drugs

The reality is that non-price factors, including several players, are causing net prices to decline and retail prices to increase. Those players include employers, health plans, and pharmacy benefit managers (PBMs), all of whom have continuously circumvented the system through loopholes and complicated systems of reimbursement that tend to hurt patients

The drug company’s choice is to walk away from millions in revenue from a given country and deny their people a lifesaving drug, or swallow hard and accept an unfair price that is nowhere near the drug’s value. For the sake of shareholders and patients, drug companies typically accept the unfair price and devote the revenue to offsetting their previous investments. In short, other nations are freeloading off of American R&D.

The life sciences sector in Massachusetts — which has been flying so high for so long — is about to experience a very hard landing. With the adoption of prescription drug price controls in the Inflation Reduction Act (IRA), drug research and development — the heart of the life sciences sector in Massachusetts — is about to experience a nuclear winter.

The Biden administration's formation of a working group to “develop a framework for the implementation of the march-in provision of the Bayh-Dole Act" could have serious adverse consequences for university research and biopharmaceutical innovation. It represents a particularly dangerous threat to the thriving life sciences cluster in Greater Boston.

In recent years, pharmacy benefit managers (PBMs) have instituted programs to keep out-of-pocket drug costs high for patients. Why is the administration so eager to protect federal employees from high out-of-pocket costs but is perfectly happy for PBMs to enroll millions of other patients in these programs?

Senator Bernie Sanders and his advisors have not caught onto the fact that the problem for consumers and patients is no longer the list prices of prescription drugs but skyrocketing out-of-pocket costs due to health insurance benefit design.

A new white paper, "Out-of-Pocket Pirates: Pharmacy Benefit Managers (PBMs) and the Confiscation of Copayment Assistance Programs," examines how the way these programs are implemented is having negative impacts on patients living with serious diseases.