開始する，打ち上げる of arthritis 麻薬 biosimilars ramps up US 圧力 on pricing 'middlemen'
By Patrick Wingrove
July 25 (Reuters) - Cheaper 見解／翻訳／版s of one of the most 高くつく／犠牲の大きい and 広範囲にわたって used arthritis 治療s in the U.S. are likely to 燃料 その上の scrutiny of the middlemen that 交渉する 麻薬 prices for most insured Americans from 国会議員s and the 連邦の 政府, によれば healthcare 専門家s.
Seven drugmakers this month 開始する，打ち上げるd their own 見解／翻訳／版s, known as biosimilars, of AbbVie's 旗艦 arthritis 麻薬 Humira, once the world's 最高の，を越す-selling prescription 薬／医学. Three have kept their 名簿（に載せる）／表（にあげる） price within 5%-7% of AbbVie's, two 定価つきの at an 85% 割引 and two have 申し込む／申し出d both types of prices.
Once several competing 見解／翻訳／版s of a 麻薬 become 利用できる prices tend to 急落する, although いっそう少なく so with コンビナート／複合体 biotech 麻薬s like Humira. 伝統的な generic pills that are exact copies and easily produced can quickly 減少（する） prices by 90% or more. Other biosimilars have had price 削減（する）s of around 50% on 開始する，打ち上げる, によれば data from the 協会 for Accessible 薬／医学s 貿易（する） group.
"That 名簿（に載せる）／表（にあげる） prices of Humira and its biosimilars remain high even with 強健な 競争 should 燃料 calls to 改革（する） our Byzantine, dysfunctional 製薬の 供給（する） chain," said Ameet Sarpatwari, a professor and 麻薬 pricing 当局 at Harvard 医療の School.
For insured 患者s who are often on the hook for co-支払う／賃金s of 10% to 25% of the 名簿（に載せる）／表（にあげる） price, the 貯金 have been 極小の.
The Biden 行政 has made lowering 麻薬 prices a 優先. It passed the first U.S. 麻薬 pricing 法律制定 ever in the インフレーション 削減 行為／法令／行動する last year, and has since turned its sights on these middlemen, known as pharmacy 利益 経営者／支配人s (PBMs).
国会議員s and the 連邦の 貿易（する） （売買）手数料，委託（する）／委員会／権限 (（日）公正取引委員会（米）連邦取引委員会) have been investigatin g the 役割 of PBMs in rising healthcare costs. Several 法案s are in the 作品 that would 要求する them to make their 商売／仕事 取引 public, 含むing the 料金s they earn on 処理／取引s.
The （日）公正取引委員会（米）連邦取引委員会 last week withdrew past 声明s 示唆するing that 軍隊ing PBMs to 公表する／暴露する their 取引 would 土台を崩す their ability to lower healthcare costs, 追加するing that the 産業 has changed since then.
The three biggest PBMs, CVS Health's Caremark, Cigna Group's 表明する Scripts, and UnitedHealth Group's Optum RX, 拒絶する／低下するd to comment.
PBMs say they play an important 役割 in 持つ／拘留するing 負かす／撃墜する 麻薬 costs for their （弁護士の）依頼人s, 含むing 雇用者s and health 保険 計画（する）s, and that most after-market 割引s go to their 顧客s.
'AN OPAQUE OPERATION'
Amgen called attention to the middlemen when it 開始する，打ち上げるd Amjevita, the first 認可するd 近づく copy of Humira, in January. It 始める，決める two prices for its 見解／翻訳／版, 説 PBMs prefer a higher 名簿（に載せる）／表（にあげる） price from which they 獲得する after-market 割引s. In return, 麻薬s receive a low co-支払う／賃金 or other より望ましい ニュース報道 条件.
Amgen 申し込む／申し出d 5% and 55% 割引s to AbbVie's $6,922 per month Humira price tag, and both were 含むd on 麻薬 ニュース報道 名簿（に載せる）／表（にあげる）s at two large PBMs.
In the その後の nearly three months, only 9% of all 患者s that used the 麻薬 had gotten the lower 定価つきの 見解／翻訳／版, によれば 産業 貿易（する） group Biosimilars 会議.
Healthcare 専門家s say that 傾向 could continue even though 表明する Scripts and Optum RX 追加するd both the high- and low-定価つきの biosimilars from Novartis' Sandoz 部隊 to their ニュース報道 this month. It also could take years for 現在の 提案s to result in meaningful 貯金 for 消費者s, 専門家s on the U.S. healthcare system say. 厳格な人 支配するs on how these companies can operate, 含むing restricti ons on how they 決定する 告発（する），告訴（する）／料金s and a possible reimagining of their 商売／仕事 model, would help, they said.
法律 professor コマドリ Feldman from University California College of the 法律, San Francisco, said some 法律を制定する 提案s, like one from Democratic 上院議員 Ron Wyden on how PBMs 決定する their 料金s, could make a dent 供給するd they stop the companies from making up lost 歳入 どこかよそで.
The U.S. 政府 spent about $9 billion on Humira in 2021.
"The basic challenge here is PBMs made a lot of sense 30 years ago," Wyden said. He told Reuters this month that PBMs should 解放（する） more 詳細（に述べる）d （警察などへの）密告，告訴（状） about how they operate.
A bipartisan 法案 in the 作品 led by 共和国の／共和党の 上院議員 Chuck Grassley would 要求する PBMs to 報告（する）／憶測 to the （日）公正取引委員会（米）連邦取引委員会 支払い（額）s received from health 計画（する）s and 料金s 告発（する），告訴（する）／料金d to pharmacies.
Earlier this month, Grassley told Reuters the PBM system was "an opaque 操作／手術. Transparency brings accountability, and there´s no accountability."
"Who gets the 利益 of the rebates?" he asked. "In most 事例／患者s you´ll find out that 地元の pharmacists and 消費者s don´t 利益 much from it."
(報告（する）／憶測ing by Patrick Wingrove in New York; 付加 報告（する）／憶測ing by Moira Warburton and Josephine Walker in Washington; Editing by Caroline Humer and 法案 Berkrot)
