Price hikes for some Medicare therapies unsupported by clinical benefits data - Report

Bhanvi Satija
·2 min read

By Bhanvi Satija

Dec 6 (Reuters) - The three costliest therapies under Medicare health insurance in the United States saw price hikes in 2020 but there was not enough evidence of new clinical benefits, the Institute for Clinical and Economic Review (ICER) said on Tuesday.

Horizon Therapeutics' gout treatment Krystexxa's list price increased by 12%, which led to an additional out-of-pocket expense of $3,210 per patient being spent on average. Under many insurance plans, patients may be responsible for paying a percentage of the list price.

The ICER, a group that reviews the value of medicines, said drugmakers hiked prices on seven of the 10 costliest prescription drugs in 2021 too, without enough clinical evidence justifying the hike. This led to an increase in drug spending by $805 million in the U.S. compared with a rise of $1.67 billion in 2020.

A Reuters analysis found that drugmakers continue to launch new medicines at record-high prices, even after President Joe Biden's signature Inflation Reduction Act was passed. The law allows the government to choose 10 drugs to negotiate from among the 50 costliest drugs for Medicare, a government healthcare program for people aged 65 and older or disabled.

The other two costliest therapies under Medicare Part B, which covers medicines received in a doctor's office, include Seagen's cancer drug Adcetris and Ipsen's injection Somatuline Depot. Both therapies led to an additional cost of over $1,000 per patient on average in 2020.

"There remain many high-cost brand drugs that continue to experience significant annual price hikes, even after accounting for rebates. List prices also continue to increase, and this can present real hardships to patients who must pay deductibles or coinsurance," said David Rind, ICER's Chief Medical Officer.

ICER said its report focuses on whether enough new clinical data exists that could help justify price hikes and is not a full cost-effectiveness analysis of the therapies. (Reporting by Bhanvi Satija in Bengaluru; Editing by Krishna Chandra Eluri)

  • Up next
  • Up next
  • Up next
  • Up next

Latest Stories

  • Pass or Fail: The New York Mets' 2024 City Connect uniforms

    The Mets are one of eight teams debuting City Connect uniforms this season.

  • Paramount stock soars as Wall Street sees possible Sony, Apollo buyout as 'positive' for all shareholders

    Paramount is currently in exclusive merger talks with David Ellison's Skydance Media.

  • The EPA is again allowing summer sales of higher ethanol gasoline blend, citing global conflicts

    The Environmental Protection Agency cleared the way Friday for a higher blend of ethanol to be sold nationwide for the third summer in a row, citing global conflicts that it says are putting pressure on the world's fuel supply. The agency announced an emergency waiver that will exempt gasoline blended with 15% ethanol from an existing summertime ban. Gasoline with 10% ethanol is already sold nationwide, but the higher blend has been prohibited in the summer because of concerns it could worsen smog during warm weather.

  • Netflix stock sinks on disappointing revenue forecast, move to scrap membership metrics

    Netflix reported first quarter earnings after the bell on Thursday. Here's what to know.

  • IN CASE YOU MISSED IT: Jack Antonoff slams Kanye West again

    During an appearance on Jimmy Kimmel Live! this week, the musician/record producer poked fun at the Stronger rapper. In the interview, host Jimmy asked Jack why he is "more inclined to work with female artists," after noting that he has worked with the likes of Taylor Swift, Florence + The Machine, Lorde and St. Vincent. "There's two people that I think are too oversensitive to even function, and it's men and members of the music industry. The amount of sensitivity - it's sort of like watching Kanye.”

  • Crews turn sights to removing debris from ship's deck in Baltimore bridge collapse cleanup

    Salvage crews at the site of the collapsed Francis Scott Key Bridge in Baltimore are turning their focus to the thousands of tons of debris sitting atop the Dali, a massive cargo ship that veered off course and caused the deadly catastrophe last month. An estimated 3,000 to 4,000 tons of steel and concrete landed on the ship’s deck after it crashed into one of the bridge’s supporting columns and toppled the span, officials said at a news conference Friday. Crews will have to remove all that before refloating the stationary ship and guiding it back into the Port of Baltimore.

  • Wells Fargo bond saleswoman sues over 'unapologetically sexist' workplace

    Wells Fargo was accused of sex discrimination in a lawsuit by a bond saleswoman who said the fourth-largest U.S. bank denied pay and promotions available to men and tolerated an "unapologetically sexist" workplace. The complaint filed on Friday in federal court in Chicago by Michal Leavitt is the latest in a long line of lawsuits accusing big U.S. banks of bias against women. Leavitt said Wells Fargo's practice of steering larger accounts toward men in its financial institutions group cost her up to one-third of her potential pay, and forced her to wait nine years for a promotion to director from vice president.

