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Amazon’s purchase of the online pharmacy PillPack answered long-lingering questions about whether and how it would enter the prescription drug business. But it also raised another big issue: What will it do about the PBMs? Pharmacy benefit managers are the companies that stand in the middle of the nation’s supply chain for prescription drugs. They administer drug benefits on behalf of employers and labor unions, and negotiate prices and reimbursements with drug makers and pharmacies that stand on either end of those transactions. In other words, they control access to the medicines and hundreds of millions of U.S. customers who take them. (Ross, 7/16)

An initiative that would have attempted to cap drug prices in South Dakota was removed from the statewide ballot by a judge on Monday, the second time that a court has prevented such a measure from going before voters in the 2018 election. The ruling came after a court determined the measure’s supporters had improperly gathered some of the signatures necessary to qualify it for the ballot, according to the initiative’s biotech-backed opposition. (Facher, 7/17)

Sen. Tammy Baldwin (D-Wis.) on Monday called on pharmaceutical giant Pfizer to “permanently roll back prices,” days after the company said it would temporarily postpone a planned price hike. In a letter to Pfizer’s CEO Ian Read, Baldwin said the company needs to stop “playing games” with the costs of prescription drugs. Pfizer instead needs to “make a firm and clear commitment” to permanent price reductions, Baldwin wrote. (Weixel, 7/16)

As a candidate and then as president, Donald Trump has had plenty to say about how drug prices are out of control and how he plans to get them down. Drug companies are “getting away with murder,” he said in January 2017, promising to save “billions” through better negotiating. On May 11, Trump called his new drug price plan “the most sweeping action in history.” And after Pfizer Inc. raised prices of many of its products this summer, he tweeted on July 9: “We will respond!” (Langreth, Koons and Gu, 7/16)

The drug manufacturing industry’s main lobbying group is backing a big change to the way prescription drugs are priced, but it’s unclear how it would impact the industry’s business model. At first glance, it looked like PhRMA is embracing one of the Trump administration’s biggest ideas for addressing prescription drug prices — eliminating rebates that drug makers pay to pharmacy benefit managers, the middlemen that negotiate drug prices on behalf of insurance companies. But in fact, PhRMA’s idea is vague enough that it’s unclear exactly what it would do and whether it will bring down the price of drugs for patients. (Swetlitz, 7/16)

Leading trade groups for brand-name and generic drugmakers endorsed overhauling the drug rebate system as a way to address the high cost of medicines, aligning themselves with HHS Secretary Alex Azar's bid to change industry practices around drug discounts. Pharmacy benefits managers, wholesalers, pharmacies and other intermediaries in the drug supply chain should not be paid based on a percentage of the list price of medicines but could instead get a flat fee, PhRMA said in comments on the Trump administration's drug pricing blueprint submitted Monday. (Karlin-Smith, 7/16)

Johnson & Johnson on Tuesday reported better-than-expected second quarter profit as sales of pharmaceuticals surged 20 percent despite a sharp decline in blockbuster arthritis drug Remicade, and its shares rose more than 4 percent. The healthcare conglomerate also expressed confidence that last week's finding by a Missouri jury that J&J's talc-based products caused cancer, and an order to pay a record $4.69 billion to defendants, would not stand. (7/17)

J&J’s pharmaceutical sales topped analysts’ expectations despite what executives said was a continued decline in average net U.S. pricing after discounts and rebates. Chief Financial Officer Joe Wolk said on a conference call with analysts that average U.S. net pricing could decline 4% to 6% this year, after a 4.6% drop last year. J&J shares surged 4% to $128.65 in midday trading after the earnings report, though the stock is still down 7.9% year to date on investors’ concerns about slower growth in other parts of J&J’s diversified business, including consumer products. (Loftus and Prang, 7/17)

Novartis says net profit rose 3 percent in the second quarter amid strong growth for some of its top products, as the Swiss pharmaceuticals giant moves to spin off its Alcon eye-care business. New CEO Vas Narasimhan touted Novartis' plans to create a "focused medicines company," including through the Alcon spinoff announced in late June. (7/18)

Novartis on Wednesday lowered its outlook for its Sandoz generics business, saying it expects a low-single digit decline in sales for the year. The company said earlier this year that the unit’s revenue would be broadly in line with the previous year or drop slightly. It raised its forecast for Alcon, saying it now expects mid-single digit growth in sales in 2018. The pharmaceutical giant earlier this year announced the purchase of rare-disease drugmaker AveXis Inc. for $8.7 billion, and Narasimhan has said he’s looking to focus Novartis’s gene-therapy program on cancer, neuroscience and ophthalmology. (Paton, 7/18)

The drug industry has officially taken center stage in an increasingly bitter Senate race in New Jersey between incumbent Bob Menendez and former Celgene CEO Bob Hugin. Last week, an ad campaign excoriated Hugin for allowing Celgene to raise prices on drugs under his leadership. Now the Republican is striking back with a pharma-focused ad of his own. (Facher, 7/16)

Martin Shkreli’s former company is losing money, watching sales of its famously costly medicine slip while considering yet another name change. Vyera Pharmaceuticals, formerly called Turing Pharmaceuticals, lost more than $1 million in the first quarter of 2018, according to financial documents obtained by STAT. Sales, driven by the $750-a-pill Daraprim, have been on the wane over the past two years, falling more than 14 percent in 2017 and on pace to drop another 7 percent in 2018. (Garde, 7/17)

Some drug companies have continued to increase prices despite growing public discontent, a move that senior equity analyst Elliot Wilbur told CNBC "makes absolutely no sense." "It’s simply bad decision-making and terrible policy on [a drug company's] part," Wilbur, who focuses on pharmaceuticals at financial firm Raymond James, said Monday on "Power Lunch." (Ell, 7/16)

Maryland government retirees will get financial assistance from the state to help pay for medications when their prescription drug coverage moves from a state plan to the federal Medicare Part D program next year. Gov. Larry Hogan and General Assembly leadership announced a one-year transition program in which the state will reimburse all out-of-pocket drug costs exceeding $1,500. That is the limit under the current state plan. The move to the federal prescription drug plan, which will take place Jan. 1, is part of state pension reform passed in 2011. (McDaniels, 7/16)

Kaiser Health News: Staggering Prices Slow Insurers’ Coverage Of CAR-T Cancer Therapy

Patients whose blood cancers have failed to respond to repeated rounds of chemotherapy may be candidates for a new type of gene therapy that could send their cancers into remission for years. But the two approved therapies, with price tags of hundreds of thousands of dollars, have roiled the insurance approval process, leading to delays and, in some cases, denials of coverage, clinicians and analysts say. (Andrews, 7/17)