Suited up: The Department of Justice responded to Merck’s Medicare negotiation suit. It leaned into the argument that this is a negotiation. “Manufacturers that do not wish to make their drugs available at negotiated prices can avoid doing so by forgoing sales of the relevant drugs to Medicare beneficiaries— including by withdrawing from the Medicare and Medicaid markets or by divesting their interests in the relevant drugs before 2026, when the negotiated prices would first take effect.”

Huh. It would kind of make sense if it was about not selling that one drug to Medicare and Medicaid but it is all drugs from that manufacturer that must be pulled. I am not a lawyer but it doesn’t feel like a negotiation if walking away from the negotiating table means that your entire company would likely go under.

They have to show up: In last week’s Fact Sheet on Medicare Negotiation, the Centers for Medicare & Medicaid Services emphasized that negotiation is voluntary for pharmaceutical manufacturers. Keeping the party line. The fact sheet also talked about factors considered in negotiation. I’m keeping an eye on therapeutic alternatives. It seems like such a slippery slope. When we compare A/B generics, sure – that’s fair. Therapeutic alternatives? Not always as clear cut. Presumably you compare Eliquis and Warfarin. Pretty big differences between them. How do you value these differences? What weight do you put on each?

Pay up: That email you send your doctor… it may cost you.I can’t say I disagree with the practice of charging patients for answering emails. It is using their professional opinion and takes time. I think my surprise is that it has taken this long.

Stuffed up: So when I said that I didn’t feel like these medicines work and I was told I was being a PITA (by my husband), guess who got the last laugh. It wasn’t OTC manufacturers using phenylephrine. 

Bottoms up: Not health-related but made me pause. Surge pricing on beer in UK.