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If people in this polarized nation can agree on one thing, it is that prescription drug prices are too high, and that the federal government should do something about it. But it seems unlikely that Congress or the administration will do enough this year to satisfy an enraged public. In the end, if Washington doesn’t overcome industry resistance to reform — in particular, letting the government negotiate the price of drugs purchased by Medicare — whatever actions it takes will be seen as too little, too late by American voters in 2020. (Shelley Lyford, 3/12)

To make medicines more affordable, President Trump insists that “foreign freeloading” must end. He complains that other wealthy countries often pay less for the same drugs while the U.S. is unfairly forced to shoulder higher costs of underwriting pharma R&D. So the administration is pushing a plan to cap what Medicare pays for certain medicines based on prices charged elsewhere. The idea is for Medicare to narrow that gap — and eventually lower costs by 30 percent. (Ed Silverman, 3/7)

The Food and Drug Administration’s approval Tuesday evening of Johnson & Johnson’s depression drug Spravato, a nasal spray that is a close cousin to the anaesthetic and party drug ketamine, is a big deal for patients. The depression medicines available now aren’t always effective and can take weeks to have an impact even when they are. Spravato is the first fast-acting medicine of its kind and works in an entirely different way than current options. The new drug could help people with severe depression and those who don’t respond to conventional treatment. It’s not a silver bullet: The spray has produced mixed data and has significant side effects and abuse potential, which has led to FDA restrictions on its use. Even so, it addresses a large unmet need and has life-changing potential. (Max Nisen, 3/6)

A week ago the Star Tribune featured an illuminating report concerning what the headline pointedly called “drug roulette.” The story lamented that many Minnesotans “pay the price” in various ways for dizzying shifts in the availability and cost of prescription drugs, especially insulin for diabetes. (D.J. Tice, 3/8)

What’s the smallest increment of medical innovation that is worth its cost to society? That question underpins some of the controversy surrounding drug pricing. Is it innovative to turn a twice-daily pill into a once-daily pill or an intravenously administered drug into a simpler injection, or to combine two generic drugs into a single pill? Each of these represents a patent-protected upgrade that was launched at typical branded-drug prices. (Peter Kolchinsky, 3/7)