Special Report: Big Pharma wages stealth war on drug price watchdog BY Reuters— 7:04 AM ET 09/11/2020 By Caroline Humer

These are the very powerful Pharma companies that POTUS is up against

(Reuters) - As evidence grew this spring that the drug remdesivir was helping COVID-19 patients, some Wall Street investors bet on analysts’ estimates that its maker,Gilead Sciences Inc ( GILD), could charge up to $10,000 for the treatment.

Then a small but increasingly influential drug-pricing research organization, the Institute for Clinical and Economic Review (ICER), said the treatment only justified a price between $2,800 and $5,000. Shortly after, Gilead announced it would charge about $3,100 for a five-day treatment and $5,700 for ten days - in line with the ICER recommendation.The episode illustrates the growing power of the Boston-based nonprofit to hold down U.S. drug prices. Over the past five years, ICER has pressured drug makers to lower the cost of nearly 100 drugs. It aims to play a similar role with emerging COVID-19 treatments and vaccines. Health insurers increasingly use ICER's fair-value analyses to limit access to expensive drugs or to negotiate steeper discounts with drug makers.

The industry has moved aggressively to combat the threat to its profits in two ways: With open criticism of ICER's formula and with a stealthier campaign to undermine its credibility through proxies, including veterans' groups and organizations that claim to advocate for patients but have ties to the pharmaceutical industry, Reuters found in a review of industry connections and funding among groups targeting ICER.

Two such groups – thePartnership to Improve Patient Care (PIPC) and Value our Health– are led by employees of Thorn Run Partners, a Washington-based lobbying and public relations firm that counts nearly a dozen drugmakers as clients. PIPC denied it is part of a larger industry-financed proxy campaign to undermine ICER's impact. Thorn Run declined to comment, and Value Our Health did not respond to inquiries.

As remdesivir gained momentum, PIPC complained to ICER in a June letter that its methodology, which examines how a drug improves patient quality of life, was unfair for COVID-19 drugs. It also held a webinar for patients criticizing ICER’s methods.

The group’s chairman, former U.S. Democratic Representative Tony Coelho, argued in the letter that ICER’s methods yield a flawed value assessment for COVID-19 drugs that could lead insurers or government programs to limit coverage to the elderly and people with disabilities because ICER’s formula attributes a lower value to their medicines than those for healthier patients. In a statement to Reuters, Coelho attacked ICER’s formula as a flawed “one-size-fits-all assessment.”

Gilead also pushed ICER for a higher price during its remdesivir review. The firm told Reuters that ICER’s assessment failed to consider savings from shorter hospital stays and underestimated how much insurers or the government would be willing to pay. Remdesivir is the only COVID-19 treatment ICER has assessed so far. Steven Pearson, a Harvard academic who started ICER, said it will likely review more coronavirus treatments if they make it to market, including potentially those being developed by Regeneron and Eli Lilly and Co ( LLY) that use antibodies to generate an immune response. The two companies declined to comment.

ICER’s assessments are not used to deny care to patients based on their health, Pearson said.Rather, the formula helps insurers or government programs choose the most cost-effective treatment for a specific condition, based on its price and benefit in providing a better quality of life. Pearson pointed out that the formula has long been used in the health systems of countries including England, Canada, the Netherlands and Sweden. “We don’t think of them as hotbeds of discrimination against sick people,” he said, “and neither are we.”

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