| THE DRUG WARS
From the Brattleboro Reformer
Wednesday, March 3, 2004
By Richard Davis
GUILFORD- There have been a lot of news stories
recently about different approaches to lowering drug prices.
It is very difficult to know what is really going on, so
I contacted the one person who, I think, has a grip on the
situation. Cheryl Rivers is the Executive Director of the
National Legislative Association on Prescription Drug Prices.
She has been working on this issue for a number of years
and also served as a state Senator in Vermont prior to taking
her current position. Rivers is a candidate for Lieutenant
Governor.
Rivers told me that, “I have become
convinced that there is no one magic thing to do to control
drug costs.
As much as the Bush administration says it
is for free markets, it is doing everything it can not to
have free markets.” The best example of this Bush
administration stance is found in the Medicare overhaul
bill that was passed last December. The bill prohibits the
federal government from negotiating with pharmaceutical
manufacturers for lower drug prices.
There have been efforts by states to pool
together for the purpose of buying drugs in bulk to lower
the cost, but the Bush administration has not been helpful
with those efforts. Rivers said that she has made unsuccessful
attempts to get Vermont to join with other states into a
buying pool.
In order for these pools to operate legally
it would require a waiver from the federal government. States
that have tried to create buying pools have applied for
the waivers, but, according to Rivers, “…The
impediment has been a lack of response (by the federal government)
to the waiver.” She said that Vermont submitted a
request for a waiver to the Centers for Medicare and Medicaid
Services (CMS) over a year ago and there has been no answer.
Governor Douglas has recently tried to create
a buying pool with the state of Michigan but hope for that
is all but dead. CMS and the Bush administration Secretary
of Health and Human Services Tommy Thompson seem poised
to make sure that the two states do not create any situation
that would force drug companies to lower their prices.
According to a February 23 Associated Press
story, Michigan and Vermont “…were the first
to pool resources for buying drugs under the state-federal
Medicaid program that provides health care to the poor.
Other states, including New Hampshire and South Carolina,
were considering joining.
The AP story went on to quote Michigan Governor
Jennifer Granholm, a Democrat, who said that the federal
Centers for Medicare and Medicaid Services rejected the
program on grounds it violated federal procurement procedures.
Keep in mind that all of these plans would
only apply to the Medicaid population and those eligible
for expanded Medicaid benefits within states. The purchasing
pools would simply be a foot in the door, and Bush and his
buddies in the pharmaceutical industry do not want to open
the door to anything that would force negotiation for affordable
drug prices.
Americans are angry, but they’re also
smart when it comes to saving a buck. Thousand are not waiting
for politicians and policymakers to do the right thing,
so they have taken matters into their own hands. Sales of
Canadian prescription drugs to Americans, especially seniors,
are soaring. The Bush administration is not going after
individuals yet, but they are trying to make life difficult
for states and cities that create Canadian drug reimportation
programs for their residents.
The federal government may be forced to do
something about drug reimportation during an election year.
That could be tricky, considering that whatever happens
will play out in a very public and visible way. I suspect
Bush and his lieutenants will stall as long as possible.
Rivers noted that drug reimportation issues are coming to
a head and that “Things are coming to a boiling point
in Congress.” It will be interesting to see when the
pot boils over and who gets burned.
Rivers group doesn’t advocate for one
particular approach to solving the drug affordability problem.
Their role is to be the policy catalyst for change and to
be a resource for state legislators. They initiated an effort
to create a non-profit pharmacy benefits manager (PBM) program.
It was River’s idea, but it is not under her control.
This new entity would manage pharmacy benefits in a non-profit
environment. In order to get up and running and to establish
a track record of saving consumers money, it would require
businesses to sign on. Things are still in the development
stage.
All of these efforts still beg the question,
“Why not just pass laws requiring drug companies to
negotiate for lower prices with governments and businesses?”
Some have tried. The task is monumental. Until we have sweeping
campaign finance reform in this country, reality would knock
you hard on the head unless you are able to scrape together
a few hundred million dollars to fight the pharmaceutical
industry lobby. the meantime we can be thankful for efforts
by forward thinking legislators such as Bernie Sanders,
governors and mayors such as Peter Clavelle and Cheryl Rivers
and members of the National Legislative Association on Prescription
Drug Prices.
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