Tag Archives: Drug Price Transparency

Healthcare’s vertical mergers kick-started a massive industry shift in 2018. Will it pay off?

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Mergers and acquisitions deals consolidation

Two massive megamergers in CVS-Aetna and Cigna-Express Scripts dominated the conversation around mergers and acquisitions in healthcare.

Whether you think the mergers will help or hurt consumers, both deals have sparked a distinct shift across the industry as competitors search for ways to keep pace. It also frames 2019 as the year in which five big vertically integrated insurers in CVS, UnitedHealth, Cigna, Anthem and Humana begin to take shape.

Combined, the mergers totaled nearly $140 billion.

Both CVS and Cigna closed their transactions in the fourth quarter with promises that their new combined companies would “transform” the industry. Unquestionably, it’s already triggered some response from other players. Whether those companies can make good on their promises to improve care for consumers remains to be seen, and the payoff may not come for several years, as 2019 is likely to be a year of initial integration.

While CVS and Cigna hogged most of the spotlight, several other notable transactions across the payer sector could have smaller but similarly important consequences going forward.

WellCare acquires Meridian Health Plans for $2.5B

In May, WellCare picked up Illinois-based Meridian Health Plans for $2.5 billion, acquiring a company with an established Medicaid footprint with 1.1 million members. The deal boosted WellCare’s membership by 26%.

But the transaction also thrust WellCare back onto the ACA exchanges. Meridian has 6,000 marketplace members in Michigan.

Importantly, the acquisition gave WellCare a new pharmacy benefit manager in Meridian Rx. CEO Kenneth Burdick said it would provide “additional insight into changing pharmacy costs and improving quality through the integration of pharmacy and medical care.”

WellCare also makes out on CVS-Aetna transaction

WellCare was also a beneficiary of the CVS-Aetna deal after the Department of Justice required Aetna to sell off its Part D business in order to complete its merger.

The deal adds 2.2 million Part D members to WellCare, tripling its existing footprint of 1.1 million.

Humana goes after post-acute care

2018 was the year of post-acute care acquisitions for Humana. The insurer partnered with two private equity firms to buy Kindred Healthcare for $4.1 billion in a deal that was first announced last year. It used a similar purchase arrangement to invest in hospice provider Curo Health Service in a $1.4 billion deal.

Both acquisitions give Humana equity stake in the companies, with room to make further investments down the road. Kindred, in particular, is expected to further Humana’s focus on data analytics, digital tools and information sharing and improve the continuity of care for patients even after they leave the hospital.

Not to be outdone, rival Anthem also closed its purchase of Aspire Health, one of the country’s largest community-based palliative care providers.

UnitedHealth keeps quietly buying up providers, pharmacies

With ample reserves, UnitedHealth is always in the mix when it comes to acquisitions. This year was no different. The insurance giant snapped up several provider organizations to add to its OptumHealth arm. In June, it was one of two buyers of hospital staffing company Sound Inpatient Physicians Holdings for $2.2 billion. It also bought out Seattle-based Polyclinic for an undisclosed sum. The physician practice has remained staunchly independent for more than a century.

Most notably, UnitedHealth is still in the process of closing its acquisition of DaVita Medical Group. DaVita recently dropped the price of that deal from $4.9 billion to $4.3 billion in an effort to speed up Federal Trade Commission approval.

The Minnesota-based insurer is also clearly interested in specialty pharmacies to supplement its PBM OptumRx. UnitedHealth bought Genoa Healthcare in September, adding 435 new pharmacies under its umbrella. Shortly after, it bought up Avella Specialty Pharmacy, a specialty pharmacy that also offers telepsychiatry services and medication management for behavioral health patients.

Centene invests in a tech-forward PBM

Perhaps in an effort to keep pace with Cigna and CVS, Centene has made smaller scale moves in the PBM space, investing in RxAdvance, a PBM launched by former Apple CEO John Sculley. Following an initial investment in March, Centene sunk another $50 million into the company in October and then announced plans to roll the solution out nationally. Notably, CEO Michael Neidorff has said he is pushing the PBM to move away from rebates and toward a model that relies on net pricing.

“You talk about ultimate transparency—that gets us there,” he said recently.

 

 

 

Californians will get more information on what’s driving prescription drug prices under law signed by governor

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http://www.latimes.com/politics/la-pol-ca-prescription-drug-price-disclosure-20171009-story.html

Image result for Californians will get more information on what’s driving prescription drug prices under law signed by governor

Gov. Jerry Brown approved a measure Monday to increase disclosure on prescription drug prices, the focal point of growing efforts to clamp down on climbing pharmaceutical costs.

