Axios Vitals

A briefcase with a red cross on the front.

January 16, 2020

Good morning.

Situational awareness: The Justice Department's top antitrust official, told the Wall Street Journal that DOJ is preparing to file new price-fixing charges against generic drugmakers.

Today's word count is 675, or a 3-minute read.

1 big thing: U.S.-China trade deal could be good for Big Pharma

Illustration of an opened pill capsule with Chinese stars. Money is falling from the inside of the pill.

Illustration: Aïda Amer/Axios

President Trump's new trade agreement with China includes patent protections that could be a big boon to drug companies.

Why it matters: China's enormous population is a lucrative market for pharma, and the country is also actively trying to build up its own domestic drug industry. But it's not guaranteed that China will actually abide by the agreement.

Details: The trade agreement would set up patent protections in China that are similar to U.S. law.

  • It would help protect branded drugs from generic competition while they're still under patent protection.
  • Drugmakers could also receive a patent extension if there's a delay during the approval process.

The big picture: This is good news for Big Pharma, especially after biologic protections were recently removed from the trade agreement with Mexico and Canada that's making its way through Congress.

Between the lines: If China complies with the agreement, it'd be great for American drug companies, which could enter the Chinese market with the expectation that their patents would be respected. But it could also be good for China's budding drug industry.

  • "This is a way for them to be able to create a domestic industry but also maintain affordability and access, which China is going to do anyway because it's a controlled economy," said Chris Campbell, chief strategist at Duff & Phelps.

The bottom line, from Axios China reporter Bethany Allen-Ebrahimian:

  • It's up to China to implement the legal protections it has agreed to in the deal — but significantly, the agreement does include six pages outlining an evaluation and enforcement mechanism. That's a step in the right direction.
  • But Chinese officials have previously falsified data, and China has reneged on agreements in the past.

Go deeper: China offers drug companies market access in exchange for lower prices

2. Day 3 at #JPM20

Yesterday was the last full day of the JPMorgan health care confab in San Francisco. Here's what caught Axios' Bob Herman’s eye.

The next Humira

  • Humira will control the market for many autoimmune conditions in the U.S. until 2023, and AbbVie executives already have a plan for when cheaper alternatives roll out.
  • AbbVie CEO Richard Gonzalez said two newly approved drugs that treat the same conditions as Humira — Skyrizi and Rinvoq — could hit or surpass $20 billion in combined sales in the future.
  • Gonzalez revealed Skyrizi's net price is "roughly the same as Humira," which is around $40,000 annually.

A hospital chain is banking on GOP states to flip on Medicaid expansion

  • A vast majority of the hospitals within Community Health Systems are located in states led by Republicans who have refused to expand Medicaid. CHS CEO Wayne Smith, who has a long history of donating money to Republicans, said that's destined to change.

The resurgence of a hospital collections firm

  • R1 RCM, a company that handles patient referrals, scheduling and debt collections for hospitals and doctors, gave a rather rosy profit outlook for 2020 and 2021.
  • R1 — which is owned partially by not-for-profit hospital giants Ascension and Intermountain Healthcare — is going on year three of its name change from Accretive Health.
  • The Accretive days were a disaster, ranging from poor accounting to a high-profile settlement that wiped away allegations of abusive collections practices in ERs.

3. Progress stalls on racial disparities

Reproduced from The Commonwealth Fund; Chart: Axios Visuals
Reproduced from The Commonwealth Fund; Chart: Axios Visuals

The Affordable Care Act reduced racial disparities in health insurance, but that progress has stalled since 2016, a new Commonwealth Fund analysis says.

Between the lines: The uninsured rate among people of color leveled off in 2016, and racial disparities in actual care still persist, even with lower uninsured rates, Axios' Marisa Fernandez reports.

4. A fight over patient records

There's an intense lobbying fight over HHS' pending health care data-sharing rules, Politico reports.

Between the lines: The fight involves hospitals, digital health firms and patient advocates.

Details: The rules would give patients patients to access their health information and allow them to share it with third-party apps.

  • Hospitals would have to send notifications when patients are admitted, discharged or transferred, information blocking would be penalized, and researchers and doctors would be allowed to share screenshots of software.

Health software giants like Epic and Cerner say the rules make patients vulnerable to venture capitalists and app developers taking advantage of their data while requiring the companies to give their trade secrets away.

  • But advocates of the policy, including HHS Secretary Alex Azar, say it would empower patients.