Congressional Investigation of RevAssist-Linked and General Pricing Strategies for Lenalidomide

Kevin Knopf, MD, MBA, Director of Clinical Innovation, VIVIO

JCO Oncology Practice, 02/27/2024

In 2022, the US Congress passed the Inflation Reduction Act (IRA) to address high drug costs and limited drug accessibility. IRA’s passage followed a 2019-2021 investigation by the House of Representatives Committee on Oversight and Reform into pharmaceutical pricing that reviewed previously sealed communications and documents from manufacturers of blockbuster drugs. The Congress concluded that pricing and market protection practices by manufacturers resulted in high costs. One investigated drug was lenalidomide, a treatment for multiple myeloma. Lenalidomide is an example of a drug whose financial success resulted from price increases and anticompetitive market strategies. We review tactics that led lenalidomide to become the third largest revenue-producing pharmaceutical product worldwide, with $12.2 US dollars (USD) billion sales in 2020, focusing on impact on patients and Medicare and developing policy recommendations.

High costs of drugs are not tightly correlated with value, and pricing decisions by many manufacturers are responsible for high costs, patient burden, and unsustainable pharmaceutical markets.