Supporting emergency insulin refill bill SB 9 in Oregon

Supporting emergency insulin refill bill SB 9 in Oregon

On April 16 Charles Fournier, policy director for the Type 1 Diabetes Defense Foundation, commented in the Oregon House Committee on Health Care public hearing on emergency insulin refill measure SB 9. Sponsored by Oregon State Senator Peter Courtney, SB 9 is a version of the “Kevin’s Law” bills pioneered by Ohio resident Dan Houdeshell after his son, who had type 1 diabetes, died when an expired prescription kept him from getting the insulin he needed.

Charles offered T1DF’s support for SB 9 and—together with other Oregonians who brought up cost as a persistent barrier to insulin access—he reminded Oregon legislators that “there are far more people in Oregon every year who don’t fill an insulin prescription because they can’t afford to do so than people who have the money to pay but don’t have a current prescription.” He outlined for Health Care Committee members how instant enrollment in the existing Oregon Prescription Drug Program discount card program and implementing OPDP’s mandate to give discount card members access to OPDP’s existing low net price for insulin could also, in Oregon, address the cost-driven insulin access crisis.

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2018 Wrap-Up – Kicking Off 2019!

2018 Wrap-Up – Kicking Off 2019!

2018 was a groundbreaking year for the Type 1 Diabetes Defense Foundation. As January draws to a close, we’d like to thank our community of supporters—and talk about all that you helped T1DF accomplish last year.

With another activist group newly captured by billionaire-funded Arnold Ventures (a donor-advised fund associated with a foundation and a PAC, interested in drug manufacturing and other healthcare corporate and commercial ventures), T1DF is now the only nonprofit voice in the U.S. insulin pricing conversation that has not been coopted by corporate interests. 

We hope you’ll read on to see what you have helped T1DF make possible—in federal court, in the news, in Washington, DC, and in the world.

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T1DF voluntarily dismisses Boss v. CVS Health, sounds alarm on agreement between PBM Defendants and plaintiffs’ counsel

T1DF voluntarily dismisses Boss v. CVS Health, sounds alarm on agreement between PBM Defendants and plaintiffs’ counsel

Yesterday in New Jersey federal court, the Type 1 Diabetes Defense Foundation and its president Julia Boss—collectively the “Foundation Plaintiffs”—filed a Notice of Voluntary Dismissal in Boss v. CVS Health (Civil Action No. 17-01823). Boss and T1DF also voluntarily dismissed their claims in the related cases Bewley v. CVS Health (Civil Action No. 17-12031) and Prescott v. CVS Health (Civil Action No. 17-13066). The Voluntary Dismissal counters a Tolling and Standstill Agreement (“Agreement”) entered into between fourteen law firms, including In re Insulin Pricing Litigation’s interim co-lead counsel and Keller Rohrback, the MSP Plaintiffs (payers) and PBM Defendants (agents and subsidiaries of payers)—here described collectively as the “Joint PBM-Payer Enterprise.”

The Agreement, executed by the Joint PBM-Payer Enterprise in January 2018 but not disclosed to plaintiffs Boss or T1DF until December 27, 2018, aims at preventing prosecution of any claim against PBM Defendants. (Boss and T1DF were not parties to the Agreement, and dispute the validity and enforceability of the Agreement.) The Agreement specifically references Boss v. CVS Health (Article 9) and, if enforceable, would also preclude current named plaintiffs and part of the putative classes in the Bewley (glucagon) and Prescott (test strip) cases from advancing claims against PBM Defendants (Article 2). Prosecuting Boss v. CVS at this time would have required directly challenging the capacity of co-lead counsel in the insulin litigation to enter into an agreement for the sole benefit of those attorneys’ current and/or former payer clients. Boss and T1DF were unable, for a period of over 12 months, to secure litigation counsel and local counsel willing to represent them in opposing this Joint PBM-Payer Enterprise. Throughout 2018, the Agreement effectively protected payers and their PBM agents from public outrage as state and federal actors began to investigate payer-controlled cost sharing and rebate pass-through.

The filing of a Notice of Voluntary Dismissal cuts the procedural Gordian knot.

