Battle Lines Form Quickly on Senate Drug Pricing Bill
11/7/19 5:06 PM
STATE HOUSE, BOSTON, NOV. 7, 2019.....Before diving into a bill aimed at making prescription drugs more affordable to consumers next week, senators will have the holiday weekend to come up with additions, changes or other amendments.
Senators rolled out the bill (S 2397) on Thursday and scheduled it for debate on Nov. 14, with amendments due by Tuesday afternoon. Health access advocates praised the bill's transparency measures and proposal to cap the cost of insulin for consumers, while groups representing the pharmaceutical industry said the bill is taking the wrong approach.
"The Senate has heard loud and clear that the rapidly rising costs of prescription drugs is the single greatest issue facing individuals and families," Senate President Karen Spilka said at a press conference. "In fact, for far too many, it is a crisis. These escalating costs are busting budgets everywhere from the family dinner table to the entire health care system as a whole."
Health Care Financing Committee Co-Chair Sen. Cindy Friedman, who Senate Ways and Means Chairman Michael Rodrigues called the "chief architect" of the bill, said it takes a "comprehensive approach" to "reining in ballooning prescription drug costs."
Friedman said she didn't know what the bill's impact on overall health care spending would be -- total health care expenditures in Massachusetts hit $60.9 billion in 2018, or $8,827 per capita -- but that its focus was making a difference for consumers feeling the pinch of rising drug prices.
The bill would authorize the state Health Policy Commission to analyze the price of certain drugs -- those that cost more than $50,000 a year per patient or fall on the World Health Organization's list of essential medicines. If the HPC determines the value of the drug is lower than its manufacturer price, the agency would be empowered to work with the drug maker privately to lower cost, with the estimated value becoming public if the manufacturer does not cooperate.
Michael Rubenstein, co-chair of the Greater Boston Interfaith Organization's health care team, said the Senate bill takes "a bold step to empower the Health Policy Commission," offering a plan that will "lower costs and lay the foundation for further consumer relief from the cost of the most expensive drugs and drugs people rely on daily to stay alive."
The GBIO hosted Spilka, Friedman and Health and Human Services Secretary Marylou Sudders at a Monday night event where its members called for "urgent reforms" to the health care system.
SHNS Audio: Full press conference audio
Nick McGee, spokesperson for the Pharmaceutical Research and Manufacturers of America, said the bill "clearly has the goal of giving the government broad authority to dictate prices and decide what treatments are available to patients, which would be devastating to patients' ability to access the medicines their doctor prescribes."
Massachusetts Biotechnology Council President Robert Coughlin said the Senate is focusing "only on drug pricing when state data show that out-of-pocket costs are the real problem with health insurance premiums and patient cost-sharing growing at 5.6% between 2017 and 2018 inflicting significant, direct financial burden on patients."
"Legislative solutions already exist to ensure patient access to prescription drugs – solutions that aren't arbitrary and punitive," Coughlin said in a statement. "Restricting the use of step therapy, non-medical switching, and extending the state's copay assistance law are all simple, lasting solutions with broad support across the Legislature. That's in strong contrast to the Senate's proposal to allow the state to determine the appropriate price of a drug, and either fine or publicly shame a company that may disagree with the state's valuations – without subjecting any other parts of the healthcare sector to such penal action."
The Senate is also proposing to cap consumers' out-of-pocket insulin costs at $25 a month, a provision Health Care for All Executive Director Amy Rosenthal said would provide "immediate relief to people living with diabetes, individuals who have experienced first-hand the impact of skyrocketing prices of live-saving drugs."
Friedman said 10 percent of the Massachusetts population is insulin-dependent.
The insulin proposal met some pushback from the Massachusetts Association for Health Plans, which voiced support for other measures of the bill.
"We appreciate the Senate's desire to control the cost drivers of insulin; however, while it limits out-of-pocket costs for consumers, the Senate approach means copayments and price increases by insulin manufacturers will simply be built into consumer premiums," MAHP President and CEO Lora Pellegrini said in a statement. "To begin addressing the underlying costs, we strongly support the transparency and oversight provisions that will hold pharmaceutical manufacturers accountable for the prices charged."
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