By Alex Calcagno, Director, Advocacy, Government, and Community Relations
Addressing the high price of prescription drugs in order to increase access to lifesaving treatments continues to be a high priority for federal and state legislators. After a series of Democratic and Republican hearings, the US House of Representatives passed HR 987 — largely along party line votes. Among its many provisions, the bill would end “pay-to-delay” practices whereby a brand name pharmaceutical company pays a generic rival to delay bringing a copycat drug to market.
The bill also included a provision prohibiting the implementation of Trump administration regulations enabling short-term insurance plans, which are exempt from the basic protections and essential benefits mandated by the Affordable Care Act. The MMS sent a letter endorsing the legislation, which was supported by the entire Massachusetts congressional delegation. While similar legislation to address generics is pending in the US Senate, final passage is unclear.
Increased Transparency, Medicare Changes
A number of other legislative proposals are in process. Massachusetts Representative Richard Neal, chair of the House Ways and Means Committee, introduced the Prescription Drug STAR (Sunshine, Transparency, Accountability and Reporting) Act, which was unanimously passed by the committee. The bipartisan bill addresses issues related to transparency and public reporting in order to improve accountability and ensure consumers, purchasers, payers, and taxpayers have a better understanding of the prescription drug market. The Trump administration has also proposed a number of regulations, including requiring the price of prescription drugs to be revealed in ads, transparency in drug pricing, and reforming the role of pharmacy benefits managers (PBMs). Other issues on the Democratic agenda include limiting the out-of pocket costs that Medicare beneficiaries must pay for prescription drugs. There is also growing interest among Democrats in pushing legislation that would allow Medicare to negotiate drug prices — a change the MMS has long advocated for.
State Proposals
On the state level, the legislature has also focused its sights on reining in the high cost of drugs. The Medical Society-endorsed health care cost and quality legislation contains several provisions, including increasing transparency about the underlying costs of prescription drug production and putting restraints on abuses of PBMs. Additionally, the MMS is a leading member of the Massachusetts Prescription Drug Affordability Coalition, a collection of stakeholders supporting legislation that would not only promote increased transparency, but also provide further regulation of PBMs, would authorize the state to negotiate supplemental drug rebates for its Medicaid program, and would authorize the Health Policy Commission to establish maximum prices for the most costly, unjustifiably high-priced drugs. MMS Immediate Past President Alain Chaoui, MD, testified at the state house in support of this bill, and the Medical Society has been engaged in trying to get key elements of the bill passed through the state budget process.