Supporters call the law the nation’s most sweeping effort to make prescription drug pricing more transparent. The measure would require drugmakers to provide notice to health plans and other purchasers 60 days in advance of a planned price hike if the increase exceeds certain thresholds.

The measure, SB 17 by state Sen. Ed Hernandez (D-Azusa), will also require health plans to submit an annual report to the state that details the most frequently prescribed drugs, those that are most expensive and those that have been subject to the greatest year-to-year price increase.

”The essence of this bill is pretty simple,” Brown said at a Capitol signing ceremony. “Californians have a right to know why their medical costs are out of control, especially when pharmaceutical profits are soaring.”

The disclosure, backers say, would help shed light on how prescription drugs are contributing to overall healthcare costs.

“SB 17 speaks to the needs of all Californians who have felt the strain of nonstop prescription drug price increases,” Charles Bacchi, president and chief executive of the California Assn. of Health Plans, said in a statement. “Pharmaceutical prices have long played an outsized role in driving up the cost of health coverage across the board. SB 17 gives us the tools to address the issue by helping us prepare for price hikes and discouraging needless cost increases.”

But pharmaceutical companies strongly opposed the measure, arguing the information would paint an inaccurate picture of drug spending, since the disclosure centers on full sticker cost set by manufacturers. Purchasers rarely pay the full list price, either through negotiated discounts or through use of consumer rebates or coupons.

“It is disappointing that Gov. Brown has decided to sign a bill that is based on misleading rhetoric instead of what’s in the best interest of patients,” Priscilla VanderVeer, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, said in a statement. She said the measure “ignores the reality that spending on prescription medicines remains a much smaller portion of overall healthcare spending.”

VanderVeer said the manufacturers’ group was ready to work to combat affordability issues but added: “It’s time to move beyond creating new, costly bureaucratic programs that don’t make a dent in patients’ costs for medicines.”

Escalating drug prices inspired a slate of measures from lawmakers this year. Brown on Monday signed an additional measure, AB 265 by Assemblyman Jim Wood (D-Healdsburg), that will restrict the use of drug rebates or coupons for brand-name drugs when cheaper generic alternatives are available.

The law includes a number of exemptions, including for when patients have gotten authorization from their health insurers for brand-name treatments. But Wood has pitched his measure as a way to stem widespread use of such vouchers, which some researchers have said drive higher overall healthcare costs by giving patients incentive to pick pricier medicines.

Other related bills, including a measure to clamp down on gifts doctors can receive from pharmaceutical companies and a proposal to regulate pharmacy benefit managers, a little-scrutinized part of the drug supply chain, sputtered earlier this year.

The disclosure bill was seen as the centerpiece of the focus on drug prices, setting off a fierce lobbying battle in which the pharmaceutical industry squared off against a coalition of backers that included health plans, labor groups and consumer advocates.

It also garnered support from some Republican lawmakers, who have typically been aligned with drug makers.

“Shouldn’t we do something to help make this system operate better so we can get better cost savings for our consumers? That’s a conservative principle,” said Assemblyman James Gallagher (R-Yuba City).

Now, Hernandez said, he hoped the law would inspire similar action on a national level.

“I want to challenge our federal elected officials…to do the same thing at the national level,” he said, “so that we can make sure that every single person in this country not only has access to healthcare but they can afford their healthcare premium dollars.”

In his signing remarks, Brown said the angst over rising drug costs — and manufacturers’ substantial profits — was symptomatic of the broader gap between the haves and have-nots.

“The social and political fabric is being ripped apart,” Brown said. “The inequities are growing. The rich are getting richer, the powerful are getting more powerful and a growing number of people are getting more desperate, more alienated.”

He directed a message to the pharmaceutical industry that opposed the bill: “You’ve got to join with us. You’re part of America. And if we all don’t pull together, we’re going to pull apart.”

Eyes Fixed On California As Governor Ponders Inking Drug Price Transparency Bill

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Eyes Fixed On California As Governor Ponders Inking Drug Price Transparency Bill

Insurers, hospitals and health advocates are waiting for Gov. Jerry Brown to deal the drug lobby a rare defeat, by signing legislation that would force pharmaceutical companies to justify big price hikes on drugs in California.

