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In the category of saying the quiet parts out loud, consider this statement by Nirmal Mulye, the chief executive of drug company Nostrum Laboratories: “I think it is a moral requirement to make money when you can ... to sell the product for the highest price.” Mulye was responding to questions posed by the Financial Times about his quadrupling the price of an essential antibiotic to $2,392 per bottle. The drug, nitrofurantoin, is used to treat urinary tract infections. It has been on the market since 1953 and is listed by the World Health Organization as an essential medicine for “basic healthcare systems.” (Michael Hiltzik, 9/11)

n health care circles, 21 words have rarely caused as much speculation as “Removal of Safe Harbor Protection for Rebates to Plans or PBMs Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection,” the title of proposed regulations currently under review at the Office of Management and Budget. Much of the buzz about the document’s content has centered on Department of Health and Human Services Secretary Alex Azar’s oft-mentioned complaint that rebates for prescription drugs contribute to high drug prices. Health plans, and their intermediaries known as pharmaceutical benefit managers (PBMs), negotiate with drug companies for rebate payments in return for covering their drugs. (Ian D. Spatz, 9/7)

Recently, The Centers for Medicare & Medicaid Services (CMS) issued a guidance allowing step therapy under Part B in Medicare Advantage Plans. Step therapy, appropriately labeled “Fail First,” is an approach that too many health-care providers and companies impose on patients in an attempt to save money on costs. However, it can also be harmful to patients, potentially leading to extended periods of illness, significant unnecessary follow-up visits and time waiting for this and all too often more complicated downstream medical issues. (Salvatore Giorgianni, 9/11)

Over the next several weeks, it is anticipated that the White House will roll out its recommendations for reducing drug prices. For the millions of Americans struggling with medical costs, this proposal could determine whether or not they will be able to afford life saving drugs. The Department of Health and Human Services (HHS) is responsible for developing the administration’s drug price policy. (Daniel Stevens, 9/5)