Storylines last week focused on drama, mystery, and intrigue. Our top case revolves around the case of the missing healthcare bill. Following President Trump’s address that focused heavily on overhauling healthcare, the GOP promised to unveil its replacement to the Affordable Care Act. However, the bill was apparently hidden in the basement of Congress, leaving a number of lawmakers wandering the halls looking for the “missing” legislation. While final legislation has yet to be unveiled, Speaker Ryan had said that it is modeled off of legislation previously proposed by current HHS Secretary Tom Price…
Other enigmas of the week include Oscar mix-ups, co-pay assistance probes, and questions around who funds patient advocacy groups. Read on for The Week That Was, Nancy Drew and the Hardy Boys’ style.
PWC & THE CASE OF THE MIXED UP ENVELOPES
Following 83 years of managing the secret ballot process, PwC was forced into crisis-response mode after a PwC employee mixed up “Best Actress” and “Best Picture” envelopes, giving Faye Dunaway and Warren Beatty the wrong script at the Oscars. Within three hours of the incident, PwC released a statement apologizing and noting its intent to investigate the matter. By Monday, hashtags related to the incident, #envelopegate and #Oscarfail, were trending on Twitter. In fact, the WSJ reported that social media may have been to blame for the snafu, as the PwC employee in question tweeted a photo of Emma Stone around the time of the incident. PwC’s US Chair swiftly responded, emailing all employees and speaking to several major media outlets the following day. Despite the apologies, the controversy continued as personal details about the specific employees were leaked online. Although PwC initially distanced itself from the employees, the firm has since provided security and confirmed that the accountants will remain employed (although they won’t be back on the red carpet next year).
After eight decades of flawless accounting, it would have been easy for PwC’s corporate team to get caught off-guard by this year’s Oscar drama. However, PwC’s willingness to take responsibility for the incident, apologize to all of those involved, and protect their employees for making a “human error,” was an award-winning crisis response. While the final outcome of the matter remains to be seen, the worst of the media coverage seems to be over, proving that being proactive and not hiding from tough issues goes a long way to quell media probes and accusations.
SUBPOENAS & SENIORS: AG LOOKS FOR COPAY CLUES
Pfizer is the latest drug maker to receive a subpoena related to its relationship with the Patient Access Network Foundation and several other non-profits that provide financial assistance to Medicare patients. Pfizer joins Gilead, Biogen, Celgene, and Regeneron, among other pharmacos, in an investigation conducted by the U.S. Attorney’s Office for the District of Massachusetts, which has been seeking documents related to manufacturer donations to these charities since December 2015. With the heightened focus on drug prices, the altruism of patient assistance programs has come into question by both policymakers and the media, which have painted PAPs as marketing tactics to either mask the cost of expensive drugs to commercially insured patients – or to use charities to subsidize the cost of medicines for government insured patients who cannot accept financial support from pharmacos.
Drug pricing is complicated enough and when the inner-workings of a financial assistance program are opaque, programs that used to bring goodwill are drawing even more scrutiny to beleaguered drug makers. It’s unlikely that the government, policymakers, and vocal advocates will take their focus off patient assistance programs anytime soon. We advise our clients to create transparency around these complicated programs: be clear about the details of assistance programs, and, when possible, disclose relationships and donations to these groups. Making facts publicly available eliminates the need for investigations and subpoenas. Read best practices published by our team in Pharmaceutical Compliance Monitor.
PATIENT ADVOCATES & THE HUNT FOR THE ‘HIDDEN’ DONATIONS
A new study from the New England Journal of Medicine raises concerns about the relationships between patient advocacy groups and their donors. The study surveyed 104 of the largest U.S.-based patient advocacy groups and concluded that 83% of the groups accept funding from drug, medical device and biotech companies. Of the groups surveyed, about a fifth of them accept over a million dollars in industry donations and roughly 39% of the groups have current or former pharmaceutical executives on their boards. The study, which relied on advocacy groups’ websites and annual reports, found only one group stating it did not accept industry money.
The goal of these advocacy groups is to give a voice to patients, but as the study’s primary author, Matthew McCoy, noted, “The ‘patient’ voice is speaking with a pharma accent.” In conversation, many professional advocacy groups will say they commonly find themselves in a bind to secure needed financial resources to advance their missions while preserving their credibility and independence. Not an easy line to walk. However, the deeper concerns raised by this report are a lack of transparency, with 13 advocacy groups failing to report on their donors at all. For pharma, however, transparency is the watchword these days. Companies that report their donations and communicate openly about these relationships might at least avoid a public shaming.
THE MYSTERIES OF MEDICAL TOURISM: CURE HEP C FOR $6K
Tour n’ Cure allows guests to see the Great Pyramids, visit the Sphinx … and save nearly $80,000 on Hepatitis C treatments. The program, created by Egyptian drug maker Pharco, treated nearly one million patients in Egypt in 2016—for a fraction of the cost patients would have paid at home. While the U.S. list price for Sovaldi is $84,000 for a 12-week course of treatment and Harvoni’s list price is $94,500, this program provides an Egyptian vacation plus a regimen of Hepatitis C pills for about $6,000. Participating patients get a weeklong stay in Egypt, complete with three full days of sightseeing to pass the time between blood tests required to get their prescriptions to take home. The program is touted by world-renowned soccer player Lionel Messi and it includes a partnership via EgyptAir for discounted travel. The promotional support highlights countless physician and patient testimonials, as well as plugs for Egyptian historical sites, and lots of patient-friendly content. Talk about a combo deal for Pharco and Egypt’s tourism industry! According to Tour n’ Cure’s managing director, Pharco is “trying to cure the whole world so there’s no more hepatitis C” and HCV patients can now “feel as good as new within months.”
Let’s face it: this is a great PR campaign. But a price tag of $6,000 isn’t exactly affordable for most of the world’s patients. And global biopharmas aren’t exactly thrilled either. Patients who come home with a bag of pills may not get the follow-up care they need, or worse—may not be able to afford care on their home turf. Plus, there are potential safety concerns. While Pharco’s treatment, a combination of sofosbuvir+ravidasvir, has been approved in Egypt, that doesn’t mean the U.S. FDA would render the same opinion. It’s also unclear whether US insurance companies will cover any medical care prompted by this very out-of-network therapy. Medical tourism is tricky business, but for desperate patients, the program has proven allure.
Until next week,
– The Issues Management Practice @inVentiv Health PR