State lawmakers aim to lower prescription drug costs
HARTFORD — Questions and opposition have emerged against a state bill that would reduce the cost of certain prescription drugs.
While supporters said the bill is needed, pointing to dire examples of people forgoing meals, taking fewer doses or buying on the black market so they could afford insulin, opponents said it could create more costs and might contradict existing laws. Others applauded the intention of the bill but said it didn’t go far enough.
“These stories are not rare exceptions to the norm, as much as we’d like to pretend otherwise,” chapter leader for Connecticut #Insulin4all, Arden Parrish said at the recent public hearing. “This is the reality that far too many of us face.”
The Human Rights Committee drafted Senate Bill 8 to reduce the cost of certain prescription drugs by establishing a handful of initiatives, such as bringing in cheaper medications, capping insulin costs, requiring hospitals to participate in a federal program and creating an advisory board.
The main initiative would establish a program to bring in prescription drugs with the “highest potential for cost savings” from Canada for the state’s medical assistance program. Florida was the first state for the U.S. Food and Drug Administration approved-program in January 2024.
“The state will be able to purchase safe, equivalent medications from a wider array of manufacturers, ensuring that we’re getting the best deal and using our limited Medicaid funding as efficiently as possible,” said state Sen. Martin Looney, D-New Haven, a bill co-sponsor.
Kelly Memphis, director of state government affairs at Healthcare Distribution Alliance, said in her written testimony the importation program could ultimately raise the state’s costs. Florida’s ability to import drugs is based on meeting several conditions, which may be costly, such as comprehensive testing, relabeling requirements, and submitting quarterly reports, she said.
“We do believe a state like Florida will ultimately spend a lot of money trying to meet a lot of very strict standards that FDA has put forward as part of their approval and not really be able to access enough supply to bring savings to their patients,” she said at the hearing.
Memphis also raised concerns about how the program would ensure the safety and quality of imported prescriptions. Although the bill states that wholesalers and Canadian suppliers should comply with track-and-trace requirements, she said the bill needs to explain how that system would work in the U.S. pharmaceutical supply chain, which has slowly strengthened over the last decade.
Memphis added the Canadian government and Canadian Association for Pharmacy Distribution Management don’t support the program because it could limit drugs available to Canadians.
Another initiative in the bill would require hospitals and drug purchasing agencies to create a strategy to prevent shortages for at least 40 drugs and have a six-month supply on reserve. It’ll also require hospitals to participate in a federal program that limits the prices drug manufacturers may charge for drugs sold to specified health care facilities and entities.
Although the Connecticut Hospital Association applauded the bill’s goal, it said the hospital requirements as written “may be unachievable and would likely add cost, not reduce it.”
CHA said requiring hospitals to reserve prescription drugs would limit suppliers’ options since providing that much product at one time is not industry standard. This requirement may also worsen drug shortages in other parts of the country, leading to “extreme costs.” There would be additional costs to hospitals so they can safely store the supply for long periods of time while also potentially increasing drug product waste.
CHA added state law can’t force hospitals to participate in the 340B Drug Pricing since it’s a voluntary program administered by a federal agency, which solely determines eligibility. The operational costs related to a hospital’s participation would negate perceived savings, the testimony added.
Andrea Barton Reeves, the state Department of Social Services commissioner, raised concerns about implementing a Canadian prescription drug import program, saying the timeline in the legislation doesn’t give their department enough time to study the program’s true impact and ensure it doesn’t conflict with federal statutes.
Another initiative builds on previous work to cap insulin costs. It would require the Office of the State Comptroller to make eligible insulin products available at the lowest wholesale acquisition cost to residents using the state employee health plan.
Pharmaceutical Research and Manufacturers of America submitted written testimony stating that setting prices could limit residents’ prescription options. It criticized the bill for its “inexplicably narrow view of health care cost drivers” and its single-outing of the biopharmaceutical industry. The testimony said that the bill doesn’t fully understand the variety of stakeholders involved in setting prices.
The next major component is the creation of a Prescription Drug Affordability Board. This five-member board of governor-appointed experts from various fields related to drug prescription prices would advise the OHS on decisions regarding affordability, though some said a patient should also be on it. It may study the drug supply chain and pharmaceutical pricing to identify potential savings. The PDAB would also be able to set upperlimit payment caps on certain prescription drugs.