Guess which one costs more. This Wall Street Journal article has been making the rounds this week. It highlights how if there are two prices for a drug, plans tend to prefer the higher cost one with higher rebates. I hesitate to call it news because it seems so obvious to those of us who work in the industry but I also appreciate that it puts the spotlight gross to net and market dynamics.

And there there were nine? Stelera might be pulled from the Inflation Reduction Act (IRA) negotiation now that a biosimilar is available.

Define patient. Late last week, U.S. District Court of South Carolina issued its opinion in Genesis Health Care Inc v. Becerra et al finding that a 340B entity can claim a patient discount on a prescription even if that script did not originate with the covered entity or provide any healthcare related to that script. This is a potentially huge expansion of the definition of patient. For now, the ruling is limited in scope to Genesis but the long-term gaming potential is priceless.

SFC TCB. This week the Senate Finance Committee unanimously passed the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act thus putting the spotlight back on pharmacy benefit management (PBM) reform. There’s also a little something in there for the gross/net Part D coinsurance basis for those of you who get into that kind of thing. Biosimilars were taken out at last minute; there was a proposal to offer biosimilars at a lower coinsurance rate in Medicare. Senator Wyden (D-OR) has said that he will work with the Congressional Budget Office to pursue this amendment.

Zepbound to be a big seller. This week the Food and Drug Administration approved Lilly’s product tirzepatide, Zepbound, for weight loss. Given the appetite for these products (sorry), uptake is likely to be immediate and significant.