A prescription for reform of drug pricing

I can vividly remember the first time I became aware of the disparities in our health care system. Standing in line with my mom at Guilford CVS, I couldn’t help but notice the conversation going on in front of us between an older woman and the pharmacist. The woman was upset to learn that the cost of her prescription had gone up and the pharmacist, while sympathetic, had little in the way of an explanation.

When we got back to the car, I remember asking my mom why that was happening and that to me it seemed very unfair. This older woman was just trying to get her medicine, I said, and she couldn’t even get an explanation as to why the price went up. It was hard for me to understand then as a middle schooler and it’s hard for me to understand now as a state representative which is why I’m trying to do something about it.

According to a recent survey commissioned by the Universal Healthcare Foundation of more than 900 Connecticut residents, half of the survey respondents reported being either ‘worried’ or ‘very worried’ about affording the cost of prescription drugs. Among those who reported regularly needing prescription drugs, a staggering 88 percent said they worry about affording them. One in five people say they are so worried about prices that they regularly didn’t fill prescriptions, cut pills in half or skipped doses.

This year, along with our State Comptroller Kevin Lembo, I introduced House Bill 5383. The bill’s premise is simple: if we are to ultimately lower the cost of prescription drugs, we need to start by finding out what is causing them to cost so much in the first place.

The bill does so in three ways:

First, the bill requires the manufacturers of the top ten drugs that increase by a certain percentage from year to year to explain in writing what caused such a dramatic price increase. This information will then be released to the public proactively, not just in cases of public outrage like what recently happened with the price spike of the EpiPen.

Second, the bill requires that pharmacy benefit managers (PBMs) — the middlemen between drug manufacturers and your insurance company — disclose the amount of their rebates. That information is currently not public information but it matters because PBM’s determine what drugs go on your formulary — the list of drugs covered by your insurance — in large part based on what how much money they get to do so in the form of rebates from big drug companies.

Finally, the bill will give consumers immediate savings at the pharmacy counter by allowing them to pay the post-rebate price for drugs. Put simply, this requires insurance companies to share the millions of dollars they are getting from drug company discounts with consumers. In the last month, United Healthcare and Aetna — two of the largest insurers in America — have announced they will begin doing this but it’s time that every consumer benefit regardless of who their insurance company is.

Connecticut residents are desperate for us to take action and by passing HB 5383 we can truly take a giant step forward in the direction of more affordable drug prices. It’s time for Democrats and Republicans to come together and deliver a real win for Connecticut seniors and all consumers.