FYI ... October 20, 2023

Pharmacy Benefit Managers (PBMs) Reform

Patients with multiple chronic diseases often spend 5-10 times more than others on their prescription drugs. Congress can lower costs for these patients by passing PBM reform that would close the loophole that allows #PBMs to intercept the discounts that drugmakers intend for patients. For more information click the link https://www.fightchronicdisease.org/.../PFCD%20...

Here is a brief background on PBMs impact on patients with chronic conditions:

Pharmacy Benefit Managers (PBMs) operate as an intermediary between drugmakers and insurers in the pharmaceutical supply chain. These middlemen corporations determine which prescription drugs will be covered by insurance plans and how much patients pay out-of-pocket. Drug manufacturers offer rebates on medications to the PBMs that are intended to be passed along to patients. Instead, PBMs often keep the savings.

This practice has had disastrous results for patients, especially those who suffer from chronic conditions. Brand name drugs currently receive an average rebate of 26%, but patients don’t see that discount at the pharmacy counter. What’s more, higher out-of-pocket costs lead to poorer medication adherence, which often leads to negative health outcomes. The situation is worse for individuals with multiple chronic conditions, who pay as much as 10 times more on prescription drugs as a result of these PBM practices.

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FYI ... October 2023

* Attn: Healthcare & Lobbying Reporters *

AARP’s 2022 Financials Reveal Over $1.1 Billion in Annual Corporate Royalty Payments

Mostly From a Single Health Insurance Conglomerate: UnitedHealth Group Washington, D.C. — October 16, 2023 — AARP’s 2022 financial disclosures revealed that the “seniors advocacy organization” was paid more than $1.1 billion in corporate royalties last year. Based on historical analysis and assumptions, most of those funds are likely attributable to a single company, Minnesota-based UnitedHealth Group (UHG). UHG is one of the nation’s largest health insurance and pharmacy benefit management (PBM) corporations. Its vast subsidiary businesses also include primary and urgent care practices, home health services, specialty pharmacies, health IT companies and more.

AARP set records with corporate royalty payments exceeding $1 billion in each of the last two years. Meanwhile, AARP saw a further decline in membership dues in 2022, similar to the previous year. These figures were released soon after the one-year anniversary of the passage of the Inflation Reduction Act (IRA), which made significant changes to the nation’s Medicare program. Many critics continue to view the IRA as a potential windfall for big insurer-PBMs such as UnitedHealth Group, given new price control measures and unrelated insurance subsidies funded from the bill’s projected Medicare drug savings.

As part of its Commitment to Seniors initiative, American Commitment has worked to highlight the AARP’s financial conflict of interests with big health insurer-PBMs generally and UHG specifically. Recent examples include not only AARP’s support and 60 million dollar campaign to pass the highly politicized IRA, but also its reluctance to advocate visibly for bipartisan PBM and copay reforms to prevent big insurer-PBMs from pocketing rebates and discounts meant for Medicare patients. The IRA not only diverted billions in funds intended for Medicare to unrelated spending; it prioritized those special interest programs before most of the IRA’s drug provisions were to be implemented for seniors in Medicare.

“AARP’s annual billion-dollar haul of corporate royalties is their lifeblood, and the reason AARP prioritizes the agenda of health insurance giant UnitedHealth and its PBM division OptumRx, over the interests of its membership and seniors across the country,” stated Phil Kerpen, President of American Commitment. “These latest financials prove once again exactly why AARP was the #1 cheerleader for the so-called Inflation Reduction Act. That misnamed bill has done little to nothing to lower costs for most seniors – but it did divert billions from Medicare to fund unrelated spending like green energy subsidies and supersized Obamacare subsidies to big insurers like UnitedHealth.”

“Meanwhile, on other critical debates in which UnitedHealth’s business practices are being called into question – like bipartisan PBM reforms or questions over billions in overcharges to Medicare – AARP is missing in action. No TV ads, no grassroots campaigns, literally nothing. It’s clear who AARP truly advocates for these days, and it’s not seniors,” continued Kerpen.

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American Commitment is dedicated to restoring and protecting our nation’s commitment to free markets, economic growth, Constitutionally-limited government, property rights, and individual freedom. American Commitment engages in critical public policy fights over the size and intrusiveness of government through direct advocacy, strategic policy analysis, and grassroots mobilization. Visit us online at www.AmericanCommitment.org.

Here is a link to the press release that was blasted to relevant healthcare and lobbying reporters recently.

Also, are the financial overview with numbers and assumptions for AARP’s 2022 financial disclosures (see below).

https://twitter.com/commit2sen.../status/1713917720754802842

https://twitter.com/commit2sen.../status/1713932817745207311

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FYI ... August 2, 2022

To Members of the Utah Delegation: On behalf of the undersigned organizations and the many constituents we represent, thank you for your continued opposition to policies that would impose drug price controls on the biopharmaceutical and biotechnology industry, with serious implications for bringing new life-changing medicines to market. We appreciate your ongoing efforts to stand up for patients and innovation. 

As you know, partisan drug pricing provisions included in the “Inflation Reduction Act” would allow Medicare to negotiate prescription drug prices similar to what was included in the “Build Back Better” bill that passed the House last year. In addition, the bill would impose inflation rebates and an excise tax of 95% on the sale of any drug that a manufacturer refuses to submit for Medicare price negotiations. This can hardly be characterized as a “negotiation”. It is effectively price-setting by government. 

Such government-driven price controls would have a chilling effect on research and development (R&D) and investment in pioneering drug startups. A recent study by “Vital Transformation” shows that under these pricing policies, only 6 of 110 currently approved therapies would have made it to the market because companies would no longer have the necessary funds to spend on R&D and critical partnerships with small biotechnology. Ultimately, producing fewer medicines is not a viable solution for improving healthcare or reducing drug costs. With fewer new drugs on the horizon, patients, especially those with serious and rare diseases, would not have access to breakthrough treatments. 

Utah’s robust and growing drug research, discovery and manufacturing sector would certainly feel the repercussions. Utah is one of only 11 states with a specialized concentration of jobs in the drugs and pharmaceuticals industry.  1 Salt Lake City is ranked one of the top 25 cities in the country with the largest employment levels in drugs and pharmaceuticals.  2 This is an important industry for Utah, generating high paying jobs and products that improve and safe lives. Examples of the state’s leadership in this area include the following:

• The University of Utah, in 2020, launched a Therapeutics Accelerator Hub (U2TAH) to speed the translation of laboratory research into new drugs for patients. 

• TEVA Pharmaceuticals, the world’s largest generic drug manufacturer, operates two large manufacturing facilities in the state, employing thousands.

• Recursion, Clene and Tolero Pharmaceuticals have grown from startups in the last decade to nationally recognized drug development companies. Recursion and Clene went public last year and Tolero (now SMP Oncology) was acquired by Sumitomo Pharma Oncology in 2017 and continues operations in cancer drug development in Lehi, Utah.

 • Innovative early-stage drug companies rooted in Utah include, Alucent BioMedical, Bastion Biologics, Cūrza, Denali Therapeutics, Halia Therapeutics, Innovative Vaccine Technologies, PEEL Therapeutics, SignPath Pharma and Thunder Biotech, to name a few. 

• A major European drug developer is expected to place their first U.S. operations in Salt Lake City. That announcement is expected in the next few months. 

These companies are innovating new medicines to fight cancers, ALS, Alzheimer’s, Parkinson’s, Superbugs and more. 

Our goal must be to provide Utahns with the best, most innovative healthcare options available and to look to solutions that will truly lower out-of-pocket costs. The drug pricing provisions of the “Inflation Reduction Act” may reduce Medicare spending, but they do not provide any measurable benefit to patients. We strongly urge you to continue to protect the millions of Americans that rely on medical advances by opposing this legislation. 

Thank you for your consideration. 

Sincerely,

BioUtah                                                                                                                                                                      Centro Civico Mexicano                                                                                                                                            Crocker Ventures/Merrimack Pharmaceuticals                                                                                                          Mental Healthy Utah                                                                                                                                                  Northern Utah Coalition                                                                                                                                             Patel Family Investments                                                                                                                                           Salt Lake Chamber                                                                                                                                                     South Valley Chamber                                                                                                                                               SURVIVEiT                                                                                                                                                               Utah Hemophilia Foundation                                                                                                                                     Utah Manufacturers Association