 States Still Interested in Unused Meds Policies |
This year the Washington Legislature is moving forward on a bill to allow pharmacies to redistribute donations of unused prescription drugs starting next year. House Bill 2228 would create general guidelines for medical officials, drug manufacturers and drug wholesalers to donate their unused and unopened prescription drugs to pharmacists. The bill passed a House vote 82 to 14 earlier this month. Washington has also had pending legislation to address takeback and disposal of unused meds; this legislation has faced stiff opposition from the drug industry. Read more. Just yesterday, Alameda County in California took steps to require drugmakers to take back unused meds. Here is a link to information compiled by NCSL, current through 2010, about takeback and reuse legislation throughout the country. The Southern Legislative Conference also has 2010-current data. |
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From the Director
States are struggling. High unemployment and foreclosure rates are reflected in reduced revenues from broad-based taxes and pressure to cut health care budgets. So it comes as no surprise that access to prescription drugs is threatened by Medicaid cuts, and at the same time, that states are looking for alternative ways to save on pharmaceutical costs. Here's what's on state legislative agendas this year:
** Specialty drug costs. Legislation to limit out of pocket specialty drug costs are under consideration in states including California, Connecticut, Kansas, Nebraska, Maine and Vermont. Read more about what these bills do and their progress.
** Cutting drug benefits for seniors. States including New York and Maine are considering, or have already acted, on plans to cut Medicare Part D wraparound programs and state-funded senior drug programs.
** Tackling health care fraud. Another approach getting some traction is whistleblower Qui Tam or false claims laws, under consideration in LD 1796 in Maine.
** Interest in PBM regulation has taken on new life. The states of Alaska, Oregon, Washington and Utah are among those with pending bills. Read more.
** Unused medicines. States are tackling this issue from different directions, including programs to redistribute unused meds in New Mexico and Washington, and seeking to require manufacturers to take them back for disposal in Washington and California's Almeda County. Read more.
** In other state news, Vermont may be shelving a mail-order drug program that allowed importing drugs from Canada; the House has amended larger health reform legislation to repeal the program which is no longer operational.
 
For regular updates on news stories of interest, the best way to stay current is to "like" us on Facebook and follow us on Twitter (where we tweet with the handle @nlarx nearly daily). Keep in touch!
Sincerely, Sharon Treat
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Specialty Drug Costs Drive Legislation Capping Out of Pocket Insurance Costs
States across the country are considering legislation that would limit out of pocket costs for super-expensive specialty drugs for chronic diseases such as hemophilia, multiple sclerosis, and Crone's disease. These drugs can cost as much as $20,000 - $100,000 or more per year, and some insurance plans have started charging co-insurance of 50%. The experiences of patients can be very persuasive to legislators considering bills to cap such costs or otherwise regulate specialty tiers.
Pending legislation in Vermont, Senate Bill 221 which is sponsored by NLARx Board Vice Chairman Senator Kevin Mullin, would cap out of pocket prescription drug costs, including for specialty drugs, at $1,000 per insured individual and $2,000 per insured family. Vermont previously passed a moratorium on specialty drug tiers in insurance effective July 1, 2012 in order to give the Legislature time to consider a longer term solution to the issue.
Maine legislation, LD 1691, that would bar specialty drug tiers was amended in committee and voted out 9-4 in favor. The amended bill may still face an uphill battle on the floor. As amended, the bill would require specialty prescription drugs to be included within any cap on out of pocket spending in an insurance policy executed or renewed on or after January 1, 2013. The provision is similar to language in the Affordable Care Act that would become effective January 1, 2014. This and other legislation is being brought forward by the drug manufacturers; in the Maine instance by Pfizer, according to bill sponsor Rep. Stacy Fitts.
A bill analysis prepared last month by the nonpartisan legislative staff found that specialty tier legislation has also been enacted in New York (Chapter 536, NY Laws 2010), was killed in Maryland, and is pending in California (AB 310), Connecticut (Raised Bill 1084), Kansas (HB 2136), Nebraska (LB 1017) and Washington (HB 1876). Read the staff analysis here.
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State PBM Regulations Get New Life
We're not sure if it's the federal attention being paid to the proposed Medco-Express Scripts merger, state budget pressure, or the advocacy of pharmacists -- probably all three -- but states are taking a second look at PBM laws and there is more attention being paid to these middlemen than we've see in years. For instance, here's an editorial in the Houston Chronicle opposing the merger.
House Bill 4122 is pending in Oregon, and PBMs have gone on the warpath with a big advertising buy and heavy lobbying. HB 4122 would require PBMs be regulated by the Oregon Board of Pharmacy, and force them to provide insurers and the Oregon Health Plan with information about the rebates and contracts the PBMs enter into with drug manufacturers. The transparency is intended to ensure that PBMs are passing on the savings they generate onto insurers and, eventually, health care consumers. The bill has bipartisan support, and is backed by the Oregon State Pharmacists Association, the Oregon Society of Health-System Pharmacists, and the National Association of Chain Drug Stores.
Bipartisan PBM legislation is also pending in Washington state - HB 2303 and SB 6096. These bills are quite comprehensive and have much in common with the Maine PBM law enacted in 2003 but recently repealed by the new Republican majority there. Unlike in Maine, though, PBM legislation has bipartisan support in most of the country, with Republicans and Democrats alike sponsoring the legislation. |
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