{"id":3003,"date":"2023-10-16T15:26:50","date_gmt":"2023-10-16T15:26:50","guid":{"rendered":"https:\/\/blogs.luc.edu\/ipbytes\/?p=3003"},"modified":"2025-09-09T17:51:22","modified_gmt":"2025-09-09T17:51:22","slug":"the-price-isnt-right-sen-warrens-antidote-to-costly-medicine","status":"publish","type":"post","link":"https:\/\/blogs.luc.edu\/ipbytes\/the-price-isnt-right-sen-warrens-antidote-to-costly-medicine\/","title":{"rendered":"The Price Isn&#8217;t Right: Sen. Warren&#8217;s Antidote to Costly Medicine"},"content":{"rendered":"<p>When I tell you the cost of many medications in America is prohibitively expensive, you likely aren\u2019t surprised. Access to medicine and drug costs has been a major topic of debate <a href=\"https:\/\/www.kff.org\/health-costs\/poll-finding\/public-opinion-on-prescription-drugs-and-their-prices\/\">for a long time<\/a>. Most recently, U.S. politicians and pharma industry leaders have stoked the fiery debate on healthcare costs in response to the <a href=\"https:\/\/www.nih.gov\/\">National Institute of Health\u2019s<\/a> (NIH) <a href=\"https:\/\/www.keionline.org\/wp-content\/uploads\/NIH-rejection-Xtandi-marchin-12march2023.pdf\">rejection for a petition<\/a> to grant <a href=\"https:\/\/www.upcounsel.com\/march-in-rights#:~:text=March%2Din%20rights%20are%20rights,the%20government%20deems%20it%20necessary.\">march-in rights<\/a> for a prostate cancer medication called, <a href=\"https:\/\/www.xtandi.com\/patient-resources?gclid=CjwKCAjw0ZiiBhBKEiwA4PT9z4V_kR81iMlcwSSTfXa_2CTgDLZpi4INg9UttIvadbWT8ecbRnChIxoCJz0QAvD_BwE&amp;gclsrc=aw.ds\">Xtandi<\/a>\u00ae. To learn more about march-in rights and the recent concern over the drug, Xtandi\u00ae, read <a href=\"https:\/\/blogs.luc.edu\/ipbytes\/2023\/09\/05\/high-drug-prices-meet-bayh-dole\/\">High Drug Prices: Meet Bayh-Dole<\/a>.<br \/>\n<!--more--><br \/>\nIn the wake of the NIH\u2019s rejection letter, the pharma industry issued a <a href=\"https:\/\/phrma.org\/blog\/setting-the-record-straight-on-the-bayh-dole-act-and-march-in\">statement<\/a>, allegedly \u201csetting the record straight\u201d on march-in rights. Meanwhile, worried Congress members issued a <a href=\"https:\/\/www.warren.senate.gov\/imo\/media\/doc\/2023.06.09%20Letter%20to%20DOC%20and%20HHS%20re%20Working%20Group.pdf\">letter<\/a> stating their concern for the NIH\u2019s actions (and inaction!). The spring and summer months of 2023 have seen a remarkable amount of <a href=\"https:\/\/www.hhs.gov\/about\/news\/2023\/03\/21\/hhs-doc-announce-plan-review-march-in-authority.html\">promises<\/a> to clarify march-in rights paired with <a href=\"https:\/\/ipwatchdog.com\/2023\/09\/28\/ip-vips-send-letter-congress-countering-calls-government-price-controls-drugs\/id=167370\/\">pleas<\/a> by advocates of strong IP rights to use other tools within the government\u2019s power to lower drug costs\u2014 let\u2019s hope for <em>action <\/em>on these issues this fall and winter. \u00a0\u00a0But, before we get into the details, let\u2019s start with some basics.<\/p>\n<p><strong>March-in Rights Denied<\/strong><\/p>\n<p>The NIH <a href=\"https:\/\/www.jdsupra.com\/legalnews\/nih-again-refuses-to-exercise-march-in-5137775\/\">rejected<\/a> the petition to exercise march-in rights for Xtandi\u00ae\u2019s because Xtandi\u00ae was readily available for purchase on the market. Although Xtandi\u00ae was available for purchase, its high price prohibited a large portion of the American population from purchasing the drug. The NIH\u2019s rejection letter provided little substantive reasoning for their rejection, besides noting that Xtandi\u00ae was already available on the market. <a href=\"https:\/\/www.statnews.com\/pharmalot\/2023\/01\/11\/cancer-xtandi-patent-biden-ucla-nih-hhs\/\">Consumer advocates<\/a> demanded more than the vague language, asking for clearer standards for granting march-in rights. The U.S. Department of <a href=\"https:\/\/www.hhs.gov\/\">Health and Human Services (HHS)<\/a> and <a href=\"https:\/\/www.commerce.gov\/\">Department of Commerce (DOC)<\/a> agreed to their demands and proposed to reevaluate march-in rights, and to provide a better understanding of the criteria for judging a march-in rights petition. \u00a0This agreement emerged as the <a href=\"https:\/\/www.hhs.gov\/about\/news\/2023\/03\/21\/hhs-doc-announce-plan-review-march-in-authority.html\">Interagency Working Group for Bayh-Dole<\/a>.