• Colorado: Amgen has filed a lawsuit against Colorado's state prescription drug affordability board, arguing that the board's plan to cap the cost of the company's drug Enbrel is unconstitutional. Last month, the board determined that Enbrel, which is used to treat rheumatoid arthritis and other conditions and costs insurers an average of $46,772 per patient each year, is unaffordable. The board has started the process of creating a price cap for the drug. In its suit, Amgen argues the board's decision violates both the U.S. Constitution and federal law, and "puts in jeopardy access to Enbrel and other innovative drugs, endangering the lives and well-being of thousands of Coloradoans with serious medical conditions." (Silverman, STAT+ [subscriptions required], 3/26)
• District of Columbia:  According to a press release, HHS' list of 41 drugs capped by inflation-based rebates is expected to impact almost 750,000 people, and some could save up to $3,575 per average dose through the Medicare Prescription Drug Inflation Rebate Program. HHS Secretary Xavier Becerra said lowering prescription drug prices is a "top priority" for the Biden administration. "Thanks to President Biden's lower cost prescription drug law, the cost of prescription drugs is coming down for people with Medicare," Becerra said. "We are putting money back in the pockets of older Americans and people with disabilities instead of Big Pharma." (Tong, Fierce Healthcare, 3/26; Lagasse, Healthcare Finance, 3/26)
• Massachusetts: Optum Care* intends to purchase Steward Health Care's physician group, which spans nine states. Under the proposed deal, Optum Care would acquire all issued and outstanding Stewardship Health stock. The Health Policy Commission (HPC) will have 30 days to determine the potential impact of the deal. Both companies said in filings they expect the transaction to occur in the second quarter of this year. "This is a significant proposed change involving two large medical providers, both in Massachusetts and nationally, with important implications for the delivery and cost of health care across Massachusetts," said David Seltz, HPC's executive director. "Details of the proposal will be reviewed by the HPC to examine potential impacts on health care costs, quality, access and equity." (Kacik, Modern Healthcare, 3/26)

(*Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent.)

The pharmaceutical market is experiencing significant shifts, and you need to be prepared. Explore the major trends shaping the industry, including the rise of high-cost drugs and the impact of changing policies, and find out what they mean for your organization.