[P]rescription drug prices have become prohibitive, and Congress is not addressing the problem, Rep. Peter Welch, D-Vt., told lawmakers on Friday. State level action is needed, he said, to combat spiralling costs.
“The good news is that they’re life-extending and pain-relieving,” Welch said. “The bad news is that the cost is starting to kill us.”
Welch told the Senate Health and Welfare and the House Human Services and Health Care committees Friday that there’s been a “market failure” in the pricing of prescription drugs.
Welch sees curbing the escalating costs of prescription drugs as an important step in making health care as a whole more affordable for government and individuals.
“These life-saving drugs are not going to save any lives if the people who use them literally can’t afford them,” Welch said.
But bipartisan progress on the issue has been slow, Welch said. In the meantime, he said, lawmakers in Vermont can take steps on a state level.
“There’s a lack of leadership in Washington in the Congress right now,” Welch said. “We should be taking on the mutual responsibility but we’re not, we’re deadlocked.”
Welch said several states, including California and Massachusetts, require pharmaceutical companies to be more transparent in disclosing information about spending on research and development of drugs, marketing and profits.
States can also take action to make sure that reductions in drug prices are passed on to consumers. Although Vermont already limits annual out-of-pocket expenses on drugs to $1,250, he suggested considering limiting monthly copayments after someone meets their deductible.
He also suggested pursuing legislation to make information about drug pricing more readily available for patients and doctors, to reduce surprises at the pharmacy counter.
Jill Sudhoff-Guerin, the state government relations and advocacy director for the American Cancer Society, said that a bill in Senate Finance would make information about drug prices more accessible to people before they get to the pharmacy.
The bill, S.216, would require insurance companies to make drug prices available to Vermonters shopping for insurance plans, subscribers and physicians.
Sudhoff-Guerin said that Vermont is one small piece of a large system, and said that federal action is likely key in addressing high drug prices. But she said transparency up front about the cost of prescriptions would be a help to cancer patients and others in Vermont.
“If people know how much things are costing, then it has to help just shed some light on it,” Sudhoff-Guerin said.
Sen. Ginny Lyons, D-Chittenden, said that prescription prices are a major concern in Vermont.
“We are being held hostage on these drug prices,” Lyons said. She said high drug prices can have an adverse impact on individuals’ health decisions. “People will not take their medications if they can’t afford to buy them.”
Lyons said she was encouraged to hear about Welch’s efforts on the federal level, noting that marketing of drugs is a particular concern for her.
Lyons is also looking at other ways Vermont can engage with drug companies. She’s been reaching out to lobbyists who represent companies in Vermont to explore their interest in collaborating with the state on drug buy-back programs that would give Vermonters opportunities to dispose of unused medications.
Rep. Bill Lippert, D-Hinesberg, chair of the House Health Care Committee, said he’s weighing how the state could approach high prescription drug costs.
“I’m interested in thinking about what we can do, and we’re still trying to articulate that,” Lippert said.
He said some things are beyond the control of state government — such as negotiating with pharmaceutical companies on bulk pricing for certain drugs.
“Without affordability, access is either diminished or at times completely precluded,” Lippert said.
According to a memo from Welch’s office:
— DVHA reported more than $185 million in prescription drug related spending in FY2015, an increase of 19 percent from FY2014. This spending is projected to rise to approximately $198 million in FY2016 a 6.6 percent increase. Vermont spent $738 million in total on Medicaid in FY 2015.
— DVHA has also experienced rising specialty drug costs: increasing from 9 percent of total drug spending in FY2013 to 16 percent in FY2015.
— The cystic fibrosis drug Orkambi has an annual cost of more than $250,000 per patient. Coverage of this drug alone is projected to increase the state Medicaid budget by more than $3 million.
— Prescription drug spending is now 15.9 percent of total health care spending for an average family of four.
