Mississippi Today

Five things to know about the new drug pricing negotiations

Published

2 years ago

August 30, 2023

The Biden administration has picked the first 10 high-priced prescription drugs subject to federal price negotiations, taking a swipe at the powerful pharmaceutical industry. It marks a major turning point in a long-fought battle to control ever-rising drug prices for seniors and, eventually, other Americans.

Under the 2022 Inflation Reduction Act, Congress gave the federal government the power to negotiate prices for certain high-cost drugs under Medicare. The list of drugs selected by the Centers for Medicare & Medicaid Services will grow over time.

The first eligible drugs treat diabetes, blood clots, blood cancers, arthritis, and heart disease — and accounted for about $50 billion in spending from June 2022 to May 2023.

The United States is clearly an outlier on drug costs, with drugmakers charging Americans many times more than residents of other countries “simply because they could,” Biden said Tuesday at the White House. “I think it’s outrageous. That’s why these negotiations matter.”

He added, “We’re going to keep standing up to Big Pharma and we’re not going to back down.”

Democratic lawmakers cheered the announcement, and the pharmaceutical industry, which has filed a raft of lawsuits against the law, condemned it.

The companies have until Oct. 2 to present data on their drugs to CMS, which will make initial price offers in February, setting off negotiations set to end next August. The prices would go into effect in January 2026.

Here are five things to know about the impact:

1. How important is this step?

Medicare has long been in control of the prices for its services, setting physician payments and hospital payments for about 65 million Medicare beneficiaries. But it was previously prohibited from involvement in pricing prescription drugs, which it started covering in 2006.

Until now the drug industry has successfully fought off price negotiations with Washington, although in most of the rest of the world governments set prices for medicines. While the first 10 drugs selected for negotiations are used by a minority of patients — 9 million — CMS plans by 2029 to have negotiated prices for 50 drugs on the market.

“There’s a symbolic impact, but also Medicare spent $50 billion on these 10 drugs in a 12-month period. That’s a lot of money,” said Juliette Cubanski, deputy director of KFF’s analysis of Medicare policy.

The long-term consequences of the new policy are unknown, said Alice Chen, vice dean for research at University of Southern California’s Sol Price School of Public Policy. The drug industry says the negotiations are essentially price controls that will stifle drug development, but the Congressional Budget Office estimated only a few drugs would not be developed each year as a result of the policy.

Biden administration officials say reining in drug prices is key to slowing the skyrocketing costs of U.S. health care.

2. How will the negotiations affect Medicare patients?

In some cases, patients may save a lot of money, but the main thrust of Medicare price negotiation policy is to provide savings to the Medicare program — and taxpayers — by lowering its overall costs.

The drugs selected by CMS range from specialized, hyper-expensive drugs like the cancer pill Imbruvica (used by about 26,000 patients in 2021 at an annual price of $121,000 per patient) to extremely common medications such as Eliquis (a blood thinner for which Medicare paid about $4,000 each for 3.1 million patients).

While the negotiations could help patients whose Medicare drug plans require them to make large copayments for drugs, the relief for patients will come from another segment of the Inflation Reduction Act that caps drug spending by Medicare recipients at $2,000 per year starting in 2025.

3. What do the Medicare price negotiations mean for those not on Medicare?

One theory is that reducing the prices drug companies can charge in Medicare will lead them to increase prices for the privately insured.

But that would be true only if companies aren’t already pricing their drugs as high as the private market will bear, said Tricia Neuman, executive director of KFF’s program on Medicare policy.

Another theory is that Medicare price negotiations will equip private health plans to drive a harder bargain. David Mitchell, president of the advocacy group Patients for Affordable Drugs, predicted that disclosure of negotiated Medicare prices “will embolden and arm private sector negotiators to seek that lower price for those they cover.”

Stacie B. Dusetzina, a professor of health policy at Vanderbilt University, said the effect on pricing outside Medicare isn’t clear.

“I’d hedge my bet that it doesn’t change,” she said.

Nonetheless, Dusetzina described one way it could: Because the government will be selecting drugs for Medicare negotiations based partly on the listed gross prices for the drugs — distinct from the net cost after rebates are taken into account — the process could give drug companies an incentive to lower the list prices and narrow the gap between gross and net. That could benefit people outside Medicare whose out-of-pocket payments are pegged to the list prices, she said.

