N.M. can help limit drug cost, specialist tells group

Presentation to committee on prescription price increase was an eye-opener, many state lawmakers say Monday

About half of all American adults take at least one prescription drug — and nearly one in four take four or more.

But due to rising costs, about three of every 10 Americans don’t regularly take those medications as prescribed, according to data presented in a new legislative report.

It’s a problem drawing more national attention in the COVID-19 era times, Colleen Becker, senior policy specialist for the National Conference of State Legislatures, told lawmakers Monday on the interim Legislative Health and Human Services Committee.

“If anything, the pandemic put more light on prescription drug costs and prices,” she said. “Lawmakers will be grappling with these issues for many years to come.”

Becker’s report comes on the heels of a provision in the federal Build Back Better bill to allow Medicare to negotiate with pharmaceutical manufacturers on prices for some prescription drugs and to limit those companies’ abilities to raise drug prices in some fashion. The U.S. House of Representatives recently passed that bill, but its chance in the Senate remain uncertain.

Becker told committee members, the feds — and not the states — control most prescription drug prices. She said the average patient spend on those drugs is $1,200 per year. For specialty drugs, infusions and injections, that cost can rise significantly to about $1,000 per month.

But she also said states can implement policies to makes costs more transparent and limit insured patients’ copays — and if enough states band together, they could pressure the federal government to do something to limit those costs.

She said states can also enact plans to limit prescription drug costs for state Medicaid and state employee insurance plans.

While Becker’s agency does not engage in policy creation or make recommendations to state legislative bodies, she told legislators eight states

have created prescription drug affordability boards, which can investigate and review drugs that undergo price increases over a short period of time.

Many lawmakers on the committee said Becker’s presentation was an eye-opener into the world of prescription drug sales and costs.

“It is a shell game, and it is disturbing how many people make money off of something that should be a human right, a right to treatment, a right to health care,” said Sen. Antoinette Sedillo Lopez, D-Albuquerque, near the end of the discussion.

Becker laid out what she called a “highly complex” drug supply chain process involving a number of players, from manufacturers to wholesalers to pharmacy benefit managers — which manage prescription drug benefits for health insurance groups — to pharmacies and consumers.

Sen. Martin Hickey, D-Albuquerque, whose professional career spanned many facets of health care, said his years of experience in the field gave him the equivalent of a master’s degree in prescription drug costs.

He called the prescription drug process a “complex shell game” and said “there’s always profit and there’s always middle men and there’s always more middle men … the question is, do they really provide value or not?”

Hickey said Monday the Legislature should begin discussing creating its own prescription drug advisory board “tomorrow.” He also suggested a yearlong study of the issue to help New Mexicans understand the cost process and find ways to address those costs.

Becker left the committee a copy of her group’s July report with some ideas for reforming the system on the state level. Among the ideas is for states to pursue prescription drug importation agreements with other countries, such as Mexico. A Utah law pays travel fare and some expense money for public employees to travel to Mexico to access cheaper prescription drugs, she said.

In 2020, Gov. Michelle Lujan Grisham signed a bill into law to allow New Mexico to apply for federal approval to import medications from Canada, where prescription drugs are on average 30 percent cheaper than in the U.S.