“If it gets signed by this governor, it’s going to send shock waves throughout the country,” said state Sen. Ed Hernandez, a Democrat from West Covina, the bill’s author and an optometrist. “A lot of other states have the same concerns we have, and you’re going to see other states try to emulate what we did.”

The bill would require drug companies to give California 60 days’ notice to state agencies and health insurers anytime they plan to raise the price of a drug by 16 percent or more over two years. They would also have to explain why the increases are necessary. In addition, health insurers would have to report what percentage of premium increases are caused by drug spending.

Drugmakers spent $16.8 million on lobbying from January 2015 through the first half of this year to kill an array of drug legislation in California, according to data from the secretary of state’s office. For the pricing bill alone, the industry has hired 45 lobbyists or firms to fight it. Against the backdrop of this opposition campaign, Brown must decide by Oct. 15 whether to sign or veto the bill.

“When they have to justify in California, de facto, they have to justify it to the other 49 states,” said Gerard Anderson, a health policy professor at Johns Hopkins Bloomberg School of Public Health in Baltimore. “Other states essentially get to piggyback on the good efforts of California, and hopefully, because they might have difficulty justifying the price increases, everybody’s prices around the country will be lower.”

Other states, including Maryland, Vermont, Nevada and New York, have passed similar laws aimed at bringing more transparency to prices and curbing price gouging. But the pharmaceutical industry has fought the hardest in California. If drug companies don’t like the disclosure laws in smaller states, they could decide not to sell their drugs there, Anderson said, but the market in California is just too big to ignore.

“States like Maryland are just not as powerful,” he said. “It just doesn’t have the clout that a state like California has.”

This is the second go-round for such a drug price bill. Last summer, similar legislation crashed and burned. Its intended regulations were gutted so extensively that Hernandez decided to pull it. But, he said, two key things happened after that, setting the stage for a successful second attempt.

First, in August 2016, less than a week after Hernandez pulled the bill, controversy erupted nationally over the price of EpiPens, which spiked nearly 500 percent. The increase sparked outrage from parents who carry the auto-injectors to save their children from life-threatening allergic reactions.

Momentum grew among federal lawmakers last September. They called for hearings. Several bills were proposed across the country aimed to rein in drug prices.

Then came the election of November 2016. After Donald Trump became president and Republicans took control of Congress, the No. 1 health policy priority became repealing and replacing the Affordable Care Act, President Barack Obama’s signature legislation.

As federal lawmakers focused on dismantling the ACA, Hernandez said he saw another opportunity for state lawmakers to act on drug prices. He reintroduced his bill in early 2017, and this time political support grew quickly — beyond the usual suspects.

“It wasn’t just labor,” he recalls. “It was consumer groups, it was health plans. It was the Chambers of Commerce, it was the hospital association.”

The Pharmaceutical Research and Manufacturers of America, or PhRMA, a drug industry’s trade group, argued that the bill known as SB 17 was full of “false promises” that wouldn’t help consumers pay for their medicines and would instead stifle innovation with cumbersome regulatory compliance.

“That takes up a lot of resources and will take up a lot of time,” said Priscilla VanderVeer, deputy vice president of public affairs for PhRMA. “And that could mean pulling resources from research and development and having to put it into the reporting structure.”

Some experts say that price transparency alone is not sufficient to bring down costs  and that other changes are needed.

Hernandez is optimistic the governor will sign SB 17 into law. But he knows nothing’s certain. That’s because of what happened on Sept. 11, the day the bill came up for a key vote in the state Assembly — the same place it went down the year before. Hernandez thought he’d secured all the votes he needed, but at the last minute the votes started slipping away.

The bill needed 41 votes to pass the Assembly. During the roll call, the tally stalled around 35. Hernandez said he had plenty of colleagues willing to cast the 42nd vote, but with drug lobbyists swarming the Capitol, no legislators wanted to be the one to cast the deciding vote.

“If the bill fails and you’re stuck out there, then you’re the person that’s attacking the industry,” Hernandez said.

Still, the bill crossed the 41-vote threshold and the remaining lawmakers joined in. In the end, the bill passed with 66 votes. All the Democrats and half of the Republicans in the state Assembly voted for it.

This was much to the dismay of drug companies, which lobbied hard and issued a blitz of advertising in the last weeks before the vote.

Experts said the drug industry doesn’t want a large influential state like California forcing them to share their data.