4. What are drug companies doing to stop this?

Even though negotiated prices won’t take effect until 2026, drug companies haven’t wasted time turning to the courts to try to stop the new program in its tracks.

At least six drug companies have filed lawsuits to halt the Medicare drug negotiation program, as have the U.S. Chamber of Commerce and the Pharmaceutical Research and Manufacturers of America, known as PhRMA.

The lawsuits include a variety of legal arguments. Merck & Co., Johnson & Johnson, and Bristol Myers Squibb are among the companies arguing their First Amendment rights are being violated because the program would force them to make statements on negotiated prices they believe are untrue. Lawsuits also say the program unconstitutionally coerces drugmakers into selling their products at inadequate prices.

“It is akin to the Government taking your car on terms that you would never voluntarily accept and threatening to also take your house if you do not ‘agree’ that the taking was ‘fair,’” Janssen, part of Johnson & Johnson, wrote in its lawsuit.

Nicholas Bagley, a law professor at the University of Michigan, predicted the lawsuits would fail because Medicare is a voluntary program for drug companies, and those wishing to participate must abide by its rules.

5. What if a drug suddenly gets cheaper by 2026?

In theory, it could happen. Under guidelines CMS issued this year, the agency will cancel or adjourn negotiations on any drug on its list if a cheaper copycat version enters the market and finds substantial buyers.

According to company statements this year, two biosimilar versions of Stelara, a Johnson & Johnson drug on the list, are prepared to launch in early 2025. If they succeed, it would presumably scotch CMS’ plan to demand a lower price for Stelara.

Other drugs on the list have managed to maintain exclusive rights for decades. For example, Enbrel, which the FDA first approved in 1998 and cost Medicare $1.5 billion in 2021, will not face competition until 2029 at the earliest.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Up Next

One House incumbent loses in Tuesday runoffs, another still trails

Don't Miss

‘Goon Squad’ could cost Rankin County taxpayers millions, experts say

Mississippi Today

Brain drain: Mother understands her daughters’ decisions to leave Mississippi

Published

20 hours ago

August 5, 2025

Staff Editor

mississippitoday.org – @BobbyHarrison9 – 2025-08-05 10:41:00

by Julie Liddell Whitehead, Mississippi Today
August 5, 2025

Editor’s note: This Mississippi Today Ideas essay is published as part of our Brain Drain project, which seeks answers to Mississippi’s brain drain problem. To read more about the project, click here.

Back when I was a kid in 1988, my mama and I had an argument about what I wanted to major in at college.

I had dreamed of being a journalist since the age of 8. To me, that meant that I was going to Ole Miss, which had the journalism department.

My mama said I could only go away from home to Ole Miss if I was going to major in law.

So I settled on going to Mississippi State University just down the road and majoring in communication. She told me I should major in engineering since that’s what State was known for.

I said, “That’s even dumber than me going to law school. I hate math.”

“Well, you could at least try,” she said.

I said no. Then she told me I was wasting my education and turned her back on me.

Julie Liddell Whitehead

I get it. She knew and I knew that I couldn’t stay in Choctaw County where I was raised and earn a living with that degree. I would have to go somewhere else — probably to the Jackson metro area and work for Gannett or the Associated Press. Or to Memphis. Or Biloxi. Or even New Orleans. She never really forgave me for moving to the Jackson metro, working in my field and raising her grandchildren so far from her.

After a while, I got used to the pace of life around here. I knew I probably wouldn’t ever move anywhere else because I noticed that people who left Mississippi often came back, whether due to family obligations or a realization that “somewhere else” wasn’t quite all it was cracked up to be.

I also noticed that a lot of people played up how they were from Mississippi while making a very good living being someplace else. I decided I wanted to prove you could be from Mississippi, live in Mississippi, work in Mississippi and make something of yourself without leaving Mississippi.

But I noticed something else over the years, too. Most of the kids in Brandon dreamed of going off from home to cities like Atlanta, Nashville, Dallas, DC, New York or Orlando. They didn’t seem to have reasons — just a desire to get away from the state as fast as they could.

Then my three daughters and I started having conversations about what they wanted to major in when they went to college. My oldest wanted to be a chef. My middle one was undecided between chemical engineering and landscape architecture. And my youngest was fascinated with roads and bridges.

I was all too aware of what had happened in the job markets in Mississippi since I had come up. Companies closed operations in a globalized economy and fled to cheaper labor markets. The advent of the internet meant employers could hire from all over the world. Longtime business leaders retired and sold out to big corporations that reduced investments in local communities that had supported those businesses for decades and then complained that those towns didn’t offer enough amenities for their employees to want to relocate there.

