Drug Prices Fall In Other Countries, PBMs Take From Needy Patients, & Wasted Healthcare Data

Hey all,

Today’s run down has some great data on how PBMs are driving up costs. I was also surprised at how much of our healthcare data is unused in the current system. Hopefully AI and new healthcare software can get rid of the waste.

Jacob Brody (Co-Founder & CEO, ZorroCard)

Brand Name Drug Prices Decrease Over Time in Some Countries (Employer Coverage) 

A JAMA study reveals that brand name drug prices in Germany and Switzerland decrease after launch, with Germany capping prices based on a drug’s incremental benefit and Switzerland reviewing and adjusting prices every three years. In contrast, U.S. prices continue to rise—climbing as much as 9% annually for cancer drugs—while starting at far higher launch prices. I’d love to see how big PBMs spin this as proof they’re “saving money” through negotiations, like a firefighter proudly taking credit for putting out a fire they helped ignite. Full Article.

J&J Expands Legal Attack on Alternative Funding Programs (Cost Curve)

Johnson & Johnson (J&J) has escalated its legal challenge against “alternative funding programs” (AFPs) by including Express Scripts and its Accredo pharmacy in its 2022 lawsuit. AFPs involve third parties removing coverage for specific drugs, redirecting patients to charity care, and manipulating copay structures, often undermining patient assistance programs provided by manufacturers. By targeting Express Scripts and its parent company, Cigna, J&J has shifted focus to PBMs and their specialty pharmacies using AFPs to divert funds intended to support patients. Full Article.

The Invisible Wasteland of Health Care Data (Stat News)

The average hospital produced 50 petabytes of data annually in 2019, with 97% of it going unused—equivalent to streaming a two-hour movie 25 million times—creating a massive environmental burden. Storing this “dark data” in energy-intensive data centers generates substantial carbon emissions, contributing to the U.S. health care sector’s role in over 8% of the nation’s annual emissions. Compounding the issue, obsolete electronic devices add hazardous waste to landfills, posing risks to public health and ecosystems. Full Article