An AV ​‘Crossover’ Episode

By Juliana Keeping, communications manager
 

This week, Eli Lilly announced a drop in the prices of its insulin products. A spate of headlines followed, including some flattering the company.

But this was not a charitable act.

What's Happening: Eli Lilly read the room and made a business decision driven by a combination of market pressures and a variety of policy changes. Research has shown that insulin prices have more than tripled in the last two decades. It’s also worth noting that some Lilly insulin products will not have price cuts, including a prefilled insulin pen with a $530 price tag. “Insulin makers may see the writing on the wall that high prices can’t persist forever,” Larry Levitt, executive vice president for health policy at Kaiser Family Foundation, told POLITICO. “Lilly is trying to get out ahead of the pricing pressures and criticism and look to the public like the good guy.”

Why it Matters: In the debate over drug prices, a vial of insulin is synonymous with all that is broken in the drug pricing market. A recent analysis by the RAND Corporation found that drug companies in the U.S. charge more for insulin than almost three dozen other countries examined. Arnold Ventures partnered with other philanthropies to manufacture and distribute through Civica Rx biosimilar insulin that will cost diabetes patients no more than $30 per vial and no more than $55 for a box of five pen cartridges.

Besides market disruptors like Civica, new federal reforms that cap insulin at $35 for older Americans and people with disabilities enrolled in Medicare’s prescription drug benefit (Part D) plays into the mix. Democrats have pledged to extend the cap to the commercial market, and lowering drug prices unites Americans across the political spectrum. Writ large, lower insulin prices provide a real benefit for some of the 7.4 million Americans with diabetes who need insulin daily.
 

What’s Next:  We are always glad to see patients and their families find relief from the struggle to cover prescription drug costs. And it is an honor to be involved in disruptive plays like Civica Rx’s to help people who need affordable and lifesaving medicines. But ultimately, it will take Congress to target the fundamental problems in a marketplace that is currently unfair and inefficient, and there is plenty of work yet to do.

By Thomas Hanna, communications manager

The United States is one of only two countries in the world where for-profit bail companies dominate the pretrial release process. In 2013, New Jersey embarked on a bipartisan journey to reform its bail system and move away from wealth (or lack thereof) being the determining factor in whether a person is released before trial.

What's Happening: Now, 10 years later, a newly released AV fact sheet shows that bail reform in the state has succeeded in dramatically reducing the number of people in jail while maintaining community safety. 

Why it Matters: Amid a nationwide spike in violence during and after the Covid-19 pandemic, bail reform has become a convenient and easy scapegoat for “tough on crime” policymakers and pundits. But now more than ever it is important to look at the actual evidence on bail reform and distinguish between different approaches.

Bottom Line: New Jersey is a national model because it has essentially eliminated cash bail while instituting a risk assessment approach in which judges consider community safety and other factors before deciding whether to detain or release someone before trial. 

Read the fact sheet here.

Among our numerous health care grantees and their associates working to improve health care affordability, it feels impossible to highlight just a few to keep our eyes on this year — but we did our best. Take a look at the people to watch in health care in 2023 and read more about their efforts here. 

• Dr. Reshma Ramachandran is a family physician, Yale University professor, and the FDA Task Force chair with AV grantee Doctors for America. Throughout 2022, she advocated for reforms to the FDA’s accelerated drug approval process that strikes a balance between ensuring timely access to promising treatments and certainty that these treatments truly work. She also argued that the PASTEUR Act is not the cure for antimicrobial resistance that industry-funded advocacy groups claim, but a blank check to the drug industry. With growing momentum, we’re excited to see what Ramachandran will do next to hold FDA accountable and improve the quality of medicines.
   
• U.S. Sen. Bill Cassidy (R‑LA), M.D., argued in a Modern Healthcare op-ed that the lack of aligned incentives across Medicare and Medicaid hurts patient care and results in inefficient spending. He is now leading a bipartisan group of senators to improve care and coverage for the more than 12 million people dually eligible for Medicare and Medicaid. Other senators in the coalition include Tim Scott (R‑SC); John Cornyn (R‑TX), Mark Warner (D‑VA), Tom Carper (D‑DE) and Bob Menendez (D- NJ). 
   
