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While drug price growth has ebbed in recent months, the problem has led providers to battle unexpected price hikes for decades-old drugs and has cost consumers dearly at the pharmacy counter and in the form of rising insurance premiums. So what could rein in rising drug prices? Modern Healthcare sought to find out. (Kacik, 4/21)

There are a lot of legitimate ways to bring down drug costs; there are also a lot of empty gestures masquerading as real change. Here's a guide to the kinds of ideas and the odds that they'll actually happen. (4/23)

Americans spend more money on prescription drugs than anyone else in the world. CNNMoney's Christine Romans explains why spending on drugs keeps rising. (4/24)

A House Republican on Tuesday unveiled a proposal that would require hospitals participating in the 340B drug discount program to disclose how much care they provide to low-income patients. But healthcare stakeholders warn the bill could place unfair reporting burdens on providers in medically vulnerable communities. Rep. Earl "Buddy" Carter (R-Ga.) said the 340B Optimization Act would fix reporting issues with the program, claiming the current system does not provide an accurate measurement of how many low-income patients receive care at a health system's hospitals, outpatient facilities and pediatric clinics. (Johnson, 4/24)

When Martin Shkreli, former CEO of Turing Pharmaceuticals, raised the price of Daraprim, which treats dangerous infections, from $13.50 to $750, the public was appalled. But lost in the outrage over predatory pricing was one crucial fact: What Shkreli did was completely legal—and common. Between 2012 and 2017, for example, the price for Nitrostat, which prevents and treats chest pain, increased by 477 percent, from $15.91 to $91.76. Nothing about the medication changed during those years—not its chemical formula, not its uses and not the manufacturing process. Pfizer, which sells Nitrostat, offered no explanation for the spike. (Wapner, 4/24)

Drug manufacturers are pushing back against one of the administration’s major proposals to bring down drug prices: a proposal to shift chemotherapy drugs and others administered in the hospital into a different part of Medicare. The idea — which Health and Human Services Secretary Alex Azar first hinted at in his confirmation hearings and then proposed in the Trump administration’s fiscal year 2019 budget — would give insurance companies and pharmacy benefit managers new power to negotiate discounts on some of Medicare’s costliest drugs. That could mean big savings for the Medicare program itself, which might be passed on to consumers. (Mershon and Swetlitz, 4/24)

Mylan headquarters searched by law enforcement in 2016U.S. prosecutors are nearing their first charges against companies in an almost four-year-old criminal investigation into alleged price-fixing by generic-drug makers, according to people familiar with the matter. At least two companies are on track to be indicted in the coming months, in addition to several executives, said two people, who spoke on condition of anonymity because the investigation is confidential. Another company could agree to plead guilty before then, said one the people. (McLaughlin and Armstrong, 4/24)

Drug seller Aceto Corp. in Port Washington said Monday it has received a subpoena in the federal investigation of price fixing allegations in the generic drugs industry. Aceto said it “is one of many operating companies in the generic pharmaceutical industry to receive a subpoena from the Department of Justice relating to its yearslong investigation into the industry. The company is currently preparing its response to the subpoena,” it said in a securities filing. (Madore, 4/23)

They are little-known lawyers and professionals — with almost no experience in health care. And yet they are poised to play an outsized role in the federal effort to bring down high prescription drug prices. The five men and women are in line to take charge of the Federal Trade Commission — a role that will let them decide whether to investigate companies over potentially anti-competitive tactics, whether to block mergers or acquisitions, and whether to demand more information about secretive business practices. (Mershon, 4/23)

Biogen’s unexpectedly successful new rare-disease drug, Spinraza, delivered another surprise in the first quarter: flat sales. The drug, which treats spinal muscular atrophy, ran off to an impressive start last year, topping analyst estimates and beating even Biogen’s projections. But everything leveled off between the fourth quarter, when revenue hit $363 million, and the first three months of 2018, when Biogen booked $364 million in Spinraza sales. Analysts had expected first-quarter sales of about $383 million. (Garde, 4/24)

The largest U.S. manager of prescription benefits is telling drugmakers that the current pricing model is broken, and taking aim at Amgen Inc and other makers of new migraine medicines to try and fix it.Express Scripts told Reuters it is pressing them to forego the usual strategy of setting a high U.S. list price, then lowering the cost for health plans through hefty rebates. It is also seeking a refund if the drugs don't work within a defined timeframe. The shift could help Express Scripts and other pharmacy benefits managers (PBMs) bring prices down, and deflect growing criticism of their role as "middlemen" in the drug supply chain. (4/24)

In a blow to the pharmaceutical industry, the U.S. Supreme Court ruled that a controversial procedure for reviewing patent disputes does not violate the constitutional rights of patent holders. Known as inter partes reviews, these are heard before a U.S. Patent and Trademark Office appeals board, not a court, and anger drug makers because they are easier and faster to pursue than typical patent lawsuits. Drug companies have argued patents are private property that may be revoked only by a federal court and the review process violates a constitutional right to be heard by a court and jury. (Silverman, 4/24)

Japanese drugmaker Takeda has reached a tentative agreement to buy Ireland-based Shire Plc for 46 billion pounds ($64 billion) in one of the biggest pharma deals to date. Takeda has offered the equivalent of 49 pounds in cash and stock for each share of Shire, almost 25 percent more than Tuesday’s closing price. Shire said Wednesday that it is prepared to recommend the deal to shareholders, pending agreement on other terms. (4/25)

If successful, the move would cap a weekslong battle by Takeda to buy the European company and mark the largest-ever acquisition by a Japanese company of a Western rival. On Tuesday, Takeda proposed a sweetened deal to acquire Shire at £49 ($68.53) a share, its fifth attempt to buy the Dublin-based drugmaker. The new offer is marginally higher than the £47 it proposed Friday. Both companies said a revised proposal was on the table Tuesday, but didn’t disclose its financial value until Wednesday. (Rana, 4/25)

Biogen will pay Ionis Pharmaceuticals $1 billion to expand the companies' collaboration around brain drugs for another ten years. Their first collaboration, Spinraza, a treatment for a deadly rare disease called spinal muscular atrophy, generated $884 million sales last year, its first on the market. In a study of the infant form of the disease, 40% of children on the drug reached a major motor milestone, compared to none on a sham treatment. Spinraza costs $750,000 for the first year of treatment, and $350,000 thereafter. (Herper, 4/20)

Congress hasn’t done much to rein in the costs of prescription drugs, so states are taking matters into their own hands. While lawmakers have railed against pharmaceutical executives and accused them of jacking up prices, they haven’t passed major legislation on the issue. That lack of action has, in part, spurred state legislatures to consider a slew of bills aimed at decreasing the cost of drugs, increasing price transparency and cracking down on controversial industry practices. (Roubein, 4/20)

Massachusetts is, in theory, ahead of many states because doctors, hospitals and insurers are required to help patients find the price of services. But that requirement does not apply to pharmacies or prescriptions, and there's no move to amend the law. (Bebinger, 4/19)

With only two weeks left in the legislative session, a Democratic lawmaker and the state comptroller are feverishly working to bring to the House floor proposed legislation that is considered Connecticut’s most comprehensive effort so far to control high prescription drug costs. The bill aims to shine light on the murky supply chain and money flow in the prescription drug industry and to save residents money at the pharmacy counter by passing down to them some of the discounts that are negotiated with manufacturers. (Rigg, 4/25)