork.com/journals/jaman… Image
The profits are small compared to overall hospital budgets, but significant when compared to costs of uncompensated care, the study finds. jamanetwork.com/journals/jaman… Image
Read 3 tweets
Sen. @PattyMurray from @HELPCmteDems follows up on that Q by noting #340B discounts aren't taxpayer dollars. It's funded 100% by drug company discounts

We can talk about transparency all we want, but let's be clear these aren't wasted taxpayer $ we're talking about, she says
.@SenSusanCollins brings up biosimilars & frmr FDA head @ScottGottliebMD's stat that if all biosimilars approved by FDA made it to market consumers save $4.5 billion

Then she brings up bill that would help w patent ticketing (1/2)
The main issue rn for biosimilars isn't that they aren't being approved (so not the patent ticketing issue, although that's a big problem in the drug sphere)

It's that insurers won't cover them. @ihdezdelso does a good job of explaining why here: news.bloomberglaw.com/pharma-and-lif…
Read 3 tweets
.@RepBuddyCarter says @ #AIR340BSummit he'll vote against his own bill, BLOCKING Act, tomorrow when House votes on package of drug price bills bc they're paired w bills that would protect ACA

He's disappointed in House Dems&"how partisan they’ve been w drug pricing bills"
Carter (R) also says he doesn't anticipate changes to requiring more "transparency&accountability" to #340B will happen this Congress

"My party doesn't control the agenda," he says at #AIR340BSummit "I don't know how much traction we’ll be able to get on this."
Carter pushed back against criticism from some #340B groups that groups like AIR340B trying to get rid/cut back on the program

Only R lawmakers set to speak at this event (Carter, Cassidy, and Buschon)

Members of the group include PhRMA--has been critical of program's growth
Read 3 tweets

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