Drugmakers are likely already devising ways to work around the California bill, warned Anderson, the Johns Hopkins professor. They’ve filed lawsuits to try to slow or stop laws from being implemented in other states, or to weaken the rules if and when they go into effect. Policy experts are watching to see what kinds of legal challenges the California law might be vulnerable to, and if it can withstand them.

“We learn from the mistakes of other states,” Anderson said. “Legislation is an iterative process. We have 50 states and hopefully, by some time, we’ll get it right. We’re looking for California to take the lead on this.”

California Drug Price Bill Sweeping In Scope, Lacking In Muscle

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California Drug Price Bill Sweeping In Scope, Lacking In Muscle

A California bill headed to the governor’s desk may be the most sweeping effort in the nation to shine a light on drug pricing, but it lacks the muscle being applied in other states to directly hold those prices down.

The idea behind the law is that if everyone knows when and why prices are rising, political leaders eventually will be more empowered to challenge those increases.

“Transparency is a longer-term play. It’s about building political will, getting more information and helping build the case for the changes that we need” in order to have more sustainable drug prices, said Ted Lee, a senior fellow at Yale University’s Global Health Justice Partnership, which recently released a report on steps states can take to reduce drug prices.

Some experts have said transparency alone is not enough to bring down drug prices, and more extensive changes are needed.

“We need really far-reaching reforms that say ‘sorry, pharma, we’ve had enough. We’re not going to do it your way. We’re going to do it our way,’” said Peter Maybarduk, director of the Global Access to Medicines Program at Public Citizen, a consumer watchdog group. The group wants sweeping changes at the federal level that would reduce spending on drugs, such as allowing Medicare to negotiate prices with drug companies and limiting market exclusivity on certain pharmaceuticals.

The California measure would put a spotlight on drug prices from different angles, imposing reporting obligations on both insurers and drug manufacturers.

The campaign for the bill brought together some unlikely political allies in the California State Capitol this year: Consumer advocates, insurers, employer groups, labor unions and even a prominent billionaire environmentalist shared the same platforms at press conferences, urging legislators to force drug manufacturers to disclose and justify their high prices.

Gov. Jerry Brown has about a month to decide whether to sign the bill. Brown rarely comments publicly about legislation before he takes action, but a spokesman, Brian Ferguson, said the governor’s office had worked closely with legislative staff on the bill.

The pharmaceutical industry remains fiercely opposed to the legislation and has vowed to lobby the governor against it.

The measure “will not improve the accessibility or affordability of medicines for patients,” Priscilla VanderVeer, deputy vice president of public affairs for the Pharmaceutical Research and Manufacturers of America (PhRMA), said in an email.

Under the proposed law, pharmaceutical companies would be required to give state agencies and insurers 60 days’ notice if they planned a price increase of more than 16 percent over two years on drugs with a wholesale cost of $40 or higher. And they would have to explain the reasons for the increase.

Manufacturers would also have to report the introduction of certain high-priced drugs to market, explain their marketing plans for the product and say if it is an improvement on drugs that are already available.

Health plans would be obliged to report to state regulators on the drugs with the highest annual cost increases and document how much drug spending factored into their premiums.

Yale’s Lee said both price control and transparency laws play important roles in regulating prescription drug costs. Ellen Albritton, a senior policy analyst at Families USA, said transparency measures such as California’s bill are a “key part” of what is needed for the U.S. to get drug prices under control. She said various actions by states, taken together, build the case for federal action.

This year, at least two states have passed laws that tackle high drug prices head-on and may have a more immediate effect on consumer costs than the California measure, Lee said.

Maryland and New York, for example, passed laws this year that use a variety of legal levers to impose financial penalties or require discounts if prices are too high.

Maryland’s law empowers the state’s attorney general to take legal action if it determines drugmakers are “price gouging” on generic drugs. A violation by the company could trigger refunds to consumers and a fine for the manufacturer.

The New York law introduces a drug price cap in the state’s Medicaid program and would require rebates on drugs that exceed their limits, according to a Yale University analysis.

The California bill’s author, Sen. Ed Hernandez (D-Covina), said he didn’t believe price controls were the right approach. “I still believe in the basic tenet of free enterprise,” he said. “The market should play itself out.”

But California’s bill is more comprehensive in some ways than other states’ laws. It requires new reporting in the private and public insurance markets and encompasses generic, brand-name and specialty pharmaceuticals. Other state laws affect only one payer, as in New York, or one subset of drugs, as in Maryland.