<\/p>\n<figure id=\"attachment_3004\" aria-describedby=\"caption-attachment-3004\" style=\"width: 300px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-3004\" src=\"https:\/\/blogs.luc.edu\/ipbytes\/wp-content\/uploads\/2023\/10\/Caglar-Oskay-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\" srcset=\"https:\/\/blogs.luc.edu\/ipbytes\/wp-content\/uploads\/2023\/10\/Caglar-Oskay-300x200.jpg 300w, https:\/\/blogs.luc.edu\/ipbytes\/wp-content\/uploads\/2023\/10\/Caglar-Oskay.jpg 560w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-3004\" class=\"wp-caption-text\"><em>Photo by \u00c7aglar Oskay licensed via Unsplash.<\/em><\/figcaption><\/figure>\n<p><strong>Sen. Elizabeth Warren Diagnoses the Problem<\/strong><\/p>\n<p>Since creating the working group in March of this year, the HHS and DOC has failed to address peoples\u2019 concerns, specifically those about the issue of drug prices. In June, <a href=\"https:\/\/www.warren.senate.gov\/\">U.S. Senators Elizabeth Warren<\/a> and <a href=\"https:\/\/www.king.senate.gov\/\">Angus King<\/a> and <a href=\"https:\/\/doggett.house.gov\/\">U.S. Representative Lloyd Doggett<\/a> said enough is enough, and sent a <a href=\"https:\/\/www.warren.senate.gov\/imo\/media\/doc\/2023.06.09%20Letter%20to%20DOC%20and%20HHS%20re%20Working%20Group.pdf\">letter<\/a> to the HHS and DOC. This letter sought to remind the public that the HHS and DOC has made a hollow promise\u2013 by creating the working group, but not proving it any power to provide clarity on march-in rights.<\/p>\n<p>Most notably, Sen. Warren and her colleagues submitted their thoughts on prohibitively high drug prices by critiquing the NIH\u2019s lackluster definition of \u201creasonable terms.\u201d Remember, if a medication enters market without \u201creasonable terms\u201d the government may exercise its march-in rights.\u00a0 Sen. Warren noted that Xtandi\u00ae, although developed with taxpayer dollars, has an exponentially higher price in the United States than it does in other countries. The average price per capsule in the United States is approximately $100, while the average cost per capsule in <a href=\"https:\/\/www.pharmacychecker.com\/xtandi\/#prices\">Canada<\/a> and in <a href=\"https:\/\/www.medscape.com\/viewarticle\/988717#:~:text=In%20the%20US%2C%20the%202020,Congress%2C%20the%20Government%20Accountability%20Office.\">Europe<\/a> is around $30. If there ever was an unreasonable presence in the market requiring march-in rights, Xtandi\u00ae is it! Prohibitively high medication that costs signifcantly more to Americans than it does to patients in other countries is certainly not reasonable.<\/p>\n<p>Sen. Warren suggested a formula to determine if a drug\u2019s cost is a \u201creasonable term.\u201d The formula boils down to this: if a list price of a prescription drug is not the lowest available in any of the countries with the highest GDPs and per capita income at least half that of the US, then the price is not a \u201creasonable term.\u201d Concrete determinations on what price is reasonable will provide pharma companies with an incentive to not charge outrageous prices for their drugs.<\/p>\n<p>Sen. Warren suggested other parameters for the scope and practice of the Working Group including:<\/p>\n<ol>\n<li>Incorporating review of the paid-up licenses provisions in the Bayh-Dole Act,<\/li>\n<li>Ensuring a robust appeals process for march-in right petitioners,<\/li>\n<li>Providing a list of drugs developed with taxpayer dollars,<\/li>\n<li>Ensuring companies disclose if they received government funding for their inventions,<\/li>\n<li>Ensuring Working Group members do not have conflicts of interest,<\/li>\n<li>Ensuring the Work Group is comprised of members from various administrative agencies, and<\/li>\n<li>Ensuring that any Working Group proceedings are open to the public and not just pharma companies are their advocates.<\/li>\n<\/ol>\n<p>Whether or not HHS and DOC agree with these enumerated responsibilities for the working group, they <em>can <\/em>agree that a more unambiguous platform or set of objectives is necessary for the working group to\u2026 work.<\/p>\n<p>Sen. Warren urged HHS to follow through on their thus far empty promises. HHS claimed they would organize a workshop before the end of 2023 to define the scope, goals, and procedures of the working group. Sen. Warren proposed the working group have a workshop before September 1, 2023 and have a definitive action plan before December 31, 2023.