Drug Price Competition IS Possible (and so are continually decreasing drug prices)

If you think we’re all stuck with the current crummy prescription coverage system – with manufacturers and PBMs engaged in a two-step dance that continuously increases drug prices – think again!

In an article published by STAT, our own Linda Cahn describes how Amazon – or several other entities like Anthem or Walmart – could entirely transform our current system and create a functioning marketplace with real drug price competition.

Succinctly summarized, all we need is for a large entity to form a new type of PBM that —

  • Renounces the PBM industry’s secret deals with manufacturers that result in rebates and other hidden payments that drive up drug costs
  • Instead requires every manufacturer to simultaneously submit on a “Bid Day” its “net prices” for every drug for the following six month period (factoring in all price reductions)
  • Six months later, provides every manufacturer with the opportunity to change its drug prices for the next six month period
  • Continues to conduct Bid Days every six months thereafter
  • Publishes every price – by drug and by therapeutic category – on an App so everyone can compare the actual prices of every drug in every therapeutic category
  • Also assembles and disseminates on its App efficacy/safety/and side effect information on every drug – by drug and by therapeutic category
  • And thus enables all doctors and patients to search for the lowest-cost and best drugs to prescribe and take, as well as to avoid those drugs that are priced non-competitively or of little or no real therapeutic value

Cahn details how the above innovations will inevitably disrupt the entire marketplace, force manufacturers to reduce their prices repeatedly, and allow the disrupter to shatter and dominate the PBM industry.

Read the article, and circulate it to everyone you know! In so doing, you’ll help create the pressure for at  least one large player to create a new type of PBM and finally shake up and transform our malfunctioning prescription coverage system.

Pro Publica Attacks Vimovo (quoting Cahn)

We’ve previously published a Rx Drug Alert about why your Plan should stop covering Horizon Pharma’s Vimovo.

So we’re very glad to see the press is now focusing on this outrageously expensive drug as well. And we’re pleased to have contributed to the story.

Penned by Pro Publica’s Marshall Allen and captioned “How Two Common Medications Became One $455 Million Specialty Pill“, the article is crammed with numerous facts reflecting how the entire drug industry works.

It’s also a wonderful read. We urge you to take it to bed with you tonight. You won’t be sorry!

Our Firm’s Success In Exposing Express Scripts’ Hidden Rebates

When Express Scripts recently filed a lawsuit against a drug manufacturer to collect purportedly unpaid monies, Express Scripts revealed shocking facts about the hidden monies it is collecting from the drug manufacturer. We discovered the lawsuit and wrote it about it in a Rx Drug Alert.

We’re pleased that numerous newspapers saw our article and picked up the story. The New York Times carried a front page Business section story quoting and including a picture of our Linda Cahn.

Barron’s also carried a story quoting Cahn. Here’s a copy of the electronic version of the story.

The Express Scripts lawsuit was also described in several other journals, including Pro Publica, USA Today, CNBC NewsBiz Journals, and other journals as well.

We urge every Plan administrator and fiduciary to investigate the extent to which your PBM is passing through – or not passing through – the monies your PBM is collecting from drug manufacturers.

Also, your Plan should consider filing a legal proceeding to obtain an “accounting” from your PBM. If you’d like to discuss this option, do call our firm.


2 News Articles – In Bloomberg & The LA Times – Explain PBMs’ Pernicious Practices – Both Quote Cahn

Bloomberg’s terrific journalists – Robert Langreth and Neil Weinberg – have written a great article about PBMs that quotes our Linda Cahn. Go here to read the article and also view Bloomberg’s graphic and video about PBMs and drug prices.

Michael Hiltzik of The Los Angeles Times has also written a terrific article about PBMs’ impact on drug prices and focused in particular on insulin drugs. Go here to read the article.

Pharmalot Interviews Cahn on PBMs, and Quotes Cahn in Article on Potential New Rebate Statute

If you don’t regularly read Pharmalot, you should. Ed Silverman’s fabulous pen is continuously focused on the drug industry, and he often uncovers stories that can’t be found anywhere else.

Accordingly, we’re pleased that Pharmalot chose to interview our Linda Cahn about PBMs. You can read the interview here. Just to give you a taste of the topic Ed and I discussed, the article is captioned “Pharma and PBMs are in a 2-step dance that raises drug prices”. 

Also, don’t miss an earlier Pharmalot article describing Senator Ron Wyden’s proposed new C-THRU statute. The article quotes our Linda Cahn on why the statute may be well-intentioned, but is likely misguided and counterproductive.

“Watchdog” quotes Linda Cahn

In a recent analysis, the predicts that PBMs may be scrutinized more carefully by the new Republican Administration. The article quotes the Coalition’s Linda Cahn about PBMs’ rebate practices.