Jun 18, 2019

Axios Vitals

By Caitlin Owens
Caitlin Owens

Good morning. Not only are robocalls extremely annoying, but it also turns out that they're dangerous when hospitals are flooded with them, WashPost reports.

Today's word count: 741 words, or ~3 minutes.

1 big thing: Everyone wants to sell cancer drugs

Photo: Spencer Platt/Getty Images

Pfizer's $11.4 billion takeover of Array BioPharma highlights how eager industry titans are to commercialize cancer medications, making cancer the most in-demand pharmaceutical asset outside of gene therapy, my colleague Bob Herman writes.

Big Pharma wants to expand cancer lineups because cancer drugs command huge price tags that health insurers and society usually pay for uncritically. 

Where it stands:

  • Merck is acquiring Peloton Therapeutics for $1 billion. 
  • Eli Lilly is buying Loxo Oncology for $8 billion.
  • AstraZeneca is paying Daiichi Sankyo upwards of $9 billion for partial rights to an experimental cancer treatment.
  • Bristol-Myers Squibb is trying to complete a $74 billion takeover of Celgene.

And all of that is just this year's activity.

What we're watching: Array has 2 FDA-approved drugs on the market, Mektovi and Braftovi, and more in development. The drugs have high prices, and Pfizer is known for its routine price hikes — even in the face of political pressure.

  • Packages of 180 Mektovi 15 mg pills, 180 Braftovi 75 mg pills and 120 Braftovi 50 mg pills each had list prices of about $11,000 when they were approved last June. Array raised those prices to $11,500 in January, according to Elsevier's Gold Standard Drug Database.

Related: Per reporters at Evaluate, if you want blockbuster drug sales, buy them.

2. Democrats don't get Medicare for All
Expand chart
Data: Kaiser Family Foundation; Chart: Andrew Witherspoon/Axios

Republicans have a better grasp on what Medicare for All would look like than Democrats do, according to a new Kaiser Family Foundation survey.

By the numbers: Only 31% of Democrats think health insurance premiums would go away under a national plan — a key component of Sen. Bernie Sanders' Medicare for All bill.

  • That's compared to 45% of Republicans.
  • The GOP also (perhaps more understandably) has a better grasp of the more negative aspects of Medicare for All, like that most people's taxes would increase.

My thought bubble: Democrats should probably start trying harder to make sure that their own voters understand at least the good parts about Medicare for All.

3. More health care terminology confusion

All those people who support "Medicare for All" but don't actually know quite what it means, take heart: The health care industry also can't define its own favorite buzzword, Axios' Sam Baker writes.

Talk of "value-based care" is everywhere — at every conference, in every PR pitch, on every investor call, everywhere. But when Humana gathered 18 industry bigwigs to try to come up with a definition of "value-based care," they couldn't do it, according to a report in FierceHealthcare.

  • The experts agreed that value-based care would account for both cost and outcomes, but "they were divided about whether patient experiences should be highlighted," per FierceHealthcare.
  • The same expert panel also struggled to agree on a definition of "population health." Although they were on the same page about the definition of the word "population" — that it's referring to groups, not individuals — that's about as far as they got.

Why it matters: If "value" is some version of getting your money's worth, it's hard to argue that the U.S. health care system is a good value, at least for patients or taxpayers.

  • And while everybody keeps talking about changing that, the old ways of doing business — chasing higher reimbursements through volume and higher fee-for-service prices — still dominate.
4. Concerns over novel depression drug

A recently approved drug for treatment-resistant depression was branded as a wonder drug, but serious questions have been raised about its approval process, effectiveness and safety, the Center for Public Integrity reports.

  • President Trump took a personal interest in the drug, Spravato, thinking it would be great for the Veterans Affairs system, and reportedly wanted the agency to buy "truckloads" of the drug.

What we're watching: A VA committee will decide this week whether to require that Spravato be available to VA pharmacies.

  • If it is, that could be a huge plus for Johnson & Johnson's marketing of the drug.

Why it matters: "For veterans whose ranks are plagued by depression and suicides, much is at stake," CPI writes. "A drug that offers [a] fast and lasting answer for treatment-resistant depression would be a godsend. But is this drug the answer?"

5. California's mental health experiment

California is partnering with Silicon Valley to work on smartphone apps that can help in the early stages of a mental health crisis, NYT reports.

  • State and county mental health officials have been meeting with 2 tech companies to test apps for people who receive care from the state's mental health system.

The big picture: While mental health apps have flooded the market, there's been little research as to whether they work. California's partnership is aiming to fill that hole.

Yes, but: "At least for now, California's effort to jump-start medicine's digital future is running into some of the same issues that have dogged old-fashioned drug trials: recruiting problems, questions about informed consent, and the reality that, no matter the treatment, some people won’t 'tolerate' it well, and quit," NYT writes.

Caitlin Owens