Drug-price mea­sure’s demise is bit­ter pill

Los Angeles Times - - CALIFORNIA - ME­LANIE MA­SON and SOPHIA BOLLAG me­lanie.ma­son@la­times.com sophia.bollag@la­times.com

SACRA­MENTO — An ef­fort to shed more light on pre­scrip­tion drug prices sput­tered in the Leg­is­la­ture on Wed­nes­day, deal­ing a set­back to a bur­geon­ing na­tional move­ment to rein in health­care ex­penses by curb­ing the cost of med­i­ca­tion.

The de­ci­sion by state Sen. Ed Her­nan­dez (D-West Cov­ina) to yank his bill from con­sid­er­a­tion af­ter it was wa­tered down in an Assem­bly panel marks an abrupt end to what promised to be the mar­quee lob­by­ing bat­tle of the leg­isla­tive ses­sion, pit­ting Capi­tol heavy­weights such as la­bor groups and health in­sur­ers against drug man­u­fac­tur­ers.

The mea­sure’s demise is a sig­nif­i­cant vic­tory for phar­ma­ceu­ti­cal com­pa­nies, but not a full re­prieve. A sep­a­rate bal­lot ini­tia­tive to clamp down on drug costs will go be­fore vot­ers this fall, and the mea­sure’s ad­vo­cates hope to cap­i­tal­ize on the Leg­is­la­ture’s in­ac­tion.

With all par­ties vow­ing to press ahead — ei­ther via ini­tia­tive or leg­is­la­tion next year — the is­sue of pre­scrip­tion drug costs is cer­tain to re­main at the fore­front of Cal­i­for­nia’s health­care de­bate.

“This is an is­sue that will not go away, and the pub­lic de­mands an­swers,” Her­nan­dez said in a state­ment Wed­nes­day. “We will get it right.”

Her­nan­dez’s mea­sure, SB 1010, took a two-pronged ap­proach. First, it would have re­quired health plans to re­port de­tailed in­for­ma­tion on phar­ma­ceu­ti­cal drug costs — such as the most pre­scribed and most costly medicines — to state reg­u­la­tors.

It also would have forced drug­mak­ers to give no­tice of fu­ture price in­creases to in­sur­ance com­pa­nies, phar­macy man­agers and the state agen­cies that buy pre­scrip­tion drugs.

It was the sec­ond piece of ma­jor drug pric­ing leg­is­la­tion to come be­fore law­mak­ers this ses­sion: An ear­lier bill by Assem­bly­man David Chiu (D-San Fran­cisco) to re­quire phar­ma­ceu­ti­cal com­pa­nies to re­port costs and prof­its as­so­ci­ated with high-priced spe­cialty drugs fal­tered ear­lier this year.

The string of high-pro­file leg­is­la­tion re­flects es­ca­lat­ing scru­tiny na­tion­wide on surg­ing drug prices and their ef­fect on over­all health­care costs. From the pres­i­den­tial cam­paign to state­houses across the coun­try, phar­ma­ceu­ti­cal com­pa­nies have found them­selves play­ing de­fense, ham­mered by head­lines about six-fig­ure spe­cialty drugs or for­mer Tur­ing Phar­ma­ceu­ti­cals ex­ec­u­tive Mar­tin Shkreli, who drew in­tense crit­i­cism af­ter in­creas­ing the price of a med­i­ca­tion to com­bat rare in­fec­tions by 5,000%.

Nearly three-quar­ters of Amer­i­cans be­lieve pre­scrip­tion drugs are too ex­pen­sive, ac­cord­ing to a poll last year by the non­profit Kaiser Fam­ily Foun­da­tion, which is not af­fil­i­ated with health­care provider Kaiser Per­ma­nente.

The drug in­dus­try coun­ters that much of the de­bate cen­ters on whole­sale prices, which can climb into five­and six-fig­ure amounts. Most in­sured con­sumers typ­i­cally pay a frac­tion of those costs un­der their co-pay­ment plans.

Her­nan­dez’s leg­is­la­tion was one of the most lob­bied bills of the ses­sion, with at least 70 groups spend­ing money to ad­vo­cate for or against it, ac­cord­ing to lob­by­ing ac­tiv­ity fil­ings.

The mea­sure was spon­sored by the Cal­i­for­nia La­bor Fed­er­a­tion, an um­brella group of 1,200 unions. Many of the in­di­vid­ual statewide unions — along with lo­cal af­fil­i­ates — pushed hard for the bill, ar­gu­ing that ad­vance no­tice on price in­creases was cru­cial to plan for their mem­bers’ health­care.

On the op­pos­ing side, the in­dus­try’s main trade group, the Phar­ma­ceu­ti­cal Re­search and Man­u­fac­tur­ers of Amer­ica, or Phrma, and other as­so­ci­a­tions were joined by at least 28 phar­ma­ceu­ti­cal com­pa­nies that paid lob­by­ists to work to de­feat the leg­is­la­tion.

