A bill that aims to lower the price of the costliest prescriptions for Mainers inspired testimony from several dozen stakeholders at a public hearing on Tuesday, with residents across the state speaking broadly in favor. of the bill and pharmaceutical organizations strongly against it.
The bill, introduced by Sen. Ned Claxton, D-Auburn, would set an upper price limit that state entities, health plans, pharmacies or other participating payers are willing to pay manufacturers for the 250 drugs costliest for Mainers. Due to the nature of Medicaid as a partnership between state and federal governments, it is excluded from the bill.
LD 1636, An Act to Reduce Prescription Drug Costs by Using International Pricing, would require that each year the State Superintendent of Insurance compile the list based on the previous year’s prices and cross-reference these with the wholesale price published by the Canadian government for its four most populous provinces.
The legislation was drafted to focus on the payer, not the manufacturer, and doesn’t set drug prices, which likely wouldn’t withstand a constitutional challenge, said Jennifer Reck, director of policy at the Center for Drug Pricing. medications.
Claxton’s bill is based on model legislation written by policy and legal experts from the academy, a nonpartisan, nonprofit forum for state policymakers with offices in Portland and Washington, D.C.
A number of people testified before the Legislative Committee on Medicare and Financial Services that they were desperate for relief from the high cost of prescription drugs.
Vilene Farina from Lewiston wrote to the committee that she was diagnosed with breast cancer last October. The cost of his life-saving drugs is in the “thousands of dollars”.
She said that although she has insurance that covers part of the cost, she has met other people who are forced to choose between buying food or cancer medicine.
“The stress of having to pay such high costs causes more problems,” she wrote. “We need to reduce the high costs of these prescription drugs so that the people of Maine can afford to live, (so) we don’t have to choose between taking a life-saving drug and eating or feeding our families. “
Sabrina Fuhrer’s son and brother both have type 1 diabetes. The Old Town resident said she for years watched her parents struggle to pay for her brother’s medication.
When his father became seriously ill and needed dialysis and various medications to live on, he finally decided to give up treatment.
“I knew a big part of his reason was that he didn’t want the family to have one more medical cost to think about,” Fuhrer said.
Now, she says, she lives in “constant fear” of what might happen if her son loses his MaineCare coverage. The disbursement for his insulin is $650 per month.
Even with health insurance, the monthly cost of life-sustaining drugs for people with chronic conditions, such as diabetes, Crohn’s disease and arthritis, can run into the thousands of dollars due to the high price of these drugs.
These same drugs cost a fraction of the price across the border in Canada.
Jane Horvath, an independent health policy analyst, told lawmakers on Tuesday that the bulk of drug company revenue comes from the United States.
“But we’re not getting the best deal,” she said. “We’re their best customer, but we’re not getting the best deal,” which speaks to the “market failure” that legislation like Claxton’s bill attempts to correct.
However, professional organizations that represent pharmaceutical companies and others in the prescription drug landscape opposed the bill.
Several Maine attorneys testifying on behalf of organizations such as Pharmaceutical Research and Manufacturers of America, or “PhRMA,” suggested the bill would not withstand legal challenges.
But legal experts who testified at Tuesday’s hearing on behalf of the National Academy for State Health Policy said the bill was drafted to withstand those legal challenges.
The bill’s legal ramifications weren’t the only issues that pharmaceutical representatives took umbrage at.
“Allowing the government to set prices at the lowest price in Canada could restrict patients’ access to drugs by reducing the availability of lifesaving therapies in the state,” PhRMA director of policy Nick Doherty told lawmakers. .
Others who spoke in opposition were representatives of Anthem Blue Cross and Blue Shield, a federation of American health insurance companies; Biotechnology Innovation Organization, which lobbies on behalf of the biotechnology industry; Pharmaceutical Care Management Agency, a professional organization that represents pharmaceutical benefit managers; Healthcare Distribution Alliance, a national organization representing pharmaceutical distributors; and CancerCare, a New York-based company that provides support for people with cancer.
The only local entities to oppose LD 1636 were the Southern Maine Chronic Pain Support Group and Eric Cioppa, the state superintendent of insurance, who also said the bill could create a situation where “no one is willing to sell the drug at a price that the carrier or state agency is authorized to pay.”
Horvath, the independent health policy analyst, called this reasoning a scare tactic.
The chronic pain support group, represented by Saco’s Ernie Merritt, spoke specifically about a provision of Canadian drug pricing law called the “quality-adjusted life year,” which is a measuring health outcomes.
“QALY devalues the lives of the elderly or disabled. By that standard, their life is not worth the investment in these drugs because they may not live as long as other people,” Merritt said in written testimony.
The pain support group, along with CancerCare, argued that because Canadian drug prices incorporate QALYs, the benefits of the bill will be out of reach for people with chronic or terminal illnesses.
Bill aims to reduce cost of most expensive prescription drugs for Mainers