OK-Pharmaceutical legislation: a national perspective
Author : James C. Sandefer
Date : 02/25/2008
(OK) Until several days ago I embarrassingly admit that I thought I had a pretty good handle on the way things were going with pharmaceutical and medical related regulatory legislation in the states across the nation. It turns out I was fooling myself or possibly I have joined the thousands of other Americans who are being fooled by the rhetoric coming from those proposing bills floundering around legislatures across the country.
As I began wading through hundreds of mind numbing, eye-blurring pages of pharmaceutical related regulatory legislative minutia currently resting on the desks of many of our elected officials, I realized I would have to wait for the ultimate outcome to reveal which of the following scenarios is fact and which is fiction:
• the public is being lured into thinking that everything is OK and will be getting better in the near future, especially if the "proper" presidential candidate is elected; and/or
• the current crop of elected representatives (e.g. politicians) are working diligently in our best interest to ensure that each of us:
1. understands the system (transparency is a popular buzz word these days),
2. receives a fair price every time we step up to the pharmacy counter and pays for our necessary prescription medications and
3. the cost of these items may, in fact, be reduced in the near future.
The following are examples (excerpts) of legislation I've read over the past several weeks including the actual numbers identifying the bills, a brief overview of the intent of these pieces of legislation, the city or state of origination in which they were introduced, and the current status of the proposals. (You may wish to sit down if you're not already doing so because the majority of these actions may induce some gastric distress, so have some over-the-counter antacids handy.)
Let's begin with the good news since this won't take long to cover, but I believe it's noteworthy to report and clears my conscience in offering balance (e.g. good news/bad news).
One of the few pieces of pharmaceutical related legislation that passed and was actually enacted occurred in a locale that is often maligned for non-action and rampant crime-the District of Columbia. Dubbed the SafeRx Act (Act A17-0282), the mayor signed this significant action into law on February 1st of this year making D.C. the first government entity in the country to enact a bill requiring the licensing of pharmaceutical representatives.
Let's focus on the issue of pharmaceutical pricing and associated issues for now. Can you imagine prescription co-pays that are actually higher than the retail cost of the medications? Sounds ludicrous and, of course, it would never happen where you live, but it is occurring in several states, along with other seemingly questionable transactions.
In Colorado, Senate Bill (SB08-090) would prohibit pharmacies from charging the recipient more than the Medicaid co-pay.
Georgia House Bill (HB 454) requires pharmacists to include the approximate retail price on the patient's receipt-this bill repeals a conflicting law. House Bill (HB 28) requires pharmacies to submit comparative price information on a state sponsored web site while (HB 150) also includes a list of prescriptions medications along with comparative pricing and wholesale/retail costs.
Hawaii (HB 6) establishes quarterly reporting that discloses the average wholesale price, acquisition cost and average manufacturer's price for every drug manufactured.
Illinois House Bill (HB 1082) establishes an online clearinghouse known as the Illinois Prescription Drug Price Finder identifying the 50 most commonly prescribed drugs in the state and their "usual" and "customary" prices, whatever that means.
Iowa (HF 506 and SF 111) provide for prescription drug retail comparisons.
Massachusetts (H 1170) establishes a disclosure in writing of wholesale drug pricing.
Michigan (SB 525) sets up a website for prescription drug comparisons, offers links to discounted or free products and generic equivalents.
New Hampshire has an interesting bill (HB 1230) requiring pharmacists to charge an insured person the "usual" and "customary" price or co-payment, whichever is less, for a prescription.
In New Jersey (A 1473) an initiative to establish the New Jersey Rx Program actually reduces prescription drug prices.
Neighboring New York has a similar proposal (S 323) that initiates bulk purchasing to reduce the cost of the most commonly prescribed drugs in the state; and (S 3028) limits co-pays to no more than the retail price of the drug.
West Virginia (HB 3914) would create the Pharmaceutical and Affordability Act of 2007, establishing pricing parameters not to exceed prices listed on the federal supply schedule.
If you assumed that most or all of these bills passed without much hesitation, then guess again. Not one of the bills listed above has enacted. Instead, each one has been shuffled to the side using one of the following bureaucratic tactics: "sent to committee; no further action before end of session; carried over to a specified date in 2008; postponed; or did not pass before end of session and carried over."
Outcome raises the obvious question: why can't seemingly logical legislation to improve the affordability of prescription drugs be successfully implemented? Apparently, the answer to this question and other related conclusions will, by necessity, have to be carried over for further consideration at a later date.
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