“I’d be sur­prised if there was any ma­jor lob­by­ing firm that did not have a con­tract … with one side or another in this fight,” said An­thony Wright, who leads the con­sumer ad­vo­cacy group Health Ac­cess, a sup­porter of the bill.

The bill was sub­stan­tially over­hauled last week in a key Assem­bly fis­cal com­mit­tee. The changes in­creased the thresh­old un­der which drug­mak­ers would have to alert pur­chasers of price in­creases, and would have de­layed the no­tice re­quire­ment for one year. The pro­vi­sion would have ex­pired in 2022.

Pro­po­nents wor­ried the new no­tice re­quire­ments would not have cap­tured the vast ma­jor­ity of drug price in­creases, and ar­gued that the de­layed im­ple­men­ta­tion would have given phar­ma­ceu­ti­cal com­pa­nies time to ma­nip­u­late their prices with­out scru­tiny. Her­nan­dez de­cided to pull the bill.

From la­bor groups to health­care in­sur­ers, the re­ac­tion struck a com­mon tone: We’ll be back.

“In the com­ing months, the Cal­i­for­nia la­bor move­ment and our coalition part­ners, rang­ing from busi­nesses and in­sur­ers to health­care ad­vo­cates and con­sumer groups, will re­dou­ble our ef­forts to en­act real re­form to con­trol ris­ing pre­scrip­tion drug prices that are hurt­ing us all,” said La­bor Fed­er­a­tion leader Art Pu­laski in a state­ment.

Even Phrma sig­naled an in­ten­tion to tackle the is­sue.

“No pa­tient should have to worry about whether they can af­ford their medicines,” said Priscilla Van­derVeer, a spokes­woman for the group. “We be­lieve that there is an op­por­tu­nity to for us to work with Sen. Her­nan­dez and his col­leagues, as well as the broader stake­holder com­mu­nity, to find so­lu­tions that will give pa­tients and fam­i­lies what they need: pre­dictable and ac­ces­si­ble in­for­ma­tion about the out-of-pocket costs they will face and en­force­able, com­mon-sense rules that pre­vent dis­crim­i­na­tion and re­move bar­ri­ers to re­ceiv­ing care.”

Mean­while, the fight now shifts to the bal­lot box, with an ini­tia­tive, Propo­si­tion 61, that would pre­vent state agen­cies from pay­ing more for a drug than the price paid by the U.S. Depart­ment of Vet­er­ans Af­fairs.

The ini­tia­tive is spon­sored by the Los An­ge­les­based AIDS Health­care Foun­da­tion and has been en­dorsed by for­mer Demo­cratic pres­i­den­tial con­tender Sen. Bernie San­ders of Ver­mont.

But its sup­port does not match that of the drug pric­ing bill. Some of the leg­is­la­tion’s back­ers, in­clud­ing the Cal­i­for­nia Med­i­cal Assn. and the statewide union of con­struc­tion work­ers, op­pose the ini­tia­tive.

Oth­ers, such as the Cal­i­for­nia Demo­cratic Party and the Cal­i­for­nia La­bor Fed­er­a­tion, did not take a po­si­tion on Propo­si­tion 61.

“Peo­ple are look­ing at each pol­icy dif­fer­ently,” said Kathy Fair­banks, a spokes­woman for the No on Propo­si­tion 61 cam­paign. “Prop. 61 still is bad pol­icy. It was bad pol­icy be­fore to­day and it will be bad pol­icy to­mor­row.”

Drug com­pa­nies have in­vested heav­ily to de­feat the mea­sure. The op­po­si­tion cam­paign had nearly $66 mil­lion on hand as of June 30, ac­cord­ing to cam­paign fi­nance fil­ings. Sup­port­ers re­ported just over $7 mil­lion in the bank.

The mea­sure’s pro­po­nents said they see vot­ers’ frus­tra­tion with climb­ing drug prices — and Sacra­mento’s in­abil­ity to ad­dress it — as work­ing in their fa­vor.

“Cal­i­for­ni­ans des­per­ately want their lead­ers to do some­thing about out­ra­geous drug price goug­ing,” said Roger Salazar, spokesman for the ini­tia­tive. “This bill was strictly about trans­parency, but the drug lobby spent mas­sively to kill it. Well, I be­lieve the vot­ers of Cal­i­for­nia aren’t afraid of Big Pharma, and if the Leg­is­la­ture won’t do it, they’ll han­dle this prob­lem them­selves by vot­ing yes on Prop. 61.”

Katie Falken­berg Los An­ge­les Times

SEN. ED HER­NAN­DEZ re­moved his leg­is­la­tion. “This is an is­sue that will not go away, and the pub­lic de­mands an­swers,” he said. “We will get it right.”

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.