Johnson & Johnson Pricing Transparency Report

2022 U.S. Pricing
Transparency Report

As one of the nation’s leading healthcare companies, we have a responsibility to engage with stakeholders in constructive dialogue to address gaps in affordability, access and health equity as well as protect our nation’s leading role in the innovation ecosystem. Through the 2022 Janssen U.S. Transparency Report, we continue our legacy of contributing insights, data and real-world evidence to help inform and advance policy solutions to create a more sustainable, equitable and innovative healthcare system.
2022 at a glance
Our net prices declined for the sixth year in a row in 2022. Unfortunately, the reality for millions of patients is growing affordability and health equity gaps caused by underinsurance and inadequate insurance benefit design driven by middlemen, including pharmacy benefit managers.
58%
Of the list prices of our medicines went to commercial insurers and others in the healthcare system[1]
$65.7B
In total R&D spending since 2016[2]
1.16M
More than 1.16M patients who were helped with support to afford their medicines through the Janssen CarePath Program[3]
Concerning trends
Notwithstanding our continued R&D investments and negotiations with payers to support patient access, we are deeply concerned about continuing trends and new policies.
Patients are not directly benefiting from continuously lower net prices and growing discounts
While the net prices that payers pay manufacturers for prescription drugs have grown at or below the consumer price index, too many patients continue to pay higher out-of-pocket costs.[4]
Underinsurance is widening gaps in affordability, health equity and access
Data show that commercial insurers’ cost-shifting is a financial burden for households nationwide, affecting tens of millions of Americans every year who are unable to afford growing out-of-pocket costs.[5], [6]
Enactment of the Inflation Reduction Act
The Inflation Reduction Act (IRA) threatens to harm the future development of innovative medicines, improvements in existing treatments and patients’ access to these treatments.
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Janssen’s net prices – lower for the 6th year in a row
In the face of inflationary pressures, American families and businesses experienced the fastest growth in prices in nearly 40 years in 2022.[7] Yet, commercial insurers, pharmacy benefit managers (PBMs) and government payers paid lower net prices for Janssen’s medicines for the sixth year in a row.[8] Net prices for our medicines declined by 3.5%, and nearly 20% when compounded over the past six years.[9]
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In 2022, we provided $39 billion in rebates, discounts and fees to private payers and government programs, as well as providers, distributors and others.[10]

Here is the breakdown:
Rebates and discounts continue to grow
Since 2016, these rebates, discounts and fees have increased 256 percent, with the 340B Federal Drug Discount Program (340B Program) driving a significant part of this increase in rebates and discounts.[11]
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Even as net prices decreased...
Out-of-pocket costs for patients continued to increase due to:
  1. underinsurance that put more financial burden on patients;[12]
  2. increased prevalence of high-deductible health plans;[13] and
  3. the growth in patient assistance diversion programs.[14]
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    What are patient assistance diversion programs?
    As manufacturer patient assistance programs have grown in conjunction with higher out-of-pocket costs, commercial insurers, PBMs and third-party intermediaries are deploying various programs to divert these funds away from patients. These patient assistance diversion programs take various forms including:
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    Accumulators: Do not allow patient assistance to count toward the patient’s deductible and out-of-pocket maximum until the maximum value of any patient assistance is reached.[15]
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    Alternative funding programs: Programs run by third-party vendors that push for the exclusion of specialty drugs from coverage by certain insurance plans.[16]
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    Non-essential Health Benefit Maximizers: While similar to regular maximizers, this program classifies certain specialty medications as “non-essential,” which takes away ACA patient protections related to maximum out-of-pocket limits.[17]
    (Required)
    Maximizers: Do not allow patient assistance to count toward the patient’s deductible and out-of-pocket maximum.[18]
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    Our role in the innovation ecosystem
    Janssen is proud of our historical investments in helping develop the global healthcare innovation ecosystem aimed at making disease a thing of the past. A healthy innovation ecosystem depends upon many elements working together to support and sustain each other. In the healthcare innovation ecosystem, biopharmaceutical industry R&D spending accounts for 75.5% of all investments in U.S. medical and health research and development.[19]
    76%
    Pharmaceuticals accounted for 76% of the mortality reduction achieved for HIV/AIDS from 1990 to 2015.[20]
    599
    Over the past 40 years, the FDA has approved 599 medicines to treat rare diseases.[21]
    800
    The biopharmaceutical industry has a robust pipeline of more than 800 new medicines, treatments and cures for diseases that disproportionately impact racial and ethnic communities.[22]
    Janssen’s continued R&D investments
    Our investments across the industry have contributed to our nation’s significant progress in addressing previously untreatable diseases and creating dramatic improvements in patients’ health.[23]
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    Helping build a more equitable healthcare system
    ‎In 2022, we continued our investments to build a more equitable healthcare system by:
    Helping to address peripheral artery disease in Black communities:
    Save Legs. Change Lives.™ is a multi-year initiative that aims to create urgency and action to address the hidden threat of peripheral artery disease (PAD)-related amputation.[24]
    Empowering the next generation of a diverse healthcare workforce:
    Building on its partnership with the National Medical Fellowship (NMF), Johnson & Johnson welcomed the newest 20 exceptional and diverse medical students from across the country to participate in the second cohort of the Alliance for Inclusion in Medicine (AIM) scholarship program.[25]
    Expanding diversity in clinical trials:
    Janssen is actively working on ways to improve diversity in clinical trials by changing clinical trial design, ensuring a more inclusive criteria approach for participants and training clinical trial site staff to engage and interact with different communities and people of color.[26]
    Supporting access for patients
    Janssen CarePath directly supports patients

