Sign up for our daily briefing

Make your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on the day's biggest business stories

Subscribe to Axios Closer for insights into the day’s business news and trends and why they matter

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Stay on top of the latest market trends

Subscribe to Axios Markets for the latest market trends and economic insights. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sports news worthy of your time

Binge on the stats and stories that drive the sports world with Axios Sports. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tech news worthy of your time

Get our smart take on technology from the Valley and D.C. with Axios Login. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Get the inside stories

Get an insider's guide to the new White House with Axios Sneak Peek. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Denver news?

Get a daily digest of the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Des Moines news?

Get a daily digest of the most important stories affecting your hometown with Axios Des Moines

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Twin Cities news?

Get a daily digest of the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Tampa Bay news?

Get a daily digest of the most important stories affecting your hometown with Axios Tampa Bay

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Charlotte news?

Get a daily digest of the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios NW Arkansas

Stay up-to-date on the most important and interesting stories affecting NW Arkansas, authored by local reporters

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Illustration: Aïda Amer/Axios

Advocates of lowering prescription drug prices are beginning to use an expensive new Alzheimer's drug to make the case for reform, but actually addressing the therapy's price raises complicated policy challenges.

Why it matters: Democrats may be positioning themselves to push policy measures that assign value to drugs and then price them accordingly. If successful, that could be a huge blow to the pharmaceutical industry.

The big picture: Many of the policies that aim to lower drug prices are rooted in the belief that Americans shouldn't pay so much more than the rest of the world for drugs, and that old drugs shouldn't be able to become significantly more expensive over time.

  • But Biogen's Aduhelm is a brand-new drug that isn't yet approved in any other country.
  • To truly address its launch price, policymakers will have to grapple with big questions that the U.S. system currently avoids: How should we determine the value of a drug, and who gets to make that decision?
  • Right now, drug companies make pricing decisions based almost entirely on what the market will bear, and Medicare generally covers drugs that get approved by the FDA.

What they're saying: "This is the scenario where the health technology assessments done in other countries become valuable," said Walid Gellad, a medicine and health policy professor at the University of Pittsburgh.

  • "They have a country-wide mechanism in place to try and identify a fair price for the drug, based on the incremental benefit it brings. We don’t have that in the US."

Between the lines: Democrats' most prominent drug legislation is a House bill that gives Medicare the power to negotiate drug prices, and then allows private insurers access to those prices as well.

  • The bill uses prices paid by other countries — or reference pricing — to cap what the U.S. will pay for that same drug. If there isn't an international reference price, the bill allows Medicare to pay a maximum of 85% of the average manufacturer price.
  • Biogen has said Aduhelm will have a list price of $56,000, which critics say is many times its value. To these critics, a price ceiling of $47,600 may not be enough of an improvement.

What we're watching: During the campaign, President Biden proposed giving an independent review board the power to determine the Medicare rate for new drugs that don't have any competition.

  • Sen. Ron Wyden, the chairman of the Finance Committee, recently called out Aduhelm by name in a document outlining the principles that will guide the Senate's drug pricing bill, a hint that the Senate's legislation will take a different direction than the House's.
  • "Many [drugs], like the recently-approved Alzheimer’s drug Aduhelm, launch at prices far beyond any reasonable justification of the clinical value to patients, caregivers, or society. Medicare does not currently have the requisite tools to ensure a fair price for such a drug," the document states.

The bottom line: "Any kind of process for valuing new drugs like Aduhelm take you immediately into the controversial quagmire of how to quantify improvements in quality of life for people," said KFF's Larry Levitt.

  • "Aduhelm presents the added complication that it’s not even very clear yet that it will improve people’s quality of life."

Go deeper: How other countries set their drug prices

Go deeper

Bryan Walsh, author of Future
Sep 15, 2021 - World

The global food price crisis isn't going away

Data: Food and Agriculture Organization of the United Nations; Chart: Axios Visuals

Global food prices have continued to rise throughout the pandemic, and they're now at close to the highest level they've been in decades.

Why it matters: Beyond the hunger and suffering that comes with costlier food, high prices are driving serious political discontent around the world — and there's little relief in sight.

Biden's big bet backfires

Two key dealmakers — Sen. Joe Manchin (D-W.Va.) and Sen. Mark Warner (D-Va.) — leave a luncheon in the Capitol yesterday. Photo: Kent Nishimura/L.A. Times via Getty Images

President Biden bit off too much, too fast in trying to ram through what would be the largest social expansion in American history, top Democrats privately say.

Why it matters: At the time Biden proposed it, he had his mind set on a transformational accomplishment that would put him in the pantheon of FDR and JFK.

Biden sinks in swing districts

Photo: Biden speaks about wild fires and climate change in Sacramento on September 13, 2021. Photo: Brendan Smialowski/ AFP via Getty Images

Sudden doubts about President Biden's competence — on Afghanistan, immigration and COVID — are driving double-digit drops in his approval in private polling in swing House seats, The Cook Political Report's Amy Walter writes.

Why it matters: "[T]hese early mistakes go directly to the very rationale of his presidency; that it would be low drama and high competence."

You’ve caught up. Now what?

Sign up for Mike Allen’s daily Axios AM and PM newsletters to get smarter, faster on the news that matters.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!