Monday, December 15, 2014

Lawmakers Pursue Answers, Remedies for Generic Inflation


Reprinted from DRUG BENEFIT NEWS, biweekly news and proven cost management strategies for health plans, PBMs, pharma companies and employers.

By Lauren Flynn Kelly, Editor

December 5, 2014 Volume 15 Issue 23

As the prices of many generic drugs continue to experience increases due to shortages, reduced competition and other potential factors, the federal government is putting the pressure on the generic pharmaceutical industry. Sen. Bernie Sanders (I-Vt.), chairman of the Senate Subcommittee on Primary Health and Aging, on Nov. 20 convened a Senate hearing to investigate the “skyrocketing” prices of generic drugs at which three generic drugmakers were no-shows.

And The Wall Street Journal last month reported that the U.S. Department of Justice issued subpoenas to two producers of generic digoxin, a congestive heart failure treatment that has severely spiked in price.

Three generic pharmaceutical manufacturers — Marathon Pharmaceuticals, Lannett Co., and Teva Pharmaceutical Industries — were invited to testify at the Nov. 20 hearing but declined to participate. Sanders and Rep. Elijah Cummings (D-Md.), ranking member of the House Committee on Oversight and Government Reform, had sent letters on Oct. 2 to those companies and 11 others seeking information on escalating prices of certain generic drugs.

The letters cited data from a survey of group purchasing organizations conducted by the Healthcare Supply Chain Association showing price increases of 300% or more in recent months for 10 generic drugs. For example, the average market price for a bottle of 100 pills of albuterol sulfate to treat asthma and other lung conditions was $11 in October 2013, compared with a whopping $434 in April 2014.

The Generic Pharmaceutical Association, however, argued on Nov. 20 that citing a mere 10 drugs out of more than 12,000 “safe, affordable generic medicines” lacks perspective and fails to recognize the “thousands of generics [that] have seen significant price erosion over time due to the competitive nature of the marketplace.”

But Sanders explained during the hearing that he and Cummings are not just concerned about a handful of drugs. “While we are focusing on 10 individual drugs that have seen extraordinary price increases, what we are also seeing in the industry is that many other generic drug prices are rising as well,” he said. “There appears to now be a trend in the industry where a number of drugs are going up at extraordinary rates.”

According to a new analysis of National Average Drug Acquisition Cost (NADAC) data collected and published by CMS, Pembroke Consulting, Inc. finds that half of all retail generic drugs rose in price when comparing November 2014 data (dated Nov. 5, 2014) with the previous year’s file (dated Nov. 7, 2013). Out of a sample size of 2,370 drugs, 9% of products had cost increases of more than 100% (see chart, below). The Pembroke data, which was posted to the Drug Channels blog on Nov. 18, also demonstrate quarterly changes in acquisition cost, and show more than one-third of generic drugs rose in price in the third quarter of 2014. Of the top 10 drugs with the largest percentage increases in NADAC per unit from July to November, eight jumped by more than 1,000%.

During the hearing, witnesses discussed various factors that could be pushing up prices, such as a backlog of more than 3,000 generic drugs awaiting FDA approval and the 2012 implementation of a generic drug user fee to supplement the costs of reviewing generic drug applications and inspecting facilities.

Rob Frankil, a Sellersville, Pennsylvania, pharmacist, testified on behalf of the National Community Pharmacists Association (NCPA) that pharmacists have no advance notice of these price increases and that PBMs are taking up to six months to update their reimbursement rates to pharmacies, “putting pharmacies underwater on these drugs.” According to a recent survey of more than 1,000 NCPA pharmacies that experienced large spikes in generic drug prices in the past six months, respondents pointed to commonly used drugs such as pravastatin for high cholesterol and levothyroxine for hypothyroidism, added Frankil.

Scott Gottlieb, M.D., a resident fellow at the American Enterprise Institute who most recently served as deputy commissioner for medical and scientific affairs at the FDA, suggested to Congress that most of the generic drugs experiencing high cost increases are “low volume drugs,” although there are some examples of high volume drugs. “To get a more accurate picture of what’s happening in the market overall, you need to adjust the price increases based on script volume,” he suggested. Regardless of which types of products are increasing, Gottlieb suggested one culprit is higher manufacturing costs due to increased FDA oversight and the agency’s “abrupt” imposition of new quality standards.

In an effort to “cushion the impact” of rising generic costs, Sanders on Nov. 20 proposed new legislation that would require generic manufacturers whose prices outpace the rate of inflation to pay extra rebates to Medicaid. The Medicaid Generic Drug Price Fairness Act proposes to extend a requirement of the Social Security Act that brand-name manufacturers whose drug prices increase at a rate faster than inflation pay an additional rebate to Medicaid.

GPhA immediately fired back, calling the effort “misguided” and a threat to patient access. “Unfortunately, the newly proposed legislation makes it clear that the hearing was not intended to be a meaningful examination of ways to ensure savings,” said GPhA President and CEO Ralph G. Neas in a Nov. 20 statement. He also recommended that Congress focus on ways to encourage competition among generics manufacturers, such as through the “timely review” of generic drug applications and by countering the misuse of Risk Evaluation and Mitigation Strategy (REMS) programs that GPhA alleges some brand companies are using as a way to keep generics out of the market.

View a replay of the hearing at http://tinyurl.com/m5qsye6. To view the Pembroke analysis, visit www.drugchannels.net.


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