    We continue to support patients through Janssen CarePath, a service that provides information about support resources for patients taking Janssen medications.Once a healthcare professional has decided a Janssen medication is right for their patient, the program can help that patient find the tools they may need to get started on a medication and stay on track, including sharing options to help manage out-of-pocket costs.[27]

    Johnson & Johnson Patient Assistance foundation, Inc.

    We also support independent programs and foundations that help patients. In the U.S., Janssen and other Johnson & Johnson companies donate medicines and funding to the Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF), an independent, nonprofit organization. JJPAF gives eligible patients prescription medicines donated by Johnson & Johnson companies. For more information, please visit JJPAF.org.[28]
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    Enactment of the Inflation Reduction Act
    While the IRA’s healthcare provisions include important affordability improvements for seniors by capping out-of-pocket costs, the negative consequences to future innovation could be severe.

    The policies included in the IRA will limit future discoveries of new treatments across the entire U.S. healthcare innovation ecosystem, which depends upon the efforts and ingenuity of small biotech companies, universities and academic institutions and large biopharmaceutical companies.
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    We are guided by our core principles
    As we continue to provide our insights, analysis and positions on these key policy issues, we are guided by our core principles:
    Patients should have affordable and timely access to the most appropriate, effective treatment options and sites of care now and in the future.
    Treatment decisions belong in the hands of patients and their healthcare providers, not commercial payers with no accountability for patient outcomes due to misaligned incentives.
    Clinically stable patients should not be switched from their treatments for non-medical reasons (unless deemed interchangeable by the FDA).
    Appropriate clinical rigor and manufacturing quality standards should be applied in all instances to ensure patient safety.
    With these principles, it is possible to create a sustainable healthcare system that:
    • Maintains a fair and competitive marketplace.
    • Fosters an environment that supports future investment in transformational innovation.
    • Ensures responsible pricing and appropriate transparency system-wide.
    • Determines value based on evidence that incorporates the benefits and risks for patients, the healthcare system and society.
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    Citations
    2022 at a glance
    1. Figure according to Janssen internal financial accounting.
    2. Ibid.
    3. Data are an approximate number of patients supported by Janssen CarePath, provided by the program administrator.

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    Concerning trends
    4. IQVIA Institute for Human Data Science, "The Use of Medicines in the U.S. 2022." April 2022. https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/the-use-of-medicines-in-the-us-2022/iqvia-institute-the-use-of-medicines-in-the-us-2022.pdf.
    5. West Health – Gallup, "Stress Prominent Among U.S. Adults Struggling to Pay for Care,” December 5, 2022." https://news.gallup.com/opinion/gallup/390425/benchmarking-healthcare-affordability-perceived-value.aspx. Accessed February 2023.
    6. The Commonwealth Fund Issue Briefs, "U.S. Health Insurance Coverage in 2020: A Looming Crisis in Affordability." August 19, 2020. https://www.commonwealthfund.org/publications/issue-briefs/2020/aug/looming-crisis-health-coverage-2020-biennial. Accessed February 2023.

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    Prescription drug net prices in the healthcare system
    7. Bureau of Labor Statistics, "Consumer prices up 9.1 percent over the year ended June 2022, largest increase in 40 years." TED: The Economics Daily. July 18, 2022. https://www.bls.gov/opub/ted/2022/consumer-prices-up-9-1-percent-over-the-year-ended-june-2022-largest-increase-in-40-years.htm. Accessed February 2023.
    8. Figure according to Janssen internal financial accounting.
    9. Ibid.
    10. Ibid.
    11. Ibid.

