�Թϲ�����

Every single Democratic presidential candidate agrees that the federal government should take a far more aggressive approach to lowering drug prices — including letting Medicare negotiate drug prices. But beyond that plank, there are quite a few differences between the candidates when it comes to taking on the pharmaceutical industry. To suss out exactly where they diverge, STAT questioned seven candidates during their interviews with the editorial board of the Boston Globe, STAT’s sister publication. (Joseph, 2/10)

For years, hospitals and clinics have used an injectable medicine called dehydrated alcohol to treat such maladies as chronic pain or to prevent infections in patients who must receive nutrients intravenously. Yet after a small company won a monopoly to sell its version for use with a specific heart procedure, the cost for a pack of 10 vials is about to spike from about $1,300 to nearly $10,000. (Silverman, 2/12)

While these people and many others in the health care world know what a PBM is, most people don’t have a clue. Yet PBMs, more formally known as pharmacy benefit managers, play a big role in the prescription drug coverage of tens of millions of Americans. (Miller, 2/10)

Discounts by pharmaceutical manufacturers to drug middlemen appear to be driving up list prices and ultimately some consumer costs, a new report by a team of researchers at the University of Southern California said. The phenomenon appears to be another symptom of an uncompetitive marketplace, they said. (Schladen, 2/11)

Senate Majority Leader Mitch McConnell (R-Ky.) on Tuesday said Senate Republicans have “internal divisions” on a bill to lower drug prices and that he does not know yet whether the measure will get a vote. Senate Finance Committee Chairman Chuck Grassley (R-Iowa) for months has been calling for action on his bipartisan bill to lower drug prices with Sen. Ron Wyden (D-Ore.), noting that it is also backed by the White House and could help vulnerable Republicans in their reelection campaigns. (Sullivan, 2/11)

President Donald Trump is considering executive action to cut drug prices ahead of the 2020 election, officials familiar with the matter say, as he enters his re-election seeking to rebut Democratic criticism that his policies have hurt U.S. health care. If he proceeds, Trump would force drug companies to accept lower payments from Medicare for treatments administered in doctors’ offices, such as Bristol-Myers Squibb Co.’s immune-boosting Opdivo for cancer and Regeneron Pharmaceuticals Inc.’s Eylea for eye conditions. The rule would apply to certain drugs bought by the “Part B” section of Medicare, the program for the elderly and disabled. (Wingrove and Griffin, 2/10)

Amid the issue of high prescription drug prices in the United States, “pharmaceutical tourism” is starting to become a new way out: unusual action for access to lower prescription drug prices. According to a recent report by the Kaiser Family Foundation, six in 10 Americans were taking at least one prescription drug and 79 percent of those surveyed said the cost of the medications was unreasonable. The report also found that three out of 10 Americans did not take their medications as prescribed because they're worried about the cost. (Miles, 2/10)

A quiet struggle over the skyrocketing price of insulin is turning the 2020 election into a referendum on survival for many New Hampshire families. "It is insulin or death," said Stacey Patterson of Pembroke, New Hampshire, of the 100-year-old drug. "There's no other treatment for Type 1 [diabetes]. There's nothing you can do. If it's $1,000, I'm going to pay $1,000, because I have to. There's no other choice for me." Dependence on life-saving prescription drugs, especially insulin, has dominated discussion on the campaign trail, as skyrocketing prices force families to confront political candidates over solutions. (Dwyer, Sunseri and Yoo, 2/11)

Patients in Pennsylvania facing the most serious stage of cancer will no longer be forced to try cheaper drugs before their insurance covers other, more expensive treatments. The state House on Tuesday gave final approval to a bill that would abolish the heavily criticized “fail first” approach for stage IV cancer, which requires patients to show no improvement with cheaper, insurance-approved drugs before moving on to more innovative approaches. (Fernandez, 2/5)

Pete Buttigieg has said he wants drug companies to “thrive.” Thriving under a Buttigieg administration, however, won’t be business as usual for the pharmaceutical industry. The former mayor of South Bend, Ind., has an expansive platform to lower drug prices that relies on aggressive planks including Medicare negotiation and, if need be, stripping monopolies from companies determined to have priced their drugs abusively. (Facher, 1/5)

If it works, we pay. If not, we get most — if not all — of our money back. That’s the gist of a deal the Massachusetts Medicaid program, MassHealth, has reached for one of the most expensive drugs on the market. (Bebinger, 2/7)