UPDATE: Order from the Hon. Brian Martinotti entered January 7, dismissing Boss. v. CVS Health without prejudice in its entirety and also dismissing without prejudice the Foundation Plaintiffs’ claims in the related cases is available here.

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In the Interest of Justice: New Jersey District Court sides with T1DF, establishes concurrent PBM/payer litigation track

In the Interest of Justice: New Jersey District Court sides with T1DF, establishes concurrent PBM/payer litigation track

INSULIN LITIGATION UPDATE - November 6, 2018. At the case management conference for In re Insulin Pricing, Judge Brian Martinotti ruled “pursuant to the interest of justice” that T1DF’s putative insulin class action, Boss v. CVS Health Corporation (Case No. 3:17-cv-01823) will be unconsolidated from the putative class action against insulin manufacturers, In re Insulin Pricing Litigation (3:17-cv–00699). Patients’ claims against PBMs and insurers for rebate capture and misrepresentation of plan cost will no longer be stayed, and can go forward independently from the manufacturer-only action.

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MMA fighter Anna Hyvärinen joins the fight for T1D civil rights and affordable insulin

MMA fighter Anna Hyvärinen joins the fight for T1D civil rights and affordable insulin

We are very pleased to welcome MMA fighter Anna Hyvärinen as the first brand ambassador for the Type 1 Diabetes Defense Foundation. Anna will be wearing T1DF’s logo on her jiu jitsu Gi and MMA fight gear in competitions coming up this summer and beyond. 

The Type 1 Diabetes Defense Foundation is the only U.S. nonprofit dedicated to the rights of people with type 1 and insulin-dependent diabetes. T1DF and its president Julia Boss (individually) are currently plaintiffs in several drug pricing lawsuits we initiated in early 2017, including Boss v. CVS (insulin pricing), now consolidated into In re Insulin Pricing Litigation (Case 3:17-cv-00699-BRM-LHG).

As a small advocacy 501(c)(3) that’s spent the past year fighting hard in a David-and-Goliath struggle on insulin, glucagon, and test strip pricing—pitting us against some of the largest corporations and class action law firms in the United States—T1DF is especially proud to see our blue diabetes justice logo on the powerful forearms and shoulders of 5’4” flyweight/strawweight Anna Hyvärinen.

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T1DF asks Oregon Gov. Kate Brown to deliver "lowest possible cost" to OPDP discount card holders

T1DF asks Oregon Gov. Kate Brown to deliver "lowest possible cost" to OPDP discount card holders

In a June 7 letter, T1DF asked Oregon's Gov. Kate Brown to address the oversight failure that has allowed the Oregon Prescription Drug Program to overcharge under- and uninsured Oregonians instead of fulfilling its statutory mandate to offer "lowest possible cost" on prescription drugs to OPDP discount card holders. OPDP discount card holders pay unrebated prices at the pharmacy counter on deep-discount rebated brand drugs like analog insulins. When individuals buy these drugs at the pharmacy counter, payers and bulk purchasers like Moda-administered OPDP receive large manufacturer rebates, amounting to 75%+ of list price. What happens to manufacturer rebates earned when OPDP discount card holders are asked to pay OPDP's current prices, $270.71 for a 10 ml vial Novolog and $269.85 for Humalog? These are not "lowest possible" prices. Even for-profit commercial enterprises like BlinkHealth and GoodRx now charge far less than OPDP does in its discount card program—BlinkHealth's Humalog price is $178.90 per vial, GoodRx prices Humalog at $177.87 Are discount card holders' earned rebates being transferred to other OPDP programs, while under- and uninsured Oregonians pay 3 or 4 times OPDP's net cost for their analog insulin?

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Drug transparency bill ignores role of insurers

Drug transparency bill ignores role of insurers

The health care debates of 2017 taught us that any conversation about the supposed premium impact of a specific drug or medical condition can be turned into an argument that people with pre-existing conditions should be pushed into high-risk pools or pay condition-specific premiums.

Health care cost legislation should avoid triggering stigma or workplace discrimination against people with disabilities or chronic medical conditions.