\u00a0 September 1<sup>st<\/sup> has now passed and the HHS and DOC have yet to answer Sen. Warren\u2019s letter.<\/p>\n<p><strong>March-In Forward<\/strong><\/p>\n<p>Sen. Warren\u2019s letter set the stage for using the Bayh-Dole Act for the benefit of Americans needing affordable medicine. The future of the Bayh-Dole Act has real-world consequences and could be the difference between life or death for people experiencing poor health and poverty. As we enter the final months of 2023, I hope the NIH, HHS, and DOC acknowledge the concerns voiced by Sen. Warren and that the working group uses its resources to provide greater access to medicine for Americans. The road to greater access to affordable medicine will certainly not be an easy one, especially in light of the recent <a href=\"https:\/\/ipwatchdog.com\/2023\/09\/28\/ip-vips-send-letter-congress-countering-calls-government-price-controls-drugs\/id=167370\/\">letter<\/a> sent to Congress by IP leaders against march-in rights and another <a href=\"https:\/\/www.nytimes.com\/2018\/06\/20\/opinion\/prescription-drug-costs-naloxone-opioids.html\">provision<\/a> that others have <a href=\"https:\/\/doggett.house.gov\/sites\/evo-subsites\/doggett.house.gov\/files\/evo-media-document\/Bicameral%20Letter%20Urging%20HHS%20to%20Lower%20Drug%20Prices.pdf\">argued<\/a> the government case use to help reduce drug costs. Nevertheless, advocates like Sen. Warren remind us that affordable medicine is possible.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-2668\" src=\"https:\/\/blogs.luc.edu\/ipbytes\/wp-content\/uploads\/2023\/05\/1668101986223-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/blogs.luc.edu\/ipbytes\/wp-content\/uploads\/2023\/05\/1668101986223-300x300.jpg 300w, https:\/\/blogs.luc.edu\/ipbytes\/wp-content\/uploads\/2023\/05\/1668101986223-150x150.jpg 150w, https:\/\/blogs.luc.edu\/ipbytes\/wp-content\/uploads\/2023\/05\/1668101986223.jpg 400w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><br \/>\n<em>Bailey Hammond<\/em><br \/>\n<em>Associate Blogger<\/em><br \/>\n<em>Loyola University Chicago School of Law, J.D. 2025<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>When I tell you the cost of many medications in America is prohibitively expensive, you likely aren\u2019t surprised. Access to medicine and drug costs has been a major topic of debate for a long time. Most recently, U.S. politicians and pharma industry leaders have stoked the fiery debate on healthcare costs in response to the National Institute of Health\u2019s (NIH) rejection for a petition to &hellip; <a href=\"https:\/\/blogs.luc.edu\/ipbytes\/the-price-isnt-right-sen-warrens-antidote-to-costly-medicine\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">The Price Isn&#8217;t Right: Sen. Warren&#8217;s Antidote to Costly Medicine<\/span><\/a><\/p>\n","protected":false},"author":59,"featured_media":3005,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[428],"tags":[17,40,41,103,223,275,346],"class_list":["post-3003","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ip-health","tag-access-to-medicine","tag-bayh-dole","tag-bayh-dole-working-group","tag-featured","tag-patent","tag-senator-warren","tag-warren"],"_links":{"self":[{"href":"https:\/\/blogs.luc.edu\/ipbytes\/wp-json\/wp\/v2\/posts\/3003","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.luc.edu\/ipbytes\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.luc.edu\/ipbytes\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.luc.edu\/ipbytes\/wp-json\/wp\/v2\/users\/59"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.luc.edu\/ipbytes\/wp-json\/wp\/v2\/comments?post=3003"}],"version-history":[{"count":4,"href":"https:\/\/blogs.luc.edu\/ipbytes\/wp-json\/wp\/v2\/posts\/3003\/revisions"}],"predecessor-version":[{"id":4183,"href":"https:\/\/blogs.luc.edu\/ipbytes\/wp-json\/wp\/v2\/posts\/3003\/revisions\/4183"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.luc.edu\/ipbytes\/wp-json\/wp\/v2\/media\/3005"}],"wp:attachment":[{"href":"https:\/\/blogs.luc.edu\/ipbytes\/wp-json\/wp\/v2\/media?parent=3003"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.luc.edu\/ipbytes\/wp-json\/wp\/v2\/categories?post=3003"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.luc.edu\/ipbytes\/wp-json\/wp\/v2\/tags?post=3003"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}