But the reality really set in when my chef daughter chose her first internship — in historic Williamsburg, Virginia.

I would never have dreamed of driving that far from home to try out a place to work when I was her age. Then after her senior year, she interned at Walt Disney World and got hired full-time before the internship was over. She was off to live in Orlando where now with her husband and young son she’s creating community and loves going to work every day with a pretty enviable benefits package, too, a thing unheard of in the culinary world in Mississippi.

My middle one finally settled on chemical engineering and was picked for a co-op job in her first semester at age 18 at a company in Georgia. When she graduated four years later, we packed her off to Indiana for a research and development job, and she now lives in New Hampshire with her husband, making six figures a year at 26 years old and looking forward to partaking in the cultural offerings in New York City when she can.

The youngest is currently in college for civil engineering, and I’m bracing myself for the inevitable. She doesn’t want to work for state government, so she’s likely going out of state as well. Her comment about coming back to Jackson metro was the most damning of all. “There’s nothing to do here,” she says.

A lot of people ask me questions: How often do you see your daughters? How can you stand being so far from your grandson? Don’t they at least come home for Christmas?

The answer to all of those questions is that we do the best we can. We text, we message on Facebook, we talk on the phone at least once a week, every Sunday. We arrange visits; sometimes it’s us driving to them while other times they drive to us.

I can’t imagine making my children as miserable as my mom made me over my life choices. We are flexible, understanding, and very, very proud of our daughters, who are grappling with enough in their lives without us loading them down with guilt over when they are coming home.

The calculus may change in the future. We may have declines in health and need to move closer to one of our children if we need assistance. Or we may need to be in assisted living care here in Mississippi where such care may be marginally cheaper than wherever our girls land.

But I don’t wish our girls had settled for life in Mississippi.

What I wish is that Mississippi could find a way to live up to its potential — to be a place more worthy of my daughters’ loyalty, affections and investment in themselves.

Maybe it will be someday. I hope so, for all of our sakes.

Julie Liddell Whitehead lives and writes from Mississippi. An award-winning freelance writer, Julie covered disasters from 9/11 to Hurricane Katrina throughout her career. Her first book is “Hurricane Baby: Stories,” published by Madville Publishing. She writes on mental health, mental health education and mental health advocacy. She has a bachelor’s degree in communication, with a journalism emphasis, and a master’s degree in English, both from Mississippi State University. In 2021, she completed her MFA from Mississippi University for Women.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post Brain drain: Mother understands her daughters' decisions to leave Mississippi appeared first on mississippitoday.org

Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

This essay reflects a Center-Left perspective by focusing on social and economic challenges faced by Mississippi, such as brain drain, job market changes, and community decline. The tone is empathetic and advocates for investment in local opportunities and amenities to retain talent, aligning with progressive concerns about economic inequality and regional development. However, it remains largely personal and reflective rather than explicitly ideological or partisan. The article critiques systemic economic shifts without advancing a polarized political agenda, emphasizing hope for future improvement and a more supportive environment for young professionals.

Mississippi Today

After 30 years in prison, Mississippi woman dies from cancer she says was preventable

Published

2 days ago

August 4, 2025

Staff Editor

mississippitoday.org – mississippitoday.org – 2025-08-04 17:37:00

by Mina Corpuz and Michael Goldberg, Mississippi Today
August 4, 2025

Behind Bars, Beyond Care:

A Mississippi Today investigation into suffering, secrecy and the business of prison health care

Susie Balfour, diagnosed with terminal breast cancer two weeks before her release from prison, has died from the disease she alleged past and present prison health care providers failed to catch until it was too late.

The 64-year-old left the Central Mississippi Correctional Facility in December 2021 after more than 30 years of incarceration. She died on Friday, a representative for her family confirmed.

Balfour is survived by family members and friends. News of her passing has led to an outpouring of condolences of support shared online from community members, including some she met in prison.

Instead of getting the chance to rebuild her life, Balfour was released with a death sentence, said Pauline Rogers, executive director of the RECH Foundation.

“Susie didn’t just survive prison, she came out fighting,” Rogers said in a statement. “She spent her final years demanding justice, not just for herself, but for the women still inside. She knew her time was limited, but her courage was limitless.”

