| |  | | | | |  | By Megan R. Wilson | - TrumpRx and community pharmacies: As more drugmakers move to sell products directly to consumers, community pharmacies are meeting with the administration to ensure they’re included in the plans.
- Updated vaccine recommendations: The CDC accepted recommendations made by a panel of federal vaccine advisers last month, including one that urges people to check with a clinician before getting one.
- CO caps drug costs: Colorado became the first state in the nation to set a limit for how much a drugmaker can charge for a drug, likely setting off a legal battle with drugmaker Amgen. Other states could follow in its footsteps.
Happy Monday, and welcome to the Health Brief newsletter. I’m Megan Wilson, and I’m your host on day six of the federal government shutdown. The Senate is voting again on bills that would reopen the federal government, but both sides appear more dug-in than ever. One of the items in today’s issue goes over the new vaccine recommendations from the federal government. Meanwhile, the head of the agency wants to go even further. I’ll be digging into that for you tomorrow, so stay tuned. Do you have any tips, scoops or intel? Let’s chat. You can reach me at megan.wilson@washpost.com or on Signal at megan.434. This newsletter is published by WP Intelligence, The Washington Post’s subscription service for professionals that provides business, policy and thought leaders with actionable insights. WP Intelligence operates independently from the Washington Post newsroom. Learn more about WP Intelligence. |  | | Community pharmacies want to be a part of the Trump administration's efforts to lower drug costs. (Fred Prouser/Reuters) | | | |  | The Lead Brief | Being able to buy medicines directly from manufacturers at a discount is a key part of the Trump administration’s drug pricing efforts, including the creation of a government website called TrumpRx. And retail pharmacies want to make sure they’re able to stay in the loop. → The move to direct-to-consumer sales mirrors a direction major pharma players have been going for almost two years now, spearheaded by a demand from consumers for GLP-1 weight loss medications with spotty insurance coverage. The administration announced it would launch the Trump-branded website, set to debut early next year, that would connect patients to the platforms set up by manufacturers. PhRMA, a leading industry group for drugmakers, will soon have a similar website of its own. While not all the details about the new federal website have been rolled out, many drugmakers have so far been contracting with online telehealth and pharmacy platforms to fulfill orders. That could be troubling for retail pharmacies, which have been struggling: “Access to pharmacy is the most prevalent and the easiest touch point in the health care system,” said Mark Ey, the chief operating officer of the National Community Pharmacists Association. | “Patients often engage with their pharmacist 10 to 14 times a year and only see their doctor once,” Ey told me. “Any major movement of business away from these pharmacies in the community could potentially put them at risk for being there in the future. And the administration tells us that they recognize that, they’re not insensitive to that.” Mark Ey, the chief operating officer of the National Community Pharmacists Association | | | | Pharmacy groups argue that pharmacists forge relationships with patients and keep records that allow them to spot harmful medicine interactions before they happen. The industry has a term for people who choose to get their medicines through multiple sources: Polypharmacy. It’s something pharmacies have been grappling with long before the administration’s newest announcement. However, it’s not yet clear whether direct-to-consumer platforms for brand-name medicines will be widely used by patients, as the cost is usually higher than they would pay with insurance, raising questions about affordability for those without it: - Amgen announced on Monday it would offer Repatha, its injectable drug meant to lower cholesterol, directly to consumers at $239 per month — a 60 percent discount from the list price.
- AstraZeneca’s Farxiga, medicine used to treat diabetes, heart failure and kidney disease, has a $182 price tag when purchased from the manufacturer directly.
- Pfizer’s migraine medication Zavzpret could still be about $600 per month, even with a 50 percent discount.
“Whether this would relate to 1 percent of medications or 100 percent of medications, to some extent, it doesn't matter, because it creates that opportunity to … underscore the idea that any great deal for Americans is going to rely on their access to their local pharmacy,” said Chris Krese, the senior vice president of congressional relations and communications at the National Association of Chain Drug Stores. Both groups said they’ve been in contact with the administration on making sure that community pharmacies remain part of the conversation. Krese said one way to include retail pharmacies as manufacturers expand direct-sales programs could include offering a voucher or card the patient would bring to the pharmacy of their choice. There could also be an effort to contract directly with drugmakers: - Kelly Kasulis Cho reported this morning for The Washington Post on a new partnership between Costco pharmacies and Novo Nordisk to provide the drugmakers’ Wegovy and Ozempic medicines used for weight loss and diabetes treatment, respectively, at a discounted out-of-pocket price of $499 a month.