• Gloria Sachdev, president and CEO of the Employers’ Forum of Indiana, is on an unrelenting crusade to shine a light on excessively high provider prices with tools like Sage Transparency, which reveals hospital prices, costs, and quality for most hospitals across the country and makes one point especially clear: High and variable prices aren’t a reflection of hospital costs or quality, but are often a product of hospitals’ market power to charge high prices.
   
• Drug patent reform champions Tahir Amin and Priti Krishtel of the watchdog group Initiative for Medicines, Access & Knowledge (I‑MAK) have been relentless in their efforts to shed light on the opaque patent system, educate and engage the public on the issue, and pound the drum on the need for reform. Their work led The New York Times Editorial Board to issue a special feature highlighting I‑MAK’s rigorous research to urge Congress and the administration to save the patent system.
   
• And finally, state Medicaid officials in Colorado, Connecticut, Massachusetts, Montana, and New Mexico are changing the way our health care system pays doctors, hospitals, and other providers to promote high quality, less costly, and more equitable care that improves population health.

By Torie Ludwin, communications manager

While the news is awhirl every week about President Biden's student loan forgiveness plan, our experts in higher education have continued to point out that the system, which perpetuates unmanageable debt for a poor quality education, needs to be examined more deeply.

What's Happening: AV's higher education team and a host of grantees have recently submitted formal comments to the U.S. Department of Education on several issues that impact higher education: how the government pays for research on the programs it funds; how to address unexamined potential consequences of the proposed income-driven repayment plan; and how to identify low-financial-value schools and programs.

Why it Matters: Students deserve a quality education at a price they can afford. Holding schools accountable to provide both that education — and the support students need to complete it — is key.

What's Next: After incorporating comments and letters from Arnold Ventures and other higher education advocates and stakeholders, the Education Department will finalize its rules and move forward these policies.

Read more:

• Why Pooled Evaluation Authority in Higher Education Matters 
   
• Getting Transparency on Low-Financial-Value Programs
   
• How to Fine-Tune Provisions to the Income-Driven Repayment Regulation

• In a new report, the Data Collaborative for Justice at John Jay College, an AV grantee, reviewed pre-arrest diversion, police-involved crisis response, non-police models, and other key alternatives to arrest.
   
• Through their participation in the National Criminal Justice Reform Project, which was supported by AV, Arizona, Delaware, Oregon, and Vermont achieved durable and transformational reforms to their state justice systems. Read the new issue briefs here.
   
• Lawmakers in Illinois recently voted to abolish life sentences without parole for people younger than 21. An article in the Chicago Tribune discusses an effort to apply this law retroactively, which would give more than 500 currently incarcerated people a chance at parole.
   
• The Gothamist recently revealed that more than a quarter of people detained in New York City jails are not being transported to court on time for their hearings and trials. This may be due to understaffing at Rikers Island.
   
• The Houston Chronicle reports that Harris County is coming under scrutiny for spending $60 million to hire just 100 court-appointed attorneys last year. Despite this spending, each attorney is burdened with an extraordinarily high caseload — oftentimes many times the recommended limit.
   
• ABC News highlights the success of Omaha 360, an initiative launched by the Empowerment Network in 2009 to address gun violence and the underlying issues that contribute to it. Thomas Abt, director for the AV-supported Center for the Study and Practice of Violence Reduction, is quoted in the piece.
   
• A new report from the Prison Policy Initiative, an AV grantee, and the ACLU Campaign for Smart Justice provides insights and data into women's mass incarceration in the U.S. It shows that currently 173,000 women are locked up in the country's jails and prisons.
   
• The New Jersey Monitor reports that Gov. Phil Murphy's proposed budget suggests eliminating the regressive and inequitable fees people are charged for state public defender representation. It also includes a pay increase for private attorneys who serve as public defenders.
   
• New research from the California Policy Lab, an AV grantee, and the Benioff Homelessness and Housing Initiative at UCSF suggests that around 766 San Francisco residents with psychotic spectrum and schizophrenia disorders could be eligible for referral to the new CARE (Community Assistance, Recovery, and Empowerment) Court when the program begins.