Oregon’s House Bill 4005 does the opposite. It directs insurers to tell the public that certain conditions are causing increased “spending.” And it bases its reporting on a definition—“‘Price’ means the wholesale acquisition cost”—so patently misleading that it’s tempting to believe HB 4005’s central purpose is to insert it into Oregon law, to prevent people harmed by insurers’ dual pricing from recognizing or taking action on their injury.

Oregon’s leaders know that insurers are negotiating low rebated net prices for themselves, while forcing patients to pay much higher list prices. They know insurers are leaving rebates out of the equation when they calculate the premiums we pay. Our lawmakers should now be demanding transparency and public reporting on the harm caused by insurers’ drug-pricing practices and the impact of those practices on individual cost-sharing and premium valuation—not passing a blame-shifting bill that’s opaque where transparency would do the most good.

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T1DF Statement to Oregon's Joint Interim Task Force on Fair Pricing of Prescription Drugs

T1DF Statement to Oregon's Joint Interim Task Force on Fair Pricing of Prescription Drugs

HB 4005 should not be needed. The Oregon Prescription Drug Program (OPDP) created in 2003, with expanded access to all uninsured and underinsured Oregonians via 2006’s Ballot Measure 44, should already be delivering to under- and uninsured individual Oregonians net price transparency and the lowest available price, net manufacturer rebates, at the pharmacy point of sale.

If this Task Force on Fair Pricing wants to achieve the stated goals of HB 4005—drug-pricing transparency and lower prescription drug prices to Oregonians—it should begin by investigating why OPDP, a program over which the Oregon government has plenary control, has not fulfilled its statutory mandate to deliver the lowest price available, i.e. point-of-sale rebate pass-through to individual discount card holders. 

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T1DF president files motion in support of PBM/insurer track in the insulin class action

T1DF president files motion in support of PBM/insurer track in the insulin class action

On Friday, April 6, 2018, T1DF president Julia Boss, as an individual pro se plaintiff, challenged the attempt by several class action law firms, led by Steve Berman and James Cecchi, to curtail the right of people with type 1 and other insulin-dependent diabetes to seek immediate relief from alleged insurer and PBM co-conspirators. She asked the Court to rule on establishing a concurrent litigation track against insurers/PBMs. Such a ruling would create a dual-track process similar to that already existing in the ongoing EpiPen litigation.

This brief, filed in New Jersey federal court (Civil Action No. 17-699-BRM-LHG) supports the previously filed Motion for Reconsideration of the Consolidation Order (Dkt. Entry 89) and responds to the opposition brief (Dkt. Entry 133) filed on April 2, 2018, by interim co-lead counsel and all law firms supporting their manufacturer-only litigation strategy, including Hagens Berman, Keller Rohrback (T1DF's former counsel retained in February 2017 to establish a PBM/insurer track), Weitz & Luxenberg, and Carella, Byrne, Cecchi, Olstein, Brody & Agnello (concurrently representing Novo Nordisk's shareholders) and Berman Tabacco. 

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T1DF president moves to establish a PBM/insurer litigation track in the insulin class action

T1DF president moves to establish a PBM/insurer litigation track in the insulin class action

On Friday, March 16, in New Jersey federal court, Julia Boss, president of the Type 1 Diabetes Defense Foundation, moved to establish a litigation track against PBMs and insurers in the insulin class action (In Re Insulin Pricing Litigation, Case No. 3:17-cv–00699-BRM-LHG). She thus challenged interim co-lead counsel Steve Berman and James Cecchi’s and Keller Rohrback’s coordinated attempt to prevent T1DF from implementing a dual-track litigation against PBMs and insurers, concurrent with the manufacturer-only consolidated complaint filed in December 2017. PBM rebating expert Larry Abrams recently wrote on his blog that Berman and Cecchi’s manufacturer-only consolidated complaint “makes no sense.” In light of increasing public knowledge and expert consensus, throughout 2017, regarding the impact of insurers’ failure to pass through rebates, Boss argued on Friday that pursuing a PBM/insurer track parallel to the manufacturer track is “critical to delivering immediate, tangible relief to the class.”

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