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    As net prices decline, who benefits?
    12. Sara R. Collins, Lauren A. Haynes, and Relebohile Masitha, “The State of U.S. Health Insurance in 2022.” Commonwealth Fund Biennial Health Insurance Survey, The Commonwealth Fund, https://www.commonwealthfund.org/publications/issue-briefs/2022/sep/state-us-health-insurance-2022-biennial-survey. Accessed February 2022.
    13. Gary Claxton, Anthony Damico, Emma Wager, Gregory Young and Heidi Whitmore, “Health Benefits In 2022: Premiums Remain Steady, Many Employers Report Limited Provider Networks For Behavioral Health.” Health Affairs. October 27, 2022. https://www.healthaffairs.org/stoken/tollfree/2022_11_CLAXTON/full.
    14. Dr. William Smith, Dr. Robert Popovian, and Dr. Wayne Winegarden, “Out-of-Pocket Pirates: Pharmacy Benefit Managers (PBMs) and the Confiscation of Out-of-Pocket Assistance Programs.” The Pioneer Institute. https://pioneerinstitute.org/wp-content/uploads/PNR-519-Maxminimizers-WP-v01.pdf.

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    Patient assistance diversion programs
    15. American Society of Clinical Oncology, “Copay Accumulators and Copay Maximizers,” Policy Brief. https://old-prod.asco.org/sites/new-www.asco.org/files/content-files/advocacy-and-policy/documents/2021-AccumulatorsPolicyBrief.pdf. Accessed March 2023.
    16. Optum.com, “Alternative funding: Real savings or problems?” https://www.optum.com/business/insights/pharmacy-care-services/page.hub.alternative-funding-savings-problems.html. Accessed March 2023.
    17. Aimed Alliance, “Non-Essential Health Benefits and Copay Maximizers,” https://aimedalliance.org/non-essential-health-benefits-and-copay-maximizers.
    18. American Society of Clinical Oncology, “Copay Accumulators and Copay Maximizers,” Policy Brief. https://old-prod.asco.org/sites/new-www.asco.org/files/content-files/advocacy-and-policy/documents/2021-AccumulatorsPolicyBrief.pdf. Accessed March 2023.

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    Our R&D investments
    19. Research!America, "U.S. Investments in Medical and Health Research and Development 2016-2020." January 2022. https://www.researchamerica.org/wp-content/uploads/2022/09/ResearchAmerica-Investment-Report.Final_.January-2022-1.pdf. Accessed December 6, 2022.
    20. Stephen Ezell and Kelli Zhao, "The Economics of Biopharmaceutical Innovation: Symposium Report." Information Technology & Innovation Foundation. March 20, 2023. https://itif.org/publications/2023/03/20/economics-of-biopharmaceutical-innovation-symposium-report.
    21. NORD, "ORPHAN DRUGS IN THE UNITED STATES: An Examination of Patents and Orphan Drug Exclusivity," March 25, 2021. https://rarediseases.org/wp-content/uploads/2022/10/NORD-Avalere-Report-2021_FNL-1.pdf.
    22. PhRMA, “More Than 800 Medicines in Development for Diseases That Disproportionately Affect Racial and Ethnic Communities.” Medicines in Development 2021 Report. https://phrma.org/-/media/Project/PhRMA/PhRMA-Org/PhRMA-Org/PDF/MID-Reports/MID-Health-Equity-2021-Report.pdf.
    23. Figure according to Janssen internal financial accounting.

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    Janssen's equity programs
    24. JNJ.com, “Screening Event Targets Hidden Threat of Amputation Related to Peripheral Artery Disease (PAD).” https://www.jnj.com/our-race-to-health-equity/screening-event-targets-hidden-threat-of-amputation-related-to-peripheral-artery-disease-pad.
    25. JNJ.com, “Tackling Health Disparities Through Empowerment, Partnership and Scholarship.” https://www.jnj.com/our-race-to-health-equity/tackling-health-disparities-through-empowerment-partnership-scholarship.
    26. JNJ.com, “What it Takes to Truly Diversify Clinical Trials.” https://www.jnj.com/innovation/inside-johnson-and-johnsons-mission-to-improve-clinical-trial-diversity.

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    Supporting access for patients
    27. Data are an approximate number of patients supported by Janssen CarePath, provided by the program administrator.
    28. Figure according to Janssen internal financial accounting.


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    Notes
    Notes on the report
    All information in this report refers to the U.S. operations of the Janssen Pharmaceutical Companies of Johnson & Johnson, unless noted otherwise. Financial and nonfinancial information covers the period between January 4, 2022 and January 3, 2023, except where noted. The methodologies used for analyses in this report may be different from those used by other organizations. This report is not audited and is not intended to address all our required disclosures.
    Additional resources
    In this report, we refer to locations where you can find more information about specific Janssen U.S. and Johnson & Johnson programs, disclosures, and patient resources. Financial performance information for our parent company and its subsidiaries, as well as its “Cautionary Note Regarding Forward-Looking Statements” and “Risk Factors,” can be found in Johnson & Johnson Annual Reports at jnj.com/about-jnj/annual-reports. Information on corporate sustainability measures can be found at the Johnson & Johnson Health for Humanity Report at healthforhumanityreport.jnj.com.