Vermont has a transparency measure, passed last year, that mandates reporting on a narrower subset of drugs than California’s proposal. Nevada’s recently passed drug price law requires disclosures from insulin makers.

Hernandez, who chairs the state Senate’s health committee, said the California bill could be a national model for drug price policy because transparency works to bring costs down. Consumers across state lines will benefit from California’s law, he said.

“I encourage the federal government, especially California’s representatives in the U.S. House and Senate, to consider similar legislation as we continue this discussion at a national level,” Hernandez said.

He said industry opposition to his bill has been fierce, with “legions” of lobbyists clogging Capitol hallways and full-page ads in local newspapers during the final days of the legislative session, which ended Friday.

Despite the industry’s resistance, Hernandez said, the effort to address high drug costs had bipartisan support and rallied players who are usually at odds on other matters.

“It has become a huge coalition because it’s impacting everybody,” he said.

Turning to the States to Solve the National Problem of Drug Pricing

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http://www.realclearhealth.com/articles/2017/06/20/turning_to_the_states_to_solve_the_national_problem_of_drug_pricing_110639.html?utm_source=morning-scan&utm_medium=email&utm_campaign=mailchimp-newsletter&utm_source=RC+Health+Morning+Scan&utm_campaign=d975383149-MAILCHIMP_RSS_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_b4baf6b587-d975383149-84752421

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Drug pricing is a national problem. So a nonprofit wants to help hand off some of that burden to the states.

The National Academy for State Health Policy just launched a new center, called the Center for State Rx Drug Pricing, to help state governments navigate the treacherous waters of drug pricing. It just received about a million dollars in funding from the Laura and John Arnold Foundation to help states get drug pricing initiatives underway.

“We believe that pricing is such a difficult, complicated issue at the federal level that states can serve as laboratories of innovation,” said Trish Riley, executive director of NASHP. “It’s an opportunity for states to try all kinds of different approaches to lower drug prices.”

It’s an opportunity, too, to allow states to learn from one another — seeing what works and what does not in lowering pricing, and using the new NASHP center as a conduit of information.

“States are desperate for meaningful efforts to address the ever-increasing burden of drug prices on our budget,” said Dr. Rebekah Gee, secretary of the Louisiana Department of Health. There was initial optimism that President Trump might enforce a new drug price negotiating process — “but that interest seems to have dwindled, so it’s up to states to drive the conversation,” she said.

NASHP, a nonprofit, has long served as a coalition of state health policy wonks. Last year it assembled 11 points of possible policy options for states to lower prices — suggesting reforms in rate regulation, importation, bulk drug ordering, and more.

Some states already have drug cost-containment initiatives underway. Maryland, for instance, now has a law in place that punishes price gouging on generic drugs. And Nevada just passed a strict pricing transparency law that focuses primarily on diabetes drugs.

“Over the last year, 79 bills on transparency, PBMs, and the like have been introduced,” Riley said. “It’s now a very active field.”

But some think that such state-driven measures to lower prices just aren’t enough. The federal government has to be involved.

“Generally it’s difficult for programs such as these to effect real industry-level change without policy-setting power at the national level,” said Scott Hinds, an analyst at Sector & Sovereign Research. Public pressures on pricing have prompted drug makers to voluntarily decrease their inflation rates, he pointed out. And payers are now limiting formularies — lists of medicines with favored insurance coverage — which forces price competition, and could therefore lower rates, he said.

“Absent policy changes that would allow Medicare to negotiate Part D prices, I’m skeptical that there’s much that would have as much of an impact at the aggregate level as these self- or market imposed- changes,” Hinds said.

Rachel Sachs, an associate professor of law at Washington University of St. Louis, agrees that it’s likely not feasible for states to go it alone. While states could embark on a number of initiatives to promote transparency in drug pricing decisions, or tinker with spending, “most of the ambitious proposals states have advanced so far would require the federal government’s cooperation.”

She said that states could, indeed, use their existing Medicaid formularies more aggressively to also force that competition, as evidenced by the work states did around Hepatitis C drugs. However, Sachs said that price cap provisions simply won’t work on their own.

The new drug pricing center will also dole out small grants — taken from the larger Arnold Foundation gift — to a handful of states in order to help fuel their proposals for lowering drug pricing.

“We’re on a fast track to get that money out,” Riley said.

