Anybody got the quick & dirty?

Type 1 and LADA
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I’ve been too busy for anything lately. But I’m not too busy to wonder why people keep telling me that pharma is suing the State of MN.

I thought that all of the legislation took years of negotiation because the State was tiptoeing around pharma. People down at the Capitol would say things like, “Well, we don’t want to get sued by Pharma, so…FILL IN THE BLANK.” Minnesota didn’t pass anything as provocative as CO. Why are they suing US? I thought it was understood by both parties - pharma and the State, that they were gonna take forever to pass worthless, ineffective legislation and in return, Pharma wouldn’t sue.

I don’t understand what’s happening…unless there’s a vendetta, which there might be.
Is this about our attorney general filing suit? That was pretty wild. I asked her if she was scared shitless. She said she was leaving office immediately after filing the suit.

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The case was dismissed.

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Unfortunately they are back in court in December.

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I thought pharma had a good case based on the interstate commerce clause of the constitution. Which I believe has in the past has been used to thwart any number of attempts by states to regulate business activity inside its borders. I was surprised when it was dismissed. My sense is this will end up at the supreme court. Where the first question is if the court will take jurisdiction and the second, will a court that ruled in favor of Arkansas in Rutledge v. Pharmaceutical Care Management, will continue to give states so much leeway to regulate health care systems.

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How psychotic is the country where we live anyway? I mean well most of us here live in the US.
But anyway. These drug companies sell their American made drugs to other countries like Canada for Pennie’s on the dollar, and here in the good of USA it’s $400 per bottle.

If we try to pass laws to give an average person a break, the drug companies sue. It’s maddening. It’s crazy that this is allowed to happen and break the backs of people.

If they would just charge a reasonable price for the drugs, then pretty much it would cost the same everywhere.

The drug companies are thugs, and yes I work for one. However the insulin manufacturers ■■■■ me off most because I need that to live.

I remember paying $17 for Humulin insulin. And yes there was some money spent to create an analog to get us Humalog.
So yea double that and maybe add some inflation.

That brings us to about, Idon’t know $60 ?

The prices they charge are just criminal, I wish every state would pass a similar law.

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I think the pharmacies, insurers and prescribers need some “blame”—either their not aware of what we’re being charged (impossible, but maybe) or they don’t know how to really help their customer/patients.

Last year I was paying $25 per pen for Humalog every 25 days.

That’s how the script was written.
That’s how the pharmacy filled it.
I assumed that was normal as a newly diagnosed T1.

Now, since speaking up with a new script, I’m paying $23 for a 5-pen box which more than covers me for 30-days and allows me to not panic about running out or rationing.

Instead of being nicely controlled as I am now, I’d probably be risking DKA again and another $250k hospital stay.

It’s pure foolishness.

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Oh my gosh, you guys are right! It sounds like they are going to Federal court. Holy crap.

Why is this particular piece of leg so inflammatory to them? As opposed to, say, the price caps imposed in Colorado? Price caps feel more costly to Pharma. Insulin Prices In Colorado Will Be Capped Starting In 2022 | Colorado Public Radio

I guess this is just one strand in a giant spider web of legal efforts towards some giant, overreaching goal to regulate drug costs. Even that can be viewed as a subset of efforts across multiple industries to regulate antitrust stuff.

I think everything boils down to the meat and potatoes of allegations of ‘market fixing’ by pharma. This guy works with really expensive conditions and medications. He says he wants to see this play out over insulin because he thinks its the easiest to prove in court. High cost of insulin has life-or-death implications for diabetic patients - Mayo Clinic News Network Mayo Clinic and The State are working on this full time. https://www.startribune.com/minnesota-attorney-general-lori-swanson-sues-insulin-makers/497711361/
Even the insurers are in it: https://www.startribune.com/blue-cross-of-minnesota-lawsuit-takes-aim-at-pharma-bro/600030295/

What a twisted web! I think that covid makes everything even more complicated. These suits need to play out because it will settle something regarding people’s distrust in the medical system.

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I am not an expert, but I think the difference in other states and MN is that MN caps the cost at $50 for a 90 day supply?, and the program applies to certain medicare enrollees.

Typically in these programs medicare enrollment negates any prescription benefits. That is a large number. Here is a comparison I read, I will not swear by it or to it.

rick

Potentially the thing about medicare is that manufacturers are forced by law to give all possible discounts to PBM’s who are supposed to lower costs for all enrollees in their plan. They usually keep 50% to 75%.

The MN law forces the manufacturer to give discounts to medicare PBM’s and then discount again to patients. Since manufactures have no control over what PBM’s do they have every reason to take as much as possible and then force manufacturers to lower the cost again.

Again I am not an expert on the issues in MN but that is what it looks like looking in from the far outside.

Others will know better?

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They passed state legislation to deal with the PBM’s first (prior to covid). That was the 1st order of business and I feel like there was a lot of hostility back and forth on that issue. There was virtually no cooperation or love lost. I perceived that as an ‘aggressive’ negotiation between the State and other parties. Minnesota Enacts New PBM Law: Notice and Comment Period for Proposed Regulations Open to the Public

I have never perceived us as having formal ‘price caps,’ like other states, so its good you raise this. I will need to look and see if anything changed. The Alec Smith Act applies to a very small number of people. I didn’t think anyone would utilize it and it was set to get phased out automatically if no one did.

I guess I wouldn’t call Alec Smith a price cap - so it must have something to do with the medicare part D issue you raise.

They actually had 500 people use it this year, but that must be because of covid and all the strange things that happened. Or, there may have been concerted effort to drum up people to use it so it didn’t get phased out. Maybe there was a bit of an orchestrated civil effort here.

The State of MN will provide health insurance to virtually everyone who is poor for free - they have done this for at least 25 years (as long as I can remember). In order to NOT have insurance in the State of MN (and be eligible for Alec Smith), you have to work pretty hard. The State plan will pay for a pump and CGM, and insulin. It’s free to anyone who is poor. Generally, In order to not have that, your living on the street and just don’t have the capability to fill out the paperwork due to mental illness or some other tragic condition.

Alec Smith is just not very applicable to very many people. It’s super burdensome, complicated paperwork in order to access it (I, personally, would never be able to figure out how to fill it out…but I have insurance, so I couldn’t use it anyway). Maybe it applies to persons who have recently moved from out of state and aren’t eligible for state care yet.

It’s possible that because of covid, the stars aligned and 500 people utilized Alec Smith this year (unexpected result) and that’s triggering the pharma lawsuit. Self employed persons (whos incomes dropped unexpectedly to $0 and who hadn’t bought health insurance) might have been making heavy use of it.

Filling out the paperwork for Alec Smith feels as time consuming and difficult as filing out the paperwork to just get on the State’s health insurance plan. For that reason, it makes no practical sense to me. I can’t visualize where these 500 users came from.

Your right, its a Medicare part D thing. That’s gotta be it.