| | | | | | Immunization Update | The Centers for Disease Control and Prevention on Monday adopted the recommendations made last month by a panel of federal vaccine advisers to change the childhood vaccine schedule and allow people to get a covid shot after talking to a provider or pharmacist. The guidance could make it harder for some people to get a coronavirus vaccine — or at least more confusing. The CDC guidance says that people can consult with anyone who administers vaccines, including primary care physicians, specialists, pharmacists, physician assistants and nurses. But the extent of such consultations may differ across states and even individual pharmacies and doctor’s offices, my Washington Post colleague David Ovalle notes. → He has a new story with all the details of the CDC’s updated coronavirus vaccine policy, including trying to clear up some of the confusion. “Informed consent is back,” said Jim O’Neill, who is acting director of the CDC and deputy secretary of the Department of Health and Human Services. The prior recommendation on covid shots, he said, had “deterred health care providers from talking about the risks and benefits of vaccination for the individual patient or parent.” → The CDC also announced it would be adopting recommended changes to the childhood vaccination schedule, separating the chicken pox vaccine from a combination shot to protect against measles, mumps and rubella. The Advisory Committee on Immunization Practices, a panel with members handpicked by Health and Human Services Secretary Robert F. Kennedy Jr., focused on separating the shots as a way to reduce seizures that can be a rare complication of the vaccine. Jason Goldman, the president of the American College of Physicians, countered that “physicians have not been deterred from talking about risks and benefits of vaccines with their patients.” In an emailed statement to your host, Goldman said that CDC’s new recommendations “put that discussion between a patient and their physician in jeopardy because they will be required to discuss recommendations that are not based on sound evidence.” → Get a refresher: My Washington Post colleagues David Ovalle, Rachel Roubein and Lena H. Sun wrote about the scrutiny the panel faced from clinicians (including Goldman) who worried that the ACIP members were often unprepared or had misunderstood or ignored key data, in addition to highlighting flawed or inconclusive research often trumpeted by vaccine critics. | | | |  | State scan | Colorado has become the first state in the nation to cap a medicine’s cost, an action that could kick off a legal battle with drugmakers and similar efforts from other states that have become fed up with high drug costs. Colorado’s Prescription Drug Affordability Review Board approved a measure on Friday to set an upper payment limit on Amgen’s blockbuster drug Enbrel of $600 per unit, or about $30,356 per year. It’s a dramatic cut from the $53,049 that the average insurance plan in Colorado paid for the drug per person in 2023. What’s next: The move is fiercely opposed by the pharmaceutical industry. Amgen had filed a lawsuit last year to stop Colorado’s efforts, but a court said the suit was too premature. Now that the PDAB has capped the price, the drugmaker will likely try again. → “In setting a UPL, the board is acting unlawfully,” Amgen said in a statement, according to a report about the news from The Washington Post’s Peter Whoriskey. Read his story to get a full picture of the action and how it fits in with other states’ efforts. - U.S. sales of Enbrel, a drug used to treat several autoimmune diseases, such as rheumatoid arthritis and plaque psoriasis, amounted to more than $3.2 billion last year, and it has commonly ranked among the top 50 best-selling drugs by revenue.
- Nearly a dozen states have created their own prescription drug affordability boards, or PDABs, aimed at lowering drug prices. The PDABs in four states — Colorado, Maryland, Minnesota and Washington — have the ability to directly set cap costs on medicines by setting upper payment limits.
| | | | | | What We’re Reading | “How some veterans exploit $193 billion VA program, due to lax controls,” Craig Whitlock, Lisa Rein and Caitlin Gilbert report for The Washington Post. “Pharma has paid billions in opioid settlements — but not to many victims’ families,” by The Washington Post’s Marisa Iati. “How Big Agriculture got its way in the latest MAHA report,” according to Amudalat Ajasa and Rachel Roubein at The Washington Post. Carolyn Y. Johnson, Danielle Douglas-Gabriel and Ben Brasch at The Washington Post report: “Trump slashed funding for universities that helped create these vital drugs.” “Their parents never got them vaccinated. As young adults, they faced a choice,” writes Trisha Thadani at The Washington Post. “Trump plan would limit disability benefits for older Americans,” Meryl Kornfield and Lisa Rein write in an exclusive for The Washington Post. “How Private Equity Oversees the Ethics of Drug Research,” reports Walt Bogdanich, Carson Kessler and Jeremy Singer-Vine at The New York Times. “Shareholder group calls on UnitedHealth to decouple CEO from board chair,” writes Rebecca Pifer at Healthcare Dive. | | | | | | |
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