D.C. readers: You're invited to Easing America's Pain, tomorrow morning at 8am.
Illustration: Aïda Amer/Axios
The Affordable Care Act was supposed to open the door to a new class of drugs that would spark competition and lower prices for some of the most expensive therapies in the world.
Why it matters: The future of drug development is hurtling toward complex, expensive biological products. If the market for cheaper versions of those treatments doesn’t get a jump-start, the health care system will see its drug spending climb to new heights.
The big picture: Some experts put a lot of the blame for biosimilars' slow start on insurers and pharmacy benefit managers.
Developing a biosimilar is difficult, time-consuming and expensive.
Doctors are generating a lot of revenue for hospitals — much more than those doctors receive in salary, according to a recent survey by physician staffing firm Merritt Hawkins.
Why it matters: It's easy to see why hospitals view acquiring physician practices as a lucrative opportunity — which hospitals are doing at a rapid pace.
Go deeper: A recent survey by the American Medical Association found that for the first time ever, the U.S. has more physicians who work as employees than those who run their own practice.
The White House is reviewing a 2020 payment rule for Medicare outpatient services, and companies that make devices for a procedure that serves as a substitute for opioids are trying to persuade Medicare to create a new payment model, Axios' Bob Herman reports.
Driving the news: Earlier this month, lobbyists with Smiths Medical and InfuSystems pushed federal officials for a new, separate medical code for "continuous peripheral nerve block," according to federal lobbying records.
The big picture: Policymakers want to find other ways to treat pain — given the destruction that addictive opioid pills has caused — and many companies sit on the other side of the table selling opioid alternatives, with the hope of getting higher government pay.
What's next? We'll see if the lobbying worked in late July, when the rule usually comes out.
Democratic House committee chairs have written new letters to White House Counsel Pat Cipollone and Attorney General Bill Barr demanding information on the administration's decisions about the latest Affordable Care Act lawsuit.
House Democrats first wrote to the administration officials in April asking for documents related to its decision. Neither the White House or the DOJ complied, and the new letters reiterate the request.
The chairs set a deadline of May 27. "If we do not receive a response by this date, we will have no choice but to consider alternative means of obtaining compliance," they write.
The stock price of Insys Therapeutics plunged 74% yesterday, below $1 a share, after the maker of opioid spray Subsys revealed it had less than $88 million in cash and may have to file for bankruptcy soon — a possibility that Insys first acknowledged in March.
The big picture: This may be the end of the road for Insys, which faces gigantic legal bills and whose founder was found guilty of a bribery scheme earlier this month, Bob writes.
Speaking of stock, Monday was a rough day for pharmaceutical companies on Wall Street. The SPDR S&P Pharmaceuticals ETF (XPH) fell more than 4%, and that was a relief, my colleague Dion Rabouin reports.
Driving the news: Generic drugmakers were hit by a price-fixing lawsuit filed by 44 states alleging 20 corporate defendants conspired to fix prices of more than 100 generic drugs, raising prices by as much as 1,000%.
Why it matters: Health care stocks overall have had a terrible 2019, and it may just be beginning.
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