Money savers won’t save much

Lawmakers have come up with all sorts of ways they say will reduce drug prices: allow importation from Canada, reducing or eliminating direct-to-consumer advertising, speeding the process for generics and biosimilars, and increasing pricing transparency, for example.

But when the Congressional Budget Office ran the numbers, it found that those ideas would have negligible impact. The only proposal that made a notable difference would be capping U.S. prices based on what other countries pay — that would result in about a 5% savings. Why so little? “[D]rugmakers could respond to the policy by delaying launches outside of the U.S. or withdrawing their products in smaller countries.”

(Price negotiations can save only 1-3% because the Inflation Reduction Act includes penalties when drug makers raise prices above the rate of inflation.)

Flu vax may be so-so this year

Based on reports from South America, this year’s flu vaccine seems to be about 34.5% effective at preventing hospitalization. That’s not great, but still better than not getting the vaccine.

(Preliminary) $2 drug list released

CMS has released the preliminary list of 101 generic drugs that will cost Medicare recipients only $2 per month. It’s a test of a program that “aims to test whether offering low-cost generics can boost seniors’ medication adherence and health outcomes, while giving them more certainty on out-of-pocket costs.”

The list covers common prescriptions like penicillin, metformin, lithium and albuterol asthma inhalers. Thirty-five of the drugs treat blood pressure and other cardiovascular conditions.

This is a ‘companion’ plan of the Biden administration that complements the $2,000 annual cap on out-of-pocket drug costs for Medicare recipients. As Axios points out, though, “A future administration could decide to change courses or halt the initiative.”

There’s a Swiss cheese joke to be made here

If you want to get a medication through the skin, the only way right now is via a microneedle patch; the epidermis is pretty good at keeping out large molecules, like a lot of drugs.

A patch is effective, but it’s limited to a small, smooth area, making it useless for conditions like psoriasis that covers a lot of skin. What you need is a mechanism as flexible as a cream, but that can send larger drug molecules though the skin.

How about a cream filled with Chinese throwing stars? That’s what researchers in Switzerland came up with. They’re three-pointed, 3D stars made of nanoceramics that, when added to a gel, roll over the skin creating “micro-wounds” that heal quickly, but not before allowing large molecules to enter. (Said one researcher, “It feels like a skin scrub.”)

Next up: making the material biodegradable (or at least disintegrable), and possibly testing it as an alternative for the needle-phobic.

Easy-to-swallow chemo?

Stanford researchers say they’ve found an “embarrassingly simple” method of turning injectable chemo drugs into pill form.

Through early trials in mice, they showed that their version of oral paclitaxel, one of the most prescribed chemotherapy drugs for many common cancers, performed better than the typical IV dose.

Honestly, the science is a bit too much to get into here, so you’ll need to read the article. Essentially, the addition of a “chemical tag” that covers the part of the drug molecule that attaches to the target. The tag only dissolves when the drug is in the right place, making the bioavailability nearly 100%.

Compounding news

Suing the FDA

A group representing outsourcing facilities — the aptly named Outsourcing Facilities Association — is suing the FDA over the agency taking Mounjaro and Zepbound out of shortage. The group points out that the FDA is basically taking Lilly’s word for the availability and should have taken public comments first, as the drugs are still hard to come by for a lot of pharmacies.

Weight Watchers hops on the bandwagon

Weight Watchers — or WW if you prefer the slimmed-down version — is offering compounded semaglutide, joining a bunch of telehealth companies that are dispensing it. WW will sell it for $129 for a month’s supply. (Novo Nordisk expects the shortage of Ozempic/Wegovy pens to last for at least several more months.)

ICYMI: BP and arm position

You probably don’t take your patients’ BP that often, but when you do — and if you counsel them on using home cuffs — be aware that arm position matters. A lot. A new study out of Johns Hopkins found that BP readings can be artificially high unless a patient’s feet are flat on the floor and the arm with the cuff is at heart level and supported (e.g., by a desk or table). No holding their arms, and no putting the arm in their laps.

Researchers found that BP measurements obtained with arm positions frequently used in clinical practice — an arm on the lap or unsupported at the side — were markedly higher than those obtained when the arm was supported on a desk.