The Arnold Foundation has had a sustained interest in lowering drug pricing. Last year, for instance, it gave Memorial Sloan Kettering Cancer Center a $4.7 million grant to support the Evidence Driven Drug Pricing Project — a three-year study that examines the payment structures of specialty drugs. It also granted $5.2 million to a Boston nonprofit, the Institute for Clinical and Economic Review, to analyze whether new drugs are worth what they cost.

Quest to Lower Drug Prices Pits Trump Against Formidable Opponents

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Aiming to significantly reduce medication prices presents the president with golden opportunities and a set of daunting challenges, healthcare industry experts say.

President Donald Trump has said medication prices are too high and he plans to address the problem.

During his presidential campaign, Trump called for Medicare to negotiate drug pricing. In January, the president criticized the lobbying efforts of pharmaceutical companies and suggested again that the federal government should negotiate drug prices.

Although he faces high hurdles, the president appears to be on the right track, says Olusegun Ishmael, MD, MBA, an emergency room physician at Paris Community Hospital in Paris, IL, and former insurance company executive.

“The biggest insurer in this country is the U.S. government—between the Veterans Administration, Medicaid, and Medicare. The government should do the same thing that UnitedHealthcare and all the Blues do to negotiate pricing based on their volume,” he says.

Insurers and foreign governments have been leveraging their purchasing power to negotiate drug prices for decades, Ishmael says.

“If someone walks into CVS or Walgreens without insurance and wants to get a prescription, they will pay almost twice as much as the UnitedHealthcare pricing. The reason is volume—it is a numbers game. As an insurer, when I have a certain amount of volume, I go to my pharmacy benefit management company and say, ‘I am bringing you a million lives.'”

Election 2016: Big Pharma’s $70 million tops California campaign contributions

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http://www.mercurynews.com/health/ci_30117115/election-2016-big-pharmas-70-million-tops-california

With Californians facing the busiest ballot in more than a decade, big spenders are poised to make it one of the most expensive election battles in state history — already contributing $185 million to fight over everything from sex, drugs and guns to tobacco and taxes.

The money is piling up on behalf of campaigns for 17 statewide ballot measures — the most since March 2000. And when it comes to big backers, Big Pharma is far and away the towering force.

According to figures released Monday by the nonprofit MapLight, drug companies have already poured $70 million into an effort to fight Proposition 61, which would limit the prices state agencies pay for prescription drugs.

That’s 38 percent of all the money so far invested into the various ballot measures through July 7, the Berkeley-based group reported. Some observers are predicting drug company contributions will top $100 million by Election Day.

“This is their bread and butter,” said Barbara O’Connor, director emeritus of Sacramento State’s Institute for the Study of Politics and Media, who expects the industry will invest as much money as its needs to win.

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The beneficiary of that drug company money, Californians Against the Misleading Rx Measure, says they got an early start on raising campaign cash. “As the other campaigns start kicking into high gear, they will start raising more,” said Kathy Fairbanks, the no campaign’s spokeswoman.

The AIDS Healthcare Foundation, the measure’s sponsor, has raised about $10 million, according to president Michael Weinstein.

“Maybe $100 million can convince people to vote against what is in their own best interest,” said Weinstein. “From our point of view, today, tomorrow or 10 years from now, justice will prevail on drug pricing.”

With tens of millions on hand, drug makers fight state efforts to force down prices

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With tens of millions on hand, drug makers fight state efforts to force down prices

Drug makers are sick and tired of coming under attack for high prices.

And they’re spending tens of millions to try to make it stop.

“We’re under unprecedented pressure because there really is profound misunderstanding out there,” Acorda Therapeutics CEO Ron Cohen, who chairs the industry trade group Biotechnology Innovation Organization, told a crowd at BIO’s conference here this week.

“Together we’re going to fight back, and we’re going to win,” Jim Greenwood, the CEO of BIO, said in his keynote address.

Bills that would have required drug companies to justify, explain, or even cap their prices have faltered in about a dozen states in recent months. Last week, however, brought two blows to the industry: Vermont Governor Peter Shumlin Drug signed into law a transparency act that requires drug makers to justify price hikes. Similar legislation passed in the California state Senate.

Meanwhile, the industry is girding for another California fight this November over a ballot measure that seeks to cap some drug prices. A similar measure is in the works in Ohio. And the industry fears such ballot measures could pop up elsewhere.

But drug makers aren’t responding by cutting prices  — or even by keeping them stable.