Tiotropium Bromide

Bayer’s Nexavar and Boehringer Ingelheim’s Spiriva are among a handful of drugs with reduced US list prices for the new year, according to a Tuesday analysis that showed average prices growing at their slowest rate in years. Bayer cut the list price of its cancer drug Nexavar in half, effective Jan. 1, according to data compiled by Drug Channels Institute (DCI). The list prices for Merck’s diabetes drugs Janumet XR and Januvia were cut by 42.4%. And Boehringer reduced the list price of its asthma drug Spiriva by 36.7% and Atrovent, which is used to treat chronic obstructive pulmonary disease, by 35.0%. On average, list prices last year for brand-name drugs grew at their lowest rate in a decade, according to the analysis. In 2024, they were up 2.3%, compared with 5% between 2019 and 2024, according to Drug Channels. Most patients don’t pay list prices, which are used as a starting point for negotiations with insurers, who typically pay a far lower net price, pocketing some of the difference in the form of rebates that can be used as incentives to prefer one drug over another. Those rebates have become an increasingly powerful force in price negotiations over the years, though they have also caused significant scrutiny of the insurance and pharmacy benefit management industry. And as list prices have risen, the handful of patients who buy drugs without insurance, or who pay a percentage of the list price, have faced financial pain from that dynamic. The shift to reduced list prices may partly be drugmakers’ reaction to the Inflation Reduction Act, which for the first time allows the federal government to directly negotiate drug prices with manufacturers. The law targets drugs with high Medicare spending based on list costs. That could “encourage manufacturers to narrow large gross-to-net gaps so as to bypass a drug’s selection by CMS,” DCI president Adam Fein said in his analysis. But Fein told Endpoints News Tuesday that the IRA won’t necessarily reduce the gross-to-net price gap for drugs not part of the negotiation process. He said that the law will still “encourage Part D plans to prefer high-list, high-rebate specialty drugs, even as the government and manufacturers will prefer a low list-price version.” A Merck spokesperson said the company lowered the list prices of its diabetes drugs to “align the list price more closely to the net price.” The price decrease is “unrelated” to the Medicare drug price negotiation process, the spokesperson said. Januvia was included in a list of drugs to face negotiations last year. The Centers for Medicare & Medicaid Services is slated to announce the second round of drugs selected for negotiation by Feb. 1. A Boehringer spokesperson said list price reductions are part of its “normal business practices” and that its action reflects the company’s “ongoing commitment to patient affordability and access.” A representative for Bayer didn’t immediately respond to a request for comment. Bayer’s and Boehringer’s drugs were not included in last year’s IRA list. Editor’s note: Updates article with comment from Boehringer.

eNavvi, an online pharmacy founded by physicians, is joining forces with Mark Cuban Cost Plus Drug Company (MCCPDC) to allow physicians to prescribe medications directly via eNavvi's digital prescription pad to more than 7,000 independent pharmacies and national grocery pharmacy chains. The aim is to streamline the prescribing process, improve convenience and enhance prescription-price transparency. In 2023, the two companies collaborated to deliver prescription-cost transparency to enable eNavvi's Marketplace to provide real-time cash-price transparency directly to physicians. Now, according to the two companies, because of integration, physicians will be able to use eNavvi's platform to compare medication prices in real time and prescribe directly from eNavvi. Additionally, patients will have the option to pick up their discounted medication prescriptions from local pharmacies. Healthcare providers can sign up via eNavvi's website, where they will be able to access the enhanced prescribing platform. Following an identity-verification process, healthcare providers can prescribe directly to a broad network of retail and online pharmacies, including major grocery chains. "Our expansion into the retail pharmacy sector exemplifies our commitment to simplifying the prescribing process for physicians and patients," Simon Chang, CEO of eNavvi, said in a statement. "By expanding with Cost Plus Drugs and integrating with major grocery pharmacies, we minimize steps and enhance convenience, ultimately benefiting both providers and patients." THE LARGER TREND Earlier this week, Mark Cuban, founder of Mark Cuban Cost Plus Drug Company, told MobiHealthNews that it is vital for government officials to think about and understand the hierarchy regarding the prescription drug market and to evaluate and set laws around drug pricing. Cuban asserted that PBMs' role needed to change in order to lower prescription drug costs. Earlier this month, Avanlee Care announced that it was integrating MCCPDC's offerings into its Ava app to give affordable medications to caregivers and their families. Avanlee said it intends to improve existing eldercare technology by combining necessary tools and services in one location for unpaid family caregivers. Through the alliance, Avanlee Care's users will have access to MCCPDC's online pharmacy via the Ava app. In 2023, MCCPDC partnered with pharmaceutical company Lupin Limited and the COPD Foundation to expand access to Tiotropium Bromide Inhalation Powder for chronic obstructive pulmonary disease patients in the U.S. That same year, MCCPDC partnered with Posterity Health, a male fertility and sexual healthcare company, to provide men access to medications to treat infertility, sexual dysfunction and low testosterone. In June, eNavvi announced the launch of its revamped user interface and introduced its Rx Marketplace with integrated ePrescribe functionality. The update was designed to enhance the user experience, while making it easier for healthcare providers to prescribe medications, and for patients to access affordable cash-priced prescriptions.