Last year, Balfour filed a federal lawsuit against three private medical contractors for the prison system, alleging medical neglect. The lawsuit highlighted how she and other incarcerated women came into contact with raw industrial chemicals during cleaning duty. Some of the chemicals have been linked to an increased risk of cancer in some studies.

The companies contracted to provide health care to prisoners at the facility over the course of Balfour’s sentence — Wexford Health Sources, Centurion Health and VitalCore, the current medical provider — delayed or failed to schedule follow-up cancer screenings for Balfour even though they had been recommended by prison physicians, the lawsuit says.

“I just want everybody to be held accountable,” Balfour said of her lawsuit. “ … and I just want justice for myself and other ladies and men in there who are dealing with the same situation I am dealing with.”

Rep. Becky Currie, who chairs the House Corrections Committee, spoke to Balfour last week, just days before her death. Until the very end, Balfour was focused on ensuring her story would outlive her, that it would drive reforms protecting others from suffering the same fate, Currie said.

“She wanted to talk to me on her deathbed. She could hardly speak, but she wanted to make sure nobody goes through what she went through,” Currie said. “I told her she would be in a better place soon, and I told her I would do my best to make sure nobody else goes through this.”

During Mississippi’s 2025 legislative session, Balfour’s story inspired Rep. Justis Gibbs, a Democrat from Jackson, to introduce legislation requiring state prisons to provide inmates on work assignments with protective gear.

Gibbs said over 10 other Mississippi inmates have come down with cancer or become seriously ill after they were exposed to chemicals while on work assignments. In a statement on Monday, Gibbs said the bill was a critical step toward showing that Mississippi does not tolerate human rights abuses.

“It is sad to hear of multiple incarcerated individuals passing away this summer due to continued exposure of harsh chemicals,” Gibbs said. “We worked very hard last session to get this bill past the finish line. I am appreciative of Speaker Jason White and the House Corrections Committee for understanding how vital this bill is and passing it out of committee. Every one of my house colleagues voted yes. We cannot allow politics between chambers on unrelated matters to stop the passage of good common-sense legislation.”

The bill passed the House in a bipartisan vote before dying in the Senate. Currie told Mississippi Today on Monday that she plans on marshalling the bill through the House again next session.

Currie, a Republican from Brookhaven, said Balfour’s case shows that prison medical contractors don’t have strong enough incentives to offer preventive care or treat illnesses like cancer.

In response to an ongoing Mississippi Today investigation into prison health care and in comments on the House floor, Currie has said prisoners are sometimes denied life saving treatments. A high-ranking former corrections official also came forward and told the news outlet that Mississippi’s prison system is rife with medical neglect and mismanagement.

Mississippi Today also obtained text messages between current and former corrections department officials showing that the same year the state agreed to pay VitalCore $100 million in taxpayer funds to provide healthcare to people incarcerated in Mississippi prisons, a top official at the Department remarked that the company “sucks.”

Balfour was first convicted of murdering a police officer during a robbery in north Mississippi, and she was sentenced to death. The Mississippi Supreme Court reversed the conviction in 1992, finding that her constitutional rights were violated in trial. She reached a plea agreement for a lesser charge, her attorney said.

As of Monday, the lawsuit remains active, according to court records. Late last year Balfour’s attorneys asked for her to be able to give a deposition with the intent of preserving her testimony. She was scheduled to give one in Southaven in March.

Rogers said Balfour’s death is a tragic reminder of systemic failures in the prison system where routine medical care is denied, their labor is exploited and too many who are released die from conditions that went untreated while they were in state custody.

Her legacy is one RECH Foundation will honor by continuing to fight for justice, dignity and systemic reform, said Rogers, who was formerly incarcerated herself.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post After 30 years in prison, Mississippi woman dies from cancer she says was preventable appeared first on mississippitoday.org

Political Bias Rating: Center-Left

This article presents a critical view of the Mississippi prison health care system, highlighting systemic failures and medical neglect that led to the death of a formerly incarcerated woman. The tone and framing focus on social justice issues, prisoner rights, and the need for government accountability and reform, which align with Center-Left values emphasizing government responsibility for vulnerable populations. While the article is largely investigative and fact-based, its emphasis on advocacy for reform, criticism of privatized prison health contractors, and highlighting bipartisan legislative efforts suggest a Center-Left leaning perspective rather than neutral reporting.

