Recent Articles by Peter Kolchinsky and Team
The Battle for the Soul of Biopharma
Peter Kolchinsky & Luke Timmerman / The Long Run Podcast / October 28, 2020
“Public anger over drug pricing has been festering for years, with no real solution being offered by either party in Washington, DC. Peter has seen the good that industry can do with creating new medicines, as well as the misdeeds that have been committed by those in the insurance industry and in pharmaceuticals. In January, he wrote about some proposed solutions in his book, The Great American Drug Deal. It’s brilliant, unorthodox in its solutions, and easy for a layperson to read—unlike a lot of health policy books.
Peter hasn’t been content to just say his piece in a book - he’s now spearheading a nonprofit called No Patient Left Behind.”
When Raising Drug Prices Helps Patients
Chris Morrison and Peter Kolchinsky / Published in Timmerman Report / July 23, 2020
“Jaguar…couldn’t afford to continue funding production of Mytesi without raising its price. It’s too early to know whether Mytesi’s new price and access programs that this price supports will save Jaguar. But the price hike gives it a chance to ensure that it can keep supplying patients who rely on the drug.
Any legislation that caps drug price increases should carve out exceptions for the Jaguars of the world facing do-or-die situations that would leave patients in the lurch if they go out of business.”
It’s Time to Bring Generic Drug Manufacturing Back to the U.S.
Peter Kolchinsky / Published in STAT First Opinion / June 2, 2020
Repatriating the American drug supply is key not just to averting shortages but to restoring and preserving the integrity of generic drugs in America. It will also create tens of thousands of high-quality jobs in part of the U.S. that have been hurt by globalization.
Reliable, high-quality generic drugs are the great value proposition of continued biomedical innovation. They are the ultimate price control on branded drugs and a unique phenomenon in all of health care, where nothing else goes generic — not hospitals, not services, not surgery.
If Trikafta Isn’t Good Enough for ICER, What Drug Is?
Jessica Sagers / Published in Timmerman Report / May 13, 2020
“It isn’t that a drug - or a cure - can never be overpriced. That’s conceivable, especially in the absence of any competition. But ICER tries to make the point that Trikafta is overpriced while leaving a lot of math on the table that doesn’t suit its argument.
It’s worth exploring those overlooked variables and the societal norms that underlie value-based pricing analyses, which CF patients have cited in their defense of this vital medicine. It’s especially important to take this broader view considering how those norms might change following the Covid-19 pandemic. Let’s explore more accurate ways to model cost-effectiveness so that we don’t risk talking ourselves out of inventing what we really need.”
How Do You Price a Pandemic?
Peter Kolchinsky / Published in City Journal / February 24, 2020
“Some health economists, such as those at the Institute for Clinical and Economic Review (ICER), believe that they can tell us the right price to pay for each new medicine that the FDA approves. These equations compare the price of a drug with the improvements it offers in patients’ quality of life and the economic savings gained by keeping patients healthy.
What the Wuhan crisis shows, though, is that we are all patients with a common symptom—fear, which many are suffering from now over the prospect of a deadly virus, COVID-19, terrorizing communities and families. Fear comes with its own costs, as the global economy is already discovering, with travel bans and quarantines. A treatment or vaccine would ease our minds, even if most of us don’t wind up using it. How should we price the value of peace of mind? Health economists don’t know.”
Johns Hopkins Study Defies Common Sense and Simple Math
Peter Kolchinsky / Published in Inside Sources / December 9, 2019
“Johns Hopkins University just examined House Speaker Nancy Pelosi’s new drug pricing bill. The conclusion? Pharmaceutical companies are so profitable that even if they lose $1 trillion in revenue over the next 10 years due to the legislation’s impact, they’ll still be very profitable and could ‘maintain current investment’ in research and development.
If Johns Hopkins’ math checks out, the bill would deliver cheaper drugs without sacrificing future medical breakthroughs. But if it doesn’t, our children and grandchildren will lose out on dozens of new treatments we could have invented for cancer, Alzheimer’s and other diseases to help them live healthier lives than we do. So, can we trust Johns Hopkins’ conclusion? Unfortunately, we can’t. The study contains severe methodological flaws.”
Booker-Sanders-Harris Drug Affordability Bureau Could Be Brilliant
Jessica Sagers & Peter Kolchinsky / Published in STAT First Opinion / November 18, 2019
“It should go without saying that allowing the government to engage in price-setting for America’s most innovative industry would decimate the early-stage biotech ecosystem that allows us to lead the world in biomedical innovation. In an environment where 9 out of 10 drugs in development don’t make it to the market, drug developers already assume a massive amount of risk…
But Booker, Sanders, and Harris aren’t completely off-base. A Bureau of Prescription Drug Affordability and Access could be exactly what we need. Instead of outright price setting, this bureau could provide vital regulatory oversight over certain complex drugs that are so hard to make they are immune to competition and, even when their patents expire, can’t ever ‘go generic.’”
Patients Will Be The Losers As Pelosi’s Plan to Control Drug Prices Nearly Strikes Out
Peter Kolchinsky / Published in STAT First Opinion / September 23, 2019
“The math behind drug development is often twisted by pharma’s critics to suggest that there is widespread price gouging in the industry. But the drug industry’s profit margin fluctuates between 10% and 20%, less than that for the software and oil and gas industries. And after all of the rebates that are already negotiated by insurers — which should be passed onto patients but aren’t — there is little room for further cuts. Shaving even 20% off net drug prices would render the industry profitless and wipe out most executive compensation. While that might please some, a 20% discount wouldn’t make an immuno-oncology treatment affordable to a patient with poor insurance coverage.”
A Quantum of Innovation and The Incentives to Match
Peter Kolchinsky / Published in STAT First Opinion / March 7, 2019
“For anyone who thinks that limiting incremental upgrades is the key to making drugs affordable for patients, I would point out that we could cut all drug prices in half, thereby wiping out profits and decimating the drug industry, yet many Americans still wouldn’t be able to afford Medicare’s 20 percent copayments. Therefore, the key to people being able to afford what their physicians prescribe lies with comprehensive insurance coverage and capping out-of-pocket costs — that is society’s end of the biotech social contract, and the U.S. needs to do better at honoring it.”
We Need A Public Domain Day to Highlight When Drugs Go Off Patent
Peter Kolchinsky & Jessica Sagers / Published in STAT First Opinion / February 14, 2019
“The expiration of a copyright on a literary work merits a moment to admire its beauty, contemplate our gratitude to its creator, and mark the place it has held and will continue to hold in our collective human story. We should do the same when branded drugs enter the public domain. These therapies keep working just as well as before, but they become much less expensive. In the case of oral drugs, there’s an average 90 percent drop in price within a few years as multiple generics come into the market. By anticipating when a branded drug is set to enter the public domain and publicizing the date as it approaches, the public might not only show innovators that they are appreciated but also apply some healthy social pressure to let them go generic with grace, instead of tying up patent expirations in complicated legislative battles that delay the entry of generics.”