[T]he attorney general’s office is seeking information from 10 pharmaceutical companies, including the maker of the EpiPen, on why the prices of their prescription drugs are going up.

The office is seeking information by Oct. 1 as part of Act 165, Vermont’s first-in-the-nation law requiring price transparency from prescription drug manufacturers whose drugs cost the state’s Medicaid program a significant amount of money.

A spokesperson for the Pharmaceutical Manufacturers and Researchers of America said Monday those companies would likely send in the information to the state: “While we cannot speculate on the actions of individual manufacturers, in general, PhRMA members follow all applicable laws and we anticipate the same to be true in this case.”

Under the law, the Green Mountain Care Board uses information from the Department of Vermont Health Access to put together a list of drugs whose sticker prices, paid by Vermont’s Medicaid program before rebates, have gone up by 15 percent in one year or 50 percent in five years. The sticker price is often called the “wholesale acquisition cost” and does not include any rebates that an insurance company, such as Medicaid, negotiates with the drug company.

The attorney general’s office has created a website to obtain information directly from the manufacturers, and the office must write a report on the causes of the drug price increases for the Legislature by Dec. 1. The office can also take the companies to civil court if they don’t comply.

The board looked at a list of 15 drugs they could put on the list and decided to seek information for 10 of them because of the limited amount of time under the law to get information from manufacturers and create an annual report, according to Susan Barrett, the executive director of the Green Mountain Care Board.

The board posted a list of 10 on Aug. 22, according to Barrett, and had intended to put the drugs with the highest acquisition costs on the list. After learning on Monday that the original list was alphabetical, not by cost, the board created an updated list and published it Tuesday.

Eight of the top 10 highest-cost drugs are branded: Abilify, Lantus, Humira, Enbrel, Crestor, EpiPen, Latuda and Prevacid. The other two are generic: doxycycline hyclate, an antibiotic, and permethrin, an insecticide often used to treat head lice.

The five drugs that the state spends significant money on but did not make the list include three branded drugs: Lioderm, Sabril and Tecfidera. The other two are a type of metformin, used to treat diabetes, and a type of neomycin, an antibiotic.

“I’m kind of just curious and anxious to see how manufacturers respond to the inquiry,” said Nancy Hogue, the pharmacy benefits manager for the Department of Vermont Health Access. “But as far as drug prices going up, that’s not a big secret. It’s been happening for quite some time.”

Rep. Bill Lippert, D-Hinesburg, agreed. He said that while the EpiPen has been in the news lately, the House Health Care Committee took testimony on that drug back in the spring. “It’s not news. It’s not new,” he said. “It’s been outrageous and unbelievable gouging of consumers as far as I can see.”

Sen. Tim Ashe, D/P-Chittenden, said the price of prescription drugs is straining the state’s budget, hospital budgets and insurance companies. “Medicaid is a huge purchaser of drugs, and every time there are big price increases, that’s being passed along to taxpayers,” he said.

Ashe said the pharmaceutical industry has historically been one of the most profitable industries in the country — “outpacing Fortune 500 profits by many multiples” — but sharp price increases have become more frequent in recent years.

“Looking at the increases particularly over five years of some of these drugs is just off the charts, so I think it’s a sign that the law that Vermont passed is really critical to start changing the environment around drug pricing,” Ashe said.

According to data from the Department of Vermont Health Access, the state’s Medicaid program spent $185.6 million on prescription drugs in 2015, and received $81.4 million in rebates. Before accounting for rebates, pharmacy has consistently been the highest single category of costs to the state’s Medicaid program.

Vermont’s largest hospital system said [during its budget hearing] that prescription drug costs go up by 8 percent to 10 percent per year. Vermont’s largest health insurance company, Blue Cross Blue Shield, also cited prescription drug costs as a reason for rising premiums.

Priscilla VanderVeer, the spokesperson for PhRMA, which represents branded drug manufacturers, said the group recognizes and shares concerns about prescription drug prices, but that Vermont’s law is based on false information.

“Legislative efforts such the one in Vermont will not do anything to help patients afford their medicines,” VanderVeer said. “The law also accepts a false notion that spending on medicines is the primary driver of the growth in health care costs, and ignores the cost savings that medicines provide to the health care system overall in the form of improved disease management and fewer physician visits, hospitalizations, surgeries, ER trips and other costs.”

“In addition, the wholesale acquisition prices (sticker prices) that are being used to compile the list do not reflect the discounts and rebates that drug manufacturers provide to both public and private payers, and the list may not accurately reflect how much is being paid for these medicines,” she said.

Ashe said any discounts that Vermont’s Medicaid program or other insurance companies receive are directly related to the sticker price, also known as wholesale acquisition cost.

“I find that a very uninteresting point,” he said. “They wouldn’t jack up the price if they weren’t going to get more money from it.”