President Biden announced his Build Back Better framework, which he believes is a bipartisan compromise that can be passed through both chambers of Congress.

The statement notes that the framework is the result of numerous negotiations with Democrats and Republicans. The plan is estimated to cost only half of what the Democrats initially proposed at $1.75 trillion. The framework is notably missing any mechanism for Medicare negotiation, inflation rebates, or Medicare Part D redesign, although all three have been key Democrat issues. The framework does include the full repeal of the Trump Rebate Rule which is estimated to offset $145 billion. To read the full statement, click here.

• To review some of the responses to President Biden’s reconciliation framework, including statements from Obama, Pallone, Center for Medicare Advocacy, and more, click here.

Although excluded from Biden’s framework, Democrats continue to push for aggressive drug pricing reform.

Key Democrat lawmakers, including Senate Finance Chair Wyden (D-OR), have reiterated their determination in lowering drug costs. While Sen. Wyden noted that they have already reached agreements on inflation rebates and a Part D redesign, Medicare negotiation must be included in the upcoming bill. To read the entire article, click here.

The exclusion of Medicare negotiation in the framework is being regarded as leaving the door open for future opportunities for negotiation.

Senator Kyrsten Sinema (D-AZ), one of the notable Democrat holdouts, met with President Biden ahead of the framework release and was rumored to have come to an agreement that included negotiation. A source close to both Sen. Sinema and Biden said that the deal was “consistent with the proposal authored by Congressman Scott Peters, with some edits in the insulin space to further lower costs for consumers.” While the source claimed that whether or not the deal was included in the framework would be “left with House leadership and Chairman Pallone,” House Democrats were unaware of the agreement.  To read the full article, click here.

Kaiser Health News created a database of the donations that key policymakers received from the pharmaceutical industry.

Going back as far as 2007, the data is organized by politician and breaks down the donations they’ve received in this cycle as well as total contributions. It is also organized by drug company where you can see which policymaker is receiving the most donations from each manufacturer. A KHN analysis of the data found that donations from the industry, which are historically dominated by Republicans, have been evenly dispersed across party lines throughout this cycle. To view the database and read the full analysis, click here and here, respectively.

The RAND Corporation published a report on the prescription drug supply chain stakeholders and the relationships between them.

This report follows the life cycle of a prescription drug for the typical supply chain of a retail pharmacy drug. The researchers note that stakeholders and incentives differ depending on the drug and how the patient accesses the drug, but that financial incentives still drive the supply chain and stakeholder behavior. The researchers also found that 80% of spending is on brand drugs, even though brand drugs only make up 10% of filled prescriptions. To read the full report, click here.

CIDSA Experts in the News

Ge Bai, Mariana Socal, and colleagues analyzed the association between waste-free formularies and drug spending among self-insured employers in a JAMA Research Letter. The researchers examined two large, self-insured employers’ per-member per-month spending information, net of rebates and discounts, before and after the implementation of their waste-free formularies. The most common substitutions among potentially wasteful drugs were me-too drugs (40%) and same-class drugs (29%). To read the full article, click here.