Week 14 Update: Prescription Drugs
This week the House Healthcare committee voted out to important bills on prescription drugs that if implemented will ultimately lower some prescription drug prices and heard testimony on the recently announced plan by the UVMMC network to expand mental health care.
S.175, An act relating to the wholesale importation of prescription drugs into Vermont, shall have the Agency of Human Services, in consultation with interested stakeholders and appropriate federal officials to design a wholesale prescription drug importation program, including requirements of safety and cost. The program would designate a state agency to become or contract with a licensed drug wholesaler to import prescription drugs at a significant cost savings to Vermonters. AHS shall submit the proposed design for the program by Jan. 1, 2019. The bill directs the state to seek the appropriate federal waivers and if obtained, the state will begin operating the program within six months of the approval. Our committee took testimony from our federal delegation who are all in full support of our efforts and are willing to help.
S. 92, An act relating to interchangeable biological products, allows VT to substitute biosimilars, a generic type of biological products, which would ultimately reduce the price of these drugs to consumers. A biological product means such things as a virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component derivative applicable to the prevention, treatment or cure of a disease or condition in human beings. When a pharmacist receives a prescription for a biological product, the pharmacist shall select the lowest priced interchangeable biological product. A health insurance or benefit plan shall apply the same cost-sharing requirements to interchangeable biological products as apply to generic drugs.
The bill also has a section on Prescription Drug Cost Transparency, which strengthens a 2016 statute. The bill would require the Department of Health Access to identify annually up to 10 prescription drugs on which the state spends significant health care dollars. Commercial insurers shall also create a list annually of prescription drugs on which its insurance plans spend significant amounts of their premium dollars, net of rebates and price concessions. The lists will be given to the state Attorney General’s office, which will require the manufacturer to provide a justification for each drug’s increase. The lists will be posted on the Green Mountain Care Board and AG’s website.
The bill will also gauge the impact of drug costs on health insurance premiums by requiring insurers with more than 1,000 covered lives to report to the Green Mountain Care Board the 25 most frequently prescribed drugs and the average wholesale price for each; the 25 most costly drugs by total plan spending and the average wholesale cost of each; and the 25 drugs with the highest year-over-year price increases and average wholesale price for each.
S.92 also eliminates the so-called “Gag Rule” that prohibits or penalizes a pharmacist for disclosing to a patient the cash price for a prescription drug or selling a lower cost drug to the patient if one is available. The pharmacist would be allowed to provide information to a patient regarding the cost-sharing amount for the drug. Remember when ordering a prescription drug you may ask your pharmacists if there is a lower price available for the drug.
The Health Care Committee joined the Institutions and Corrections committee to listen to an early proposal by UVMMC to add secure residential beds for mental illness at the Central Vermont Hospital, which is part of UVMMC network. The proposal would allow additional inpatient beds that would help address the problem with patients being held for long times in hospital emergency departments around the state. This proposal would also free the beds at the VT Psychiatric Hospital that would be used to as a secure residential facility, thereby eliminating the problem of relocating or adding beds in Middlesex. This proposal is in it’s infancy and will take 3-4 years to implement so will not address our immediate problems. However, it is an exciting opportunity when looking long term and with our state’s desire to bring parity to mental health and health care in that it locates the beds for mental health in a hospital setting.
S175 and S92 will be on the House floor this week for a vote. Should they pass both would go back to the Senate.
Any questions on these bills or anything else, please reach out.
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