SALT LAKE CITY - It isn't a prescription to cure high drug prices - but it may be a start. The U.S. Supreme Court has just given the Federal Trade Commission (FTC) the authority to challenge deals between drug-makers to keep generic drugs off the market for certain time periods. Such arrangements allow the brand-name manufacturers to make more money as their drug patents expire, but the FTC has said these "pay for delay" arrangements cost people who use the drugs $3.5 billion a year.

According to Leigh Purvis, senior strategic policy adviser at the AARP Public Policy Institute, it's one of many ways drug companies shore up their profits.

"We take a lot of what the drug industry does as, 'Yeah, this is just the cost of doing business,' and it isn't necessarily illegal, but it also isn't necessarily something that has to happen," Purvis remarked. "So, you kind of have to get into the mindset that maybe we could try to stop some of this behavior."

AARP filed a brief in the Supreme Court case supporting the FTC's position. The high court ruling doesn't mean pay-for-delay deals are illegal, only that they'll now be subject to more scrutiny.

Generic drug companies like the pay-for-delay strategy, because it minimizes their risk of being sued if they infringe on an expiring patent. Purvis said AARP views it through the eyes of those who have to pay more for the medications they need.

"From AARP's perspective, we would really like to see pay-for-delay deals go away," she stated. "I think people also need to be wise consumers of their prescription drugs. It really does benefit people to take a look at what they're taking and maybe talk to their prescriber to see if there's a less expensive option available."

Last week, AARP's Public Policy Institute released a case study on pricing of the popular cholesterol drug Lipitor, made by Pfizer. It said that in the five years before Lipitor's patent expired in 2011, its price continued to climb. Purvis called Pfizer's approach "unusually aggressive."

"The price increases that were taking place occurred while they were officially or supposedly under a pay-for-delay deal - which means not only were they holding a generic effectively off the market, but they were also increasing their prices at, say, 17.5 percent in a year, just kind of adding insult to injury," as she characterized the situation.

The report alleges that, in addition to pay-for-delay agreements, rebates were offered to insurance companies to reject claims for generic equivalents and prompt more Lipitor prescriptions. Pfizer says it also offered discounts to consumers.

Purvis is co-author of the report. The SCOTUS decision in FTC v. Actavis is at supremecourt.gov.




get more stories like this via email

After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


get more stories like this via email

New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.