• The passage of new laws to reduce health care costs are rarely the end of the story: Courts shape U.S. health care policy. A new tool from O'Neill Institute tracks litigation efforts on the country's most important health care cost policies.
   
• Read this first-person piece in CNN, "What I’ve learned being reliant on a caregiver," from Alice Wong, founder of the Disability Visibility Project and a disability advocate for caregivers.
   
• Top drugs from Bristol Myers Squibb, Eli Lilly, and Johnson & Johnson are among those that could face Medicare price negotiations as part of the Inflation Reduction Act, reports Fierce Pharma.

• The U.S. Department of Education announced that it will hold for-profit college owners and executives personally liable should the schools defraud students or close precipitously.
   
• In The Hill, Michelle Dimino of AV grantee Third Way reinforces the importance of accountability in the wake of the student debt cancellation debate.
   
• Third Way released the State of Higher Education Outcomes Report, which offers a snapshot of how the higher education system is faring across different performance indicators and whether schools are providing a good return on investment to both students and taxpayers.
   
• The Supreme Court heard oral arguments in two cases this week that will decide the fate of student debt cancellation, CNBC reports. President Biden’s student debt cancellation plan would cancel $10,000 in student loan debt for all borrowers making less than $125,000 and $20,000 for Pell borrowers making less than $125,000. The Department estimates that more than 40 million borrowers could qualify for the program and expects it to cost around $379 billion; however, several other estimates are higher.
   
• Forbes reports that the $6 billion settlement relief for defrauded students will move forward after a federal judge rejected a challenge on the Sweet vs. Cardona case.

• House Ways and Means Committee Chairman Jason Smith (MO) introduced a bill to incentivize states to investigate and prosecute rampant fraud in pandemic unemployment insurance programs by allowing states to keep 25% of the funds they recover for modernization of their unemployment insurance systems. 
   
• The pledge to not touch programs like Social Security and Medicare in debt limit talks pushes the burden onto programs that support children, writes Elaine Maag of AV grantee the Tax Policy Center.
   
• Ben Ritz, director of the Center for Funding America’s Future at PPI, writes in Forbes about the critical nature of judicial review of executive actions like President Biden’s push for student loan forgiveness.
   
• The Committee for a Responsible Federal Budget, an AV grantee, released an update on what cuts would be needed to balance the budget — either 27% across the board, or 78% if defense, veterans, Social Security, and Medicare spending were taken off the table — and encouraged lawmakers to set reasonable, realistic goals when working to move the country toward fiscal sustainability.
   
• “The Fiscal Ship,” an interactive game from Brookings, helps individuals understand the trade-offs lawmakers are considering when working to “right the ship” of out-of-control federal spending.

• The world needs more nuclear power, argues Jeremy Harrell of ClearPath, who says the next Congress presents opportunities to make sure America leads the way on this crucial clean energy technology.

• On the Probable Causation podcast, AV grantees Sara Heller and Max Kapustin discuss their research on the effects of the READI program on gun violence in Chicago. Learn more about the RCT they conducted in this summary from AV's Evidence-Based Policy team.
   
• On the latest Radically Pragmatic podcast from AV grantee the Progressive Policy Institute, Nick Buffie of the Center for Funding America’s Future talks about the state of the Child and Earned Income Tax Credits, along with the importance of equitable tax administration.

• The Free 2Move Coalition and BPI, an AV grantee, are holding a two-part webinar on the use — and harm — of traffic stops in Chicago and around the country. The first event, "The Problem with Traffic Stops in Chicago," will be on Tuesday, March 7, 2023. The second event, "Alternatives to the Current Traffic Safety System," will be on Tuesday, March 21, 2023. Register for one or both of the webinars here.
   
• On March 8 at 6 p.m. EDT, Impact Justice will hold a night of connection and conversation at the National Building Museum in Washington, D.C. AV Vice President of Criminal Justice Julie James will be a featured speaker at the event. RSVP here.

• Data makes the case for a work bestie.
   
• Travel around the world with the Wonders of Street View.
   
• Do you agree with this list of the best one-hit wonders of the 1990s?