Prescribing Changes
OKLAHOMA CITY – A southwest Oklahoma legislator thinks Oklahomans should be allowed to import cheaper-priced prescription drugs legally.
House Bill 2852 by state Rep. Daniel Pae, R-Lawton, would direct the State Health Department to apply to the U.S. Secretary of Health and Human Services for permission to import prescription drugs. The Health Department “is authorized to establish a nominal fee per unit of drug to cover only costs necessary to efficiently administer the program and not jeopardize consumer savings,” the bill decrees. Pharmaceutical manufacturers would be prohibited from taking any action that would have the effect of “fixing or otherwise controlling the price” that a pharmaceutical supplier, distributor or dispenser “charges or advertises” for drugs in the program.
According to the Commonwealth Fund, at least 40% of the prescription drugs used in the U.S. are manufactured abroad and are considered safe. Former Food and Drug Administration Commissioner Scott Gottlieb has said that any drug manufactured overseas for the U.S. market is made in the same FDA-registered plant that makes the drug for markets in other countries. A proposal to import prescription drugs from Canada to New Hampshire received bipartisan support in the Granite State’s legislature on Jan. 21. A Concord legislator told his colleagues that in a 2017 survey, roughly one-fifth of the New Hampshire residents with prescriptions stopped taking them at some point during the year because they couldn’t afford them anymore.
“Every January, drug manufacturers ring in the new year by raising the price of their drugs,” Tori Marsh of the Research team at GoodRx wrote last month. For reference, last January, 486 brand drugs increased in price by an average of 5.2%, while the cost of 580 brand drugs increased by an average of 8.0% in 2018. As of Jan. 24, 2020, Ms. Marsh reported, the prices for 619 drugs had increased by an average of 5.9%.
Those included Eliquis, often prescribed to prevent blood clots (6.0%); Jardiance (6.0%); Truvada (4.8%); Chantix, to help reduce the urge to smoke (5.0%); Cosentyx (7.0%); Enbrel (7.4%); Xarelto, approved by the FDA to help reduce the risk of blood clots (4.9%); Symbicort, for treatment of COPD (3%), Trintellix, an antidepressant (5%); and Humira, used to treat inflammation in patients with autoimmune disease (7%). Fifteen generic drugs had increased by an average of 38%. Those included Diazepam (generic for Valium), a 7.8% price hike.
The pharmaceutical price hikes occurred just days after the Trump administration proposed a rule that would allow less expensive medicines to be imported from Canada. “Our ultimate goal is to provide a robust program that clearly lays out procedures to import drugs that could provide lower prices while also maintaining the high-quality Americans expect,” Assistant Secretary for Health Brett Giroir said in December. But in a statement issued last July, pharmaceutical representation firm Innovative Medicines Canada said, “Canada cannot supply medicines and vaccines to a market ten times larger than its own population without jeopardizing Canadian supplies and causing shortages.”
Accordingly, H.R. 3, the Lower Drug Costs Now Act of 2019, passed the U.S. House of Representatives in a bipartisan 230-192 vote on Dec. 12; the measure includes the Capping Out-of-Pocket Costs for Seniors Act proposed by U.S. Rep. Kendra Horn, D-Oklahoma City. H.R. 3 awaits consideration in the U.S. Senate. H.R. 3 would require the Centers for Medicare & Medicaid Services (CMS) to negotiate prices for certain drugs (current law prohibits the CMS from doing so). Specifically, the CMS must negotiate maximum prices for insulin products and for at least 25 single-source, brand-name drugs that do not have generic competition and that are among the 125 drugs which account for the greatest national spending or the 125 drugs that account for the greatest spending under the Medicare prescription drug benefit and Medicare Advantage (MA). The negotiated prices must be offered under Medi- care and MA and may also be offered under private health insurance unless the insurer opts out.
The negotiated maximum price may not exceed (1) 120% of the average price in Australia, Canada, France, Germany, Japan, and the United Kingdom; or (2) if such information is not available, 85% of the U.S. average manufacturer price. Drug manufacturers that fail to comply with the bill’s negotiation requirements are subject to civil and tax penalties. The bill also would make a series of additional changes to Medicare prescription drug coverage and pricing. Among other things, the bill would (1) require drug manufacturers to issue rebates to the CMS for covered drugs that cost $100 or more and for which the average manufacturer price increases faster than inflation; and (2) reduce the annual out-of-pocket spending threshold.