Mississippi Today

FBI concocted a bribery scheme that wasn’t, ex-interim Hinds sheriff says in appeal

Published

2 days ago

August 4, 2025

Staff Editor

mississippitoday.org – @MSTODAYnews – 2025-08-04 13:16:00

by Mina Corpuz, Mississippi Today
August 4, 2025

Former interim Hinds County sheriff Marshand Crisler is appealing bribery and ammunition charges stemming from his 2021 campaign, arguing that the federal government played on his relationship with a former supporter to entrap him.

Crisler had asked Tonarri Moore, who donated to past campaigns, for a financial contribution for the sheriff’s race. Moore said he would donate if Crisler helped with several requests. Without the previous relationship, Crisler would not have acted, his attorney argues, and Crisler had no reason to believe he was being bribed.

“The government, having concocted a bribery scheme to entrap Crisler, then had to contrive a corresponding quid pro quo to support the scenario with which to entrap him,” attorney John Holliman wrote in a Saturday appellant brief.

Crisler is asking the U.S. 5th Circuit Court of Appeals to reverse his conviction and render its own rulings on both counts.

He was convicted in federal court in November after a three-day trial and sentenced earlier this year to 2 ½ years in prison. Crisler is serving time in FCI Beckley in West Virginia.

The day before Crisler reached out to Moore to ask for support for his campaign for sheriff, Drug and Enforcement Administration agents raided Moore’s home and found guns and drugs. An FBI agent called to the scene looked through Moore’s phone and saw Crisler had called.

According to the appellant brief, the agent asked Moore what Crisler would do if offered money, and if Moore was bribing him. Moore said he wasn’t bribing Crisler, and the agent asked if Moore would do it.

At that time, there weren’t reasonable grounds to start a bribery investigation into Crisler, his attorney argues, nor was there reason to believe he was seeking a bribe.

Moore agreed to become an informant for the FBI, in exchange for the government not prosecuting him for the guns and drugs.

The FBI fitted him with a wire to record Crisler during meetings, which began that day. The meetings included one inside Moore’s night club and a cigarette lounge in Jackson. Agents provided Moore with the $9,500 he gave to Crisler between September and November 2021.

Crisler’s 2023 indictment came as he campaigned again for sheriff and months before the primary election. He remained in the race and lost to the incumbent who he faced in 2021.

At trial, the government argued the exchange of money were attempts to bribe because Moore made several requests of Crisler: to move his cousin to a different part of the Hinds County Detention Center, to get him a job in the sheriff’s office and for Crisler to let Moore know if law enforcement was looking into his activities.

In closing arguments, Assistant U.S. Attorney Charles Kirkham pointed to examples of quid pro quo in recordings, including one where Moore said to Crisler, “You scratch my back, I scratch yours” and Crisler replied “Hello!” in a tone that the government saw as agreement.

The appellant’s brief argues that without Moore’s requests, the government lacked a way to show quid pro quo, a requirement of bribery charge: that Crisler committed or agreed to commit an official act in exchange for funds.

Moore also asked Crisler to give him bullets despite being a convicted felon, which is prohibited under federal law. The brief notes how the government directed Moore to come up with a story for needing the bullets and to ask Crisler to give them to him.

In response, Crisler told Moore he could buy bullets at several sporting goods stores. Moore said they ran out, and eventually Crisler gave him bullets.

Crisler also argues that the government prosecuted routine political behavior. Specifically, accepting campaign donations is not illegal, and can not constitute bribery unless there is an explicit promise to perform or not perform an official act in exchange for money.

“Our political system relies on interactions between citizens and politicians with requests being made for this or that which is within the power of the elected official to do,” the brief states. “This does not constitute a bribery scheme. It is the normal working of our political system.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post FBI concocted a bribery scheme that wasn’t, ex-interim Hinds sheriff says in appeal appeared first on mississippitoday.org

Political Bias Rating: Center-Right

The article presents the legal appeal of former interim Hinds County sheriff Marshand Crisler with a focus on his argument that the FBI orchestrated an entrapment scheme. The language is largely factual and centers on the defense’s claims and legal standards for bribery, emphasizing normal political behavior versus illegal conduct. While the article reports on the government’s position, it gives significant space to Crisler’s defense and critiques of federal prosecution tactics. This framing, highlighting skepticism toward federal law enforcement and emphasizing the defense perspective, suggests a slight center-right leaning, reflecting a cautious stance on government overreach without overt ideological language.