Drugmakers aim big price hikes at US patients

Drugmakers have targeted the U.S. market to earn outsized profits from old medicines, according to a report released on Friday by the House Oversight Committee that highlighted Eli Lilly and Co, Novo Nordisk and Sanofi, which dominate the market for insulin.

The staff report also noted pricing and marketing tactics by Pfizer Inc that helped it earn billions of dollars from its now off-patent pain drug Lyrica.

The report, put out following a nearly three-year probe, took issue with assertions by the pharmaceutical industry that high drug prices were needed to fund innovation and research and development programs.

"The Committee's investigation also found that companies dedicated a significant portion of their R&D expenditures to research that was intended to extend market monopolies, support the companies' marketing strategies, and suppress competition," the report said.

The report, which focused on 12 drugs made by 10 companies, said that Lilly, Novo Nordisk and Sanofi own some 90 per cent of the market for life-sustaining insulin, which was invented in the 1920s.

A Lilly spokesperson said the company offers discounts to make its insulin affordable. A Sanofi spokesperson said the price of its insulin product Lantus had declined almost 45 per cent since 2012. A Novo Nordisk spokesperson said the report reflected a limited picture of the company's efforts to make drugs accessible.

Medicare, the U.S. government health insurance program for those age 65 and older and the disabled, could have saved more than $16.7 billion from 2011 to 2017 on insulin purchases had it been allowed to negotiate discounts with drug companies, the report found.

"We found that drug companies target American patients for price increases, in large part because Medicare is prohibited from negotiating for lower prices. At the same time, the drug companies maintained or cut prices for the rest of the world," Committee Chairwoman Carolyn Maloney said at a news conference on Friday.

The high prices have had human costs. More than 40 per cent of insulin-dependent patients surveyed said they rationed their medicine in the previous year, the Colorado attorney general's office found in a 2020 report.

President Joe Biden's Build Back Better plan, which passed the House and should come before the Senate this year, includes a provision allowing Medicare to negotiate with drugmakers, although only for a small number of medicines.

The report also found that some pharmaceutical companies engage in what it called "product hopping," a practice of making small tweaks to formulations to get a new patent and then switching patients to the newer, more expensive version. There are bills before Congress to ban product hopping.

Among big-selling insulin products, Eli Lilly raised the price of its Humalog 1,219 per cent per vial since it launched, Novo Nordisk raised the price of NovoLog 627 per cent since launch and Sanofi has raised the price of Lantus 715 per cent, the report found.

The report also found that Pfizer targeted the U.S. market for higher prices for its blockbuster Lyrica, as well as using product hopping to prevent patients from shifting to cheaper, generic versions of the medicine.

Lyrica's price had gone up 420 per cent since it was approved in 2004, the report said. It had sales of about $2 billion in 2019.

Pfizer did not have an immediate comment.

The report also listed price hikes of 825 per cent for Teva Pharmaceutical Industries' Copaxone, 486 per cent for Amgen's Enbrel, 395 per cent for Novartis' decades-old Gleevec, more than 100,000 per cent for Mallinckrodt's Acthar, 471 per cent for AbbVie's Humira and 82 per cent for its Imbruvica, and 255 per cent for Celgene's Revlimid, now owned by Bristol Myers Squibb.

Most of the drugs mentioned in the report are over a decade old.

Novartis said it invested over 18 per cent of its global revenue into R&D. Mallinckrodt and Bristol Myers did not have an immediate comment. Amgen, AbbVie, and Teva did not respond to requests for comment.