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The pharmaceutical industry, pilloried by President Trump for the last two years, is war-gaming for the possibility that its worst fear is realized: that Democrats, if they flip control of the House, find common ground with the president to rein in drug prices. Democrats say they are determined to squeeze the industry’s prices and profits, and they have a stack of legislative proposals that could do so. Drug makers are quietly making contingency plans. (Pear, 10/20)

Washington law firms are preparing for a boom in business from a projected Democratic takeover of the House in 2019, anticipating that pharmaceutical, tech, and oil and gas companies will need help navigating a flurry of oversight investigations. Law firms that specialize in helping businesses manage congressional investigations, including Covington & Burling and Akin Gump, have been tracking Democrats’ criticisms of a host of corporations all year. (Levine, 10/22)

What would you say if a cancer patient could be given a lower dose of a pricey treatment that was not only equally effective, but could also save a bundle of money? That’s the proposition being advanced by some leading oncologists, who are promoting what they call value-based prescribing, which involves giving patients fewer or less frequent doses. The notion is being increasingly talked up as concerns mount over the rising cost of medicines and, consequently, the so-called financial toxicity that more patients are said to be experiencing. (Silverman, 10/23)

PhRMA has already spent $21 million on lobbying this year — a sum that puts it on course to smash its previous annual lobbying records. The group, which represents dozens of major drug makers, spent nearly $6 million on advocacy in the third quarter of this year, according to lobbying disclosures released Monday, about $400,000 more than it spent in the same period last year. After an unprecedented first half of 2018, that total puts it just $4 million shy of a new record annual spend —and it hasn’t spent less than $4 million in a quarter since 2015. (Florko, 10/23)

Regulators had something of an atypical message for the new nonprofit drug company backed by a host of the nation’s top hospitals: “What can we do to help?” One of the executives behind the new drug maker, Civica Rx, told STAT he’d set up a Capitol Hill briefing after he fielded calls from roughly two dozen senators, all wanting to hear from the company about its plans. A meeting with the Food and Drug Administration also went far more smoothly than some industry tussles with their regulator. (Florko, 10/23)

For Bridgett Snelten, changing her health insurance meant enduring wild blood sugar swings, bouts of vomiting and weight gain. The Sandy, Utah mother of two young girls has diabetes and has had to change health insurance plans three years in a row. Twice, new insurers wouldn't cover Trulicity, a once-a-week injected diabetes medicine she'd been taking that helped control her blood sugar tightly. Instead, they made her return to an inexpensive, twice-a-day injected diabetes drug she and her doctor knew didn't work for her. (10/17)

Billionaire John D. Arnold is spending a chunk of his fortune to campaign against America’s high drug prices. The drug industry is spending a chunk of its fortune to counter him. Mr. Arnold is the biggest single spender on his side of the battle. He made his money placing bets on price swings in the natural-gas market, first as an energy trader at Enron, then at his own hedge fund after Enron’s collapse. Now retired, the 44-year-old Texan with an estimated $3.3 billion in assets is dedicating himself to the topic of the U.S.’s ballooning health care costs. (Loftus, 10/21)

Last week, the Trump administration put it in writing: Under a proposal published in the Federal Register, drugmakers will have to put list prices in their TV ads. So what's next for pharma? Here's what to keep an eye on. First, the basics: The Trump administration's proposal in the Federal Register formalized HHS Secretary Alex Azar's comments last week. Specifically, the Centers for Medicare and Medicaid Services is seeking to amend Medicare and Medicaid programs to require direct-to-consumer television advertisements to include a list price for any covered drugs that cost more than $35. (Bulik, 10/22)

Pfizer Inc. and private-equity firm Bain Capital LP on Tuesday said they have formed a company to develop drugs for disorders of the central nervous system. Pfizer, which earlier this year said it would stop trying to discover new drugs for central nervous system disorders such as Alzheimer’s disease and Parkinson’s disease, said it is contributing a portfolio of pre-commercial neuroscience assets to the new company, called Cerevel Therapeutics LLC. (Kellaher, 10/23)

Roche's entrectinib cancer pill was shown to shrink tumours in 57 percent of patients within a group that can only be identified via genetic profiling, as the Swiss drugmaker challenges an alliance of Bayer and Loxo Oncology in a new targeted treatment area. The trial results on patients with a gene anomaly known as NTRK fusion, which occurs in less than 1 percent across a range of tumour types, were presented at the annual congress of the European Society for Medical Oncology (ESMO) in Munich on Sunday. (10/21)