  • New Home Sales Due Next Week in Canada

    Monday U.S. Featured Earnings Verizon Communications Inc. (NYSE:VZ) (Q1) EPS of $1.12, ...

  • Cannabis seizures at checkpoints by US-Mexico border frustrates state-authorized pot industry

    The U.S. Border Patrol is asserting its authority to seize cannabis shipments — including commercial, state-authorized supplies — as licensed cannabis providers file complaints that more than $300,000 worth of marijuana has been confiscated in recent months at highway checkpoints in southern New Mexico. New Mexico's Democratic governor says the disruptions prompted a discussion this week with U.S. Homeland Security Secretary Alejandro Mayorkas, whose impeachment charges were dismissed this week. Gov. Michelle Lujan Grisham says she voiced concerns that the scrutiny of cannabis companies appears to be greater in New Mexico than states with regulated markets that aren't along the U.S. border with Mexico.

  • ‘Sick note’ crackdown: The charts and figures behind Sunak’s welfare reform claims

    Fit notes handed out by the NHS have increased by 26 per cent since 2016-17

  • MPs chide 'incompetent' health agency over fired National Microbiology Lab scientists

    OTTAWA — Federal officials in charge of the National Microbiology Lab are defending security protocols at the Winnipeg institution against accusations of incompetence from opposition MPs. The head of the Public Health Agency of Canada appeared before a parliamentary committee on relations between Canada and China, where she was peppered with questions about the firing of two researchers in 2021. The agency fired two researchers who left Canada after their security clearances were revoked over qu

  • Soviet-era tech and 1970s American jets: Inside Iran’s ageing air defences

    Israel’s strike on Iran early on Friday appears to have been fairly limited.

  • Shadow of Saudi Arabia looms as World Snooker Championship faces toughest decision

    WORLD SNOOKER CHAMPIONSHIP 2024: The World Championship is not guaranteed to remain at the iconic Crucible Theatre, writes Luke Baker, as snooker ponders its future

  • Man Sets Himself on Fire Outside Donald Trump's Manhattan Trial

    "Someone has set himself on fire in the protest area here at the Donald Trump trial," a Fox News reporter said during a live broadcast Friday

  • N.B. environment minister resigns, citing political differences with Higgs's Tories

    FREDERICTON — New Brunswick's Environment Minister has announced his resignation, citing political differences with the Progressive Conservative party led by Premier Blaine Higgs. Gary Crossman says in a social media post today that his health must be his priority and he feels it's time to "step aside." He says he is resigning immediately from cabinet and will step down from his duties as the Progressive Conservative member for the Hampton district in the coming days. The 69-year-old was first e

  • Nigeria's NNPC, First E&P venture produce 20,000 barrels of crude at OML 85

    Nigeria's NNPC Ltd and its local joint venture partner, First E&P, have commenced production at OML 85 and achieved 20,000 barrels per day (bps) output, the state-oil firm said in a statement on Friday. OML 85 was one of two blocks sold to First Exploration and Petroleum Development Company Limited (First E&P) in 2015 by Chevron. That and OML 83 are located between 30 to 40 km offshore in the central Niger Delta, where water depths range from 15 to 50 metres.

  • Man sets himself on fire outside Donald Trump hush money trial in New York

    People rushed to douse the person with a fire extinguisher and try to bat the flames away, according to reports

  • Trump Media Stock Has Fallen So Much It’s Blaming Short Sellers

    Shares of Trump Media & Technology Group seem custom fit for a short seller to target. The stock has since plummeted, and TMTG CEO Devin Nunes thinks some short sellers aren’t playing fair. Nunes wrote a letter to Nasdaq CEO Adena Friedman on Thursday asking her to look into potential market manipulation of the stock, which trades on the Nasdaq exchange.

  • Nova Scotia Health contacting 2,690 patients after privacy breach

    Nova Scotia Health said it will be contacting 2,690 patients after their personal information was "inappropriately accessed" at Saint Martha's Regional Hospital in Antigonish, N.S."We are extremely disappointed that an employee of Nova Scotia Health would engage in activity of this nature. Nova Scotia Health will not tolerate any unauthorized access or snooping," Derek Spinney, the health authority's chief financial officer and vice-president of corporate services, told reporters on Friday.Spinn

  • Mandisa, Grammy-winning gospel singer and ‘Idol’ contestant from Sacramento area, dies at 47

    Mandisa, a Grammy-winning gospel singer and former "American Idol" contestant from the Sacramento area, has died. She was 47. Mandisa was found dead at her home on Thursday from unknown causes, her social media accounts said.