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November 15, 2019

Senate approves new drug-cost oversight

The Massachusetts Senate on Thursday unanimously agreed to impose new oversight on the pharmaceutical industry and cap consumer costs for insulin.

The 40-0 vote drew praise from the Greater Boston Interfaith Organization, which said the bill "contains necessary provisions for making the costs of prescription drugs more transparent, regulating pharmacy benefit managers and requiring that pharmacists help consumers find the lowest prices possible for prescription drugs."

"For too long, pharmaceutical companies have taken unbridled profits at the expense of Massachusetts businesses, consumers and patients," said Michael Rubenstein, co-chair of the GBIO's health care team. "By increasing the transparency and accountability of prescription drug manufacturers and various middlemen in our health care system, the Senate has risen up on the side of the people."

Before the vote, senators told stories of people who had had to ration insulin because of costs, were required to fill prescriptions at inconvenient pharmacies, and struggled to pay the soaring costs of Epi-Pen injectors for children's allergies.

The bill sparked criticism from the pharmaceutical industry, with the Massachusetts Biotechnology Council saying the legislation "focused only on drug pricing when the state data show that out-of-pocket costs are the real problem, with health insurance premiums and patient cost-sharing growing at 5.6 percent between 2017 and 2018 inflicting significant, direct financial burden on patients."

Last session, the House and Senate were unable to agree on sweeping health care legislation, and senators said during debate that many of the drug pricing bