This bill would bring more transparency to PBMs

Happy Friday. We recap yesterday’s hearing on the Pharmacy Benefit Manager Transparency Act and what BIO says about it—and look at why 2023 could be the year of RSV (in a good way). (610 words, 3 minutes, 3 seconds)

Good Day BIO will take a break on Monday, February 20 for Presidents’ Day. We’ll return to our regular publishing schedule on Tuesday, February 21. In the meantime, keep an eye on Bio.News for breaking news.

This bill would bring more transparency to PBMs

The Senate Commerce, Science, and Transportation Committee held a hearing yesterday on the bipartisan Pharmacy Benefit Manager Transparency Act of 2023 (S. 127)—which BIO supports. Here’s what happened.

The bipartisan bill aims to bring transparency into PBM business practices and prohibits conduct that increases prescription drug costs for consumers.

Why it matters: “Just three PBMs control 80% of the PBM market. Pharmacy chains and health insurers now own the biggest PBMs, giving independent pharmacies, care providers, and patients nowhere else to turn when PBMs increase their price,” said bill co-sponsor and Committee Chair Maria Cantwell (D-WA) in her opening statement. 

Read: What are PBMs, anyway?

Bipartisan agreement: “PBMs will claim they pass on savings to consumers or through lowering premiums, but their spread pricing and clawback tactics prove otherwise,” echoed the bill’s co-sponsor Sen. Chuck Grassley (R-IA). “When a PBM goes with a higher price product, consumers may pay more out of pocket before their deductible kicks in or through co-insurance.

PBMs hurt patients, agreed several witnesses. “PBMs steering the filling of [cancer drugs] to their specialty and mail order vertically integrated pharmacies all too often results in unnecessary delays, denials, and waste for cancer patients getting potentially life-saving drugs,” said oncologist Debra Patt. They also raise costs and cause independent and community pharmacies to close.

BIO supports the bill—and applauds Sens. Maria Cantwell (D-WA) and Chuck Grassley (R-IA) for introducing legislation that “would increase transparency and authorize the Federal Trade Commission (FTC) to hold pharmacy benefit managers (PBMs) accountable for unfair practices that harm patients,” we said in the Senators’ joint press release. 

Read: While net drug prices drop, patients pay more thanks to health plans and PBMs

Listen to Drug Prices:A Dysfunctional Market Limits Patient Access on the I am BIO podcast

2023 could be the year of RSV (in a good way)

RSV (a.k.a. respiratory syncytial virus) has long been a challenge for vaccine developers. But thanks to rapid jumps in technology and understanding, a pediatric vaccine could soon be here—Bio.News has an exclusive interview with Sanofi to learn more.

The news: The FDA accepted an application for Nirsevimab, a pediatric RSV vaccine co-developed by BIO member Sanofi and AstraZeneca, which showed a 74.5% reduction in RSV-caused lower respiratory tract infections requiring medical care in healthy infants.

“RSV is the leading cause of hospitalization in infants,” Michael Greenberg, VP and Medical Head of Vaccines in North America at Sanofi, told Bio.News. “I think we have an opportunity to make a significant impact.”

How we got here: After unsuccessful clinical studies in the 60s, the industry stepped back from RSV, said Jon Heinrichs, Associate Vice President and Head of Innovation and Emerging Sciences at Sanofi. But recent developments, coupled with the evolution of monoclonal antibody technology, allowed researchers to pinpoint how to attack and neutralize the virus.

But: “If we’re going to be able to have an intervention that’s going to be able to protect all infants in that first year of life, when they’re most vulnerable, then it is key for Nirsevimab to be slotted into the infant immunization schedule,” said Greenberg—read what he said.

More Health News: 

RealClearPolicy (Opinion): The state of drug development in America is strong, but the IRA unintentionally weakens it
“As part of the IRA’s Medicare price control provisions, negotiation for small molecule medicines is allowed 9 years after U.S. Food and Drug Administration (FDA) approval compared to 13 years for large molecule biologics. This distinction – for which there is no legitimate scientific or policy reason – shifts economic incentives away from small molecules which have important patient benefits over large molecule biologics,” writes Shawn O’Neail, SVP of Global Government Affairs at Eli Lilly and Company.

President Biden’s Friday: Nothing official on the schedule.

What’s Happening on Capitol Hill: Enjoy the weekend.