To watch footage of the Senator’s remarks click here.
WASHINGTON – Senator Maggie Hassan today raised concerns about recent news that the drug giant Novartis brokered a sweetheart deal with the Centers for Medicare and Medicaid Services (CMS) over an innovative new gene therapy that Novartis has priced at $475,000. The deal was halted after CMS’s own lawyers raised concerns, saying they were “surprised and concerned” with Novartis' influence on the process.
“Thankfully this inappropriate relationship between CMS and Novartis has come to light and the reimbursement scheme CMS and Novartis cooked up has been halted,” Senator Hassan said during a Senate Health, Education, Labor, and Pensions Committee hearing focused on health care costs. “But I raise this issue today because it’s not the first time we’ve seen troubling ties between the Trump Administration and big pharma that put consumers’ interests at risk. And I worry about what other kind of backroom or insider deals with big pharma the Trump Administration may be pursuing. We need to make sure patients have access to these amazing new drugs like [Novartis’] CAR-T cell therapy, and we need to figure out how to reimburse properly for these groundbreaking therapies. But letting the drug company write the reimbursement policy is like the proverbial fox in the hen house.”
Under the proposed arrangement, Novartis would have been paid based on how well its therapy worked – but the timeline for evaluating that performance would have only been a month, which experts say is too short of a timeline for evaluating the success of the therapy.
The Senator asked David Lansky, Ph.D, President and Chief Executive Officer of the Pacific Business Group on Health, what Congress can do to prevent these sorts of bogus reimbursements schemes in the future.
“A very important question of course. The structure that is being discussed now of creating outcomes-based payments for drugs is a structure worth exploring, it makes a lot of sense as you said,” said David Lansky, Ph.D., President and Chief Executive Officer, Pacific Business Group on Health (PBGH). “The outcomes have to be fairly long-term, long enough to capture the meaningful outcome for the patient and for a definitive therapy.”
Senator Hassan has a record of taking on big pharmaceutical companies and fighting to lower drug prices for consumers. Last year, she joined her colleagues in introducing the Improving Access to Affordable Prescription Drugs Act, which would help ensure that drug companies put patients before profits and bring much-needed relief to families and seniors. The Senator also pushed back on the drug giant Allergan in response to their shady practices to stifle competition. Additionally, last month, during a Senate Health, Education, Labor, and Pensions Committee hearing, Senator Hassan called out the Secretary of Health and Human Services, Alex Azar, for claiming that the Trump Administration is concerned about lowering prescription drug prices while also seeking to eliminate protections for people with pre-existing conditions, which would lead many Americans to lose health insurance coverage and, in turn, force them to pay more for prescription drugs.