Springfield News-Sun : 2019-02-11

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A4 | SPRINGFIELDNEWS-SUN | MONDAY, FEBRUARY 11, 2019 COMPLETE. IN-DEPTH. DEPENDABLE. MORE OF TODAY’S TOPNEWS DIGGINGDEEPER If some proposals become laws, court are certain. drugs give the state’s Medicaidagency discounts beyond those set by federal statute. Vertex, themanufacturer ofacysticfifififififibrosismedication witharetail priceof $272,000 ayear, refused. AndNewYork was forcedto acknowledge it couldnotrequirecompliance. Vertex touted the effifficacy ofitscysticfifififififibrosisdrug.“The price ofourmedicines reflflect the significant value they bring to patients,” saidSarah D’Souza, a Vertex spokeswoman, adding,“We do not believe an additional rebate is warranted.” Still, states see promise in that approach. Massachusetts Gov. Charlie Baker, a Republican, recently proposed ameasure that would the state Medicaid agency to negotiate further discounts on certain drugs. Ifnegotiations don’twork, the state could subject the manufacturer to a public rate-setting process, require more transparency on pricing, or refer the matter to the state’s attorney general’s offiffice for possible prosecution consumer protection laws. therapeutic class, one medicationmayworkbetter for an individual patient. Some organizations that represent people with certain diseases joined drug manufacturers in objecting to Massachusetts’ proposal. TheTrumpadministration alsoopposes statesimporting cheaper drugs fromCanada. Lastyear, Vermontbecame thefifififififirststatetopursueimportation. Vermont’s measure would save the commercial insurance industry between $1 million and $5 million a year, astatereport estimated. LawmakersinColorado, Connecticut, Illinois, Maryland, Missouri, Oregon and Virginia have proposed studies of the idea. ButbuyingdrugsfromCanadarequiresfederalapproval, which, until recently, seemed unlikely. U. S. Health Human Services Secretary AlexAzar last spring saidseveral times he had no interest in allowing Vermont or states to proceedwith such a plan. But in response to some dramatic increases in drug prices, he softened his position, at least in the case of some generic medications produced by a singlemanufacturer. He saidlast summer thathewas settingupaworking groupto study importing drugs from abroad. Maryland’s attempt tocontrol drug prices ran aground last year in a federal courtroom. The 4th Circuit Court of Appeals inApril a 2017Marylandlawenacted to curb “unwarranted” price hikes, saying the state hadno authority to regulate interstate commerce. Knowing that states are onshaky ground, somedrug companieshavepushedback against attempts to limit their prices. They did so in New York, where lawmakers in 2017 enacted a requirement that makers of certainhigh-priced than another fifights ByMichaelOllove TribuneNews Service Frustrated by federal inaction, state lawmakers in 41 states have proposeddetailedplans to lower soaring prescription drug costs. Somemeasureswould give state Medicaid agencies morenegotiatingpower. Otherswoulddisclosethepricing decisions of the drugmanufacturers the companies that administer prescription drug plans. The more ambitious proposalswouldbumpupagainst federal authority, such as legislation that would allow importing drugs from Canada or alter federal statutes on the prices states pay for drugs in Medicaid. They likelywould have to survive a challenge in federal court. And many likely would face resistance froma deep-pocketed industry. According to the National Institute onMoney Politics, a that collects campaign data, the pharmaceutical industry in 2018 contributed nearly $19 million to state campaigns, and $56 million to federal ones. “Statesarelimitedinpower in this area,” said Rachel Sachs, a health law expert at Washington University in St. Louis School of Law. “But of the impacts of these efffffffffffforts is to put pressure on the federal government, and force it to justify its actions to stymie the states.” President Donald Trump has criticized soaring drug prices, on Thursday the Department of Health and Human Services announced a draft regulation thatwould allow drugmakers to offer discounted prices directly WASHINGTON— Rep. Elijah Cummings (left) the chairman of the HouseOversight and Government Reform Committee, has praisedwhat he said is a bipartisan consensus that drug companies’ aggressive price hikes need to be reined in. Alex Azar (right), secretary ofHealth and Human Services, announced earlier this week a draft regulation