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?Read More
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.Read More
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.Read More
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.Read More
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.”Read More
The Type 1 Diabetes Defense Foundation (T1DF) has submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the proposed rule entitled “Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program,” published in the Federal Register on November 28, 2017 (file code CMS–4182–P). T1DF demands strict implementation of individual beneficiary access to negotiated net price as defined under and mandated by MMA legislation.Read More
How patients with insulin-dependent diabetes forced by commercial insurers, with CMS complicity, to overpay for ‘deep-discount’ rebated insulin are subsidizing premiums and bailing out America’s public-private health insurance partnership.Read More
Six million Americans have type 1 and other insulin dependent diabetes.
That’s over six million people to stand together against inflated drug prices, discrimination in access to health care and insurance (including inflated cost sharing), discrimination in school or employment. T1DF was created to safeguard and, if necessary, fight for your rights. But we can't do it without your help.
Our civil rights and consumer protection programs depend on people like you who are willing to take action.Read More
The Type 1 Diabetes Defense Foundation (“T1DF”) welcomes the opportunity to submit comments on the Food and Drug Administration’s (“FDA’s”) Draft Guidance entitled “ANDAs for Certain Highly Purified Synthetic Peptide Drug Products That Refer to Listed Drugs of rDNA Origin” issued on October 4, 2017 (“Draft Guidance”). Effective implementation of the Biologics Price Competition and Innovation Act (“BPCI Act”) is of importance to the individuals T1DF represents, and we greatly appreciate the FDA’s efforts to provide clarity on the interplay between the new drug approval pathways under the BPCI Act and the existing approval pathways under the Federal Food, Drug, and Cosmetic Act (“FD&C Act”).
As detailed below, we do have concerns about (1) the agency’s arbitrary reduction of the scope of “biological products,” as defined in the Public Health Service Act (“PHS Act”) and as amended by the BPCI Act, to a class solely based on the number of amino acids; (2) the resulting misclassification of glucagon as a molecule governed by the FD&C Act instead of the PHS Act; and (3) the bifurcation of approval pathways for analogous biological products, e.g. analog glucagon and analog insulin.Read More
Dear H.E.L.P. Committee Chairman, Ranking Member, and Committee Members:
As you and your staff are preparing follow-up questions to submit to Mr. Azar by Friday, we hope you will take into consideration the clarifications we offer below and the potential follow-up questions we list at the end of this letter.
I’d like to begin by thanking members of the H.E.L.P. committee for their bipartisan attention during yesterday’s hearing to the crisis now facing Americans with type 1 diabetes, for whom access to insulin and glucagon emergency kits isn’t an issue of choice or convenience, but a matter of life and death. As accurately described by Mr. Azar during a November 2016 talk at the Manhattan Institute, current drug-channel actors have collectively created a pricing crisis for the uninsured, and a “cost-sharing” crisis for those insured under high deductible and high cost-sharing benefit designs.Read More