California Healthline Daily Edition

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Pharma Defends Drug Prices As Cost Of R&D, But Analysis Finds That May Be A Stretch

In other news on pharmaceutical costs, Sen. Chuck Grassley (R-Iowa) questions Kaleo about the $4,500 price tag of its EpiPen alternative and some payers are denying coverage of pricey hepatitis C treatments, despite more discounts.

Stat: R&D Spending May Not Really Justify Those High Prices, After All
For years, the pharmaceutical industry has maintained that high prices charged for many medicines in the US are needed to fund R&D, since so many other countries use various means to cap pricing. Now, though, a new analysis suggests that the additional sales that drug companies generate in the US, compared with four other well-to-do countries, greatly exceeds what they have spent on their global research and development. (Silverman, 3/8)

Stat: Grassley Probes EpiPen Rival Over Its $4,500 List Price
For the second time in recent weeks, a small, privately held drug maker with a piece of the action in two hot markets is being scrutinized by lawmakers over its pricing. In the latest episode, US Senator Chuck Grassley (R-Iowa) wants Kaleo to explain why it set a $4,500 list price for the Auvi-Q allergic reaction device that is competing with EpiPen. The move is actually part of a complicated pricing strategy that may appeal to some consumers, but not so much to insurers. (Silverman, 3/8)

Stat: Despite Discounts For Hep C Drugs, Coverage Denials Keep Rising
After pricey new hepatitis C treatments emerged a few years ago, public and private payers restricted coverage in order to ease the financial strain on budgets. But even as more competition among drug makers has prompted discounting, payers continue to deny coverage, including to patients who suffer from the most advanced forms of the disease, according to a new analysis. As of last September, 37 percent of patients with little to moderate trace of the disease were denied coverage, a mostly steady increase from 27 percent in October 2015. Meanwhile, 24 percent of those severe forms of hepatitis C were denied, up from 15 percent during the same time period. These figures represent an overall trend that includes commercial and government payers. (Silverman, 3/8)

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