Continued criticism around drug company pricing policies has extended to the insulin market, with a 197% price increase from 2002–2013, despite only minor modifications/improvements to the drug class. Oral diabetes medications, however, did not experience this drastic price hike – with the cost of some drugs actually decreasing. The exception to the insulin price hikes is Lantus (by Sanofi) a well-established, long-acting form of insulin. After major pushback from PBMs, Sanofi decreased the cost of the drug by 14% in 2015. Drug cost predictions are also hampered by the anticipated release of a biosimilar version of Lantus – although generic competition typically drives down drug costs by 80%+, actual price impacts of biosimilars on the US market remain unknown. Drug manufacturers continue to defend drug costs, stating that the list price is very rarely the cost paid by insurers or patients.

Stanley Riddell of the Fred Hutchinson Cancer Research Center announced at a conference in February that his team had discovered a way to program patients’ immune systems to recognize and fight cancer cells. The treatment lead to complete remission in 24 of 26 late stage cancer patients and, by targeting only cancer cells, the unpleasant side effects associated with chemotherapy are avoided. While the patients tested all had various types of blood system cancer, researchers are hopeful that the therapy will have similar effects on localized tumors, as well.

Links to the podcast from The Naked Scientists:

http://www.thenakedscientists.com/HTML/specials/show/20160224/

Despite the many concerns posed in the article Novartis, Roche find outcome-based drug pricing an elusive dream, the hopeful manufacturer, Novartis, has struck a deal with the health benefit manager, Cigna (as well as another insurer according to a Jan 27th investor conference). The terms are based on the ultimate success of Entresto, a medication for patients with chronic heart failure, in reducing hospital admissions and includes a rebate that will decrease or increase based on the drugs measured effectiveness.

Despite off-label prescribing occurring in between 12% and 20% of prescriptions, studies show that doctors do not always know if their suggestions are based on off-label or on-label indications, spurring JAMA Internal Medicine to suggest that doctors take more care in monitoring and evaluating the drugs they prescribe. JAMA found a large majority of off-label use is not supported by strong experimental evidence, increasing the incidence of side effects by between 44% and 54%. Doctors suggest, however, that, since off-label use is often applied to patients who have significant, progressive ailments that have not responded to traditional treatment, an increase in side effects is to be expected.

Both Hillary Rodham Clinton and Bernie Sanders have gone on record to voice their disapproval of the recent price hikes in prescription costs. Sanders history includes a 2014 investigation into the soaring costs of generics, an inquiry letter to Turing Pharmaceutical about the Daraprim price increase and, most recently, the introduction of legislature that would allow the Department of Health and Human Services to negotiate drug prices, impose stiffer penalties for fraud, ban ‘pay-for-delay’ practices and ease access of lower-cost Canadian medications. Clinton’s approach is similar to Sanders’, banning ‘pay-for-delay,’ allowing Medicare to negotiate costs and imposing a $250 monthly cap on out-of-pocket specialty drug costs. Experts, however, site that legislation should promote market competition to systematically reduce drug costs instead imposing regulations that could hamper future innovation.