thatwould allow drugmakers to offffer discounted prices directly to consumers. ANDREWHARRER / TOMBRENNER / THE NEWYORK TIMES BLOOMBERG 2018 other and few bills offffffffffffered this session would force actions either from insurers or pharmacy benefifit managers, the companies that administer drug plans. Other proposalswould study foreign drug importationorencouragepricenegotiations to benefifit, say, Medicaid patients. The federal government has zealously guarded its authority drug pricing. Last year, for example, the Trump administration rejected Massachusetts’ request to become state to excludecertain drugs fromits Medicaid program, to extract better prices from pharmaceutical companies. By law, all state Medicaid agencies must carry every drug approved by the U.S. Food and Drug Administration, in return for rebates from drugmakers. Massachusetts proposed to offffffffffffer at least in every “therapeutic class,” that is, treatments to address a specifific condition or illness, such as blood clots or angina. It also sought the authority to evaluate the effffffffffffectiveness of newly introduced drugs, by comparing them with other medicines in the same class. That idea worries some health analysts, who note that even within the same Hill, DouglasHoltz-Eakin, presidentoftheself-described “center- right” American ActionForum, toldtheRepublican-ledSenateFinanceCommittee that government policies were at least partly to blame for rising drug prices. Holtz-Eakincitedlaws governing Medicaid payments to drug companies and the Affordable Care Act’s tax increases on manufacturers and importers. “It should not be surprising,” he said, thatdrugprices increased simultaneously with the passage of theACA. Priscilla VanderVeer, a spokeswoman for the Pharmaceutical Research Manufacturers of America, thelobbyingarmoftheindustry, saidPhRMA, as the group is known, would oppose many of the state bills. The proposals wouldn’t lowerpricesonmedications, she said, andwould discourage corporate investment in research and development of new drugs. “Weabsolutelyunderstand where patients are coming from, and their struggles to get the medications need at an affffffffffffordable price,” VanderVeer said. “But let’s focusonthe entire chain, not just manufacturers.” It isn’t the case, though, that lawmakers are focusing only onmanufacturers; a to consumers — but without giving rebates to Medicaid managed care organizations or the middlemen known as pharmacy benefifit managers. Between 2012 2017, drug spending in theUnited States increased nearly 29 percent while health spending rose less than 25 percent. 2013, the growth in prescription drug spending has exceededGDP growth, which means industry is consuming an large share of the U.S. economy. Committeesinbothhouses of Congress held hearings in January to consider how to arrest the trend. In his opening statement, U.S. House Oversight CommitteeChairmanElijahCummings, a Maryland Democrat, praised what he said is a bipartisan consensus that drug companies’ aggressive price hikes need to be reined in. “We have seen time after time that drug companies make money hand by raising the prices of their drugs— oftenwithout justifification, and overnight— while patients are left holding the Cummings in his statement, adding later: “We have a duty to act now.” On the other side of Capitol enable and and overall Since other over the pharmaceutical under the fifirst increasingly in Connecticut and Maryland are pushing similar proposals. State lawmakers in Massachusetts, Minnesota, New York and Virginia also want to prevent drugmakers from steep year-to-year price increases in the commercial market. LindaGorman, director of theHealthCarePolicyCenter, attheIndependenceInstitute, a libertarianthinktankbased in Denver, said interfering in the market is a bad “It’s a waste of time, and you’ll only regulation higher prices,” Gormansaid. She argues, for example, that by requiring drugmakers to give discounts toMedicaid agencies, the federal government drivesupdrugprices incommercial plans. Legislators and nonprofifit fifinance and enacting set threwout onemedicine intended one idea. over fifist endupwithmore and overall they sometimes and bill,” said Introductory Price! LOW AS $ 1945 each Actual size is 40.6 mm Just Released: Secure Your New U.S. 2019 Silver Dollars Now! M Timing is Everything illions of people collect the American Silver Dollar. In fact, been the country’s most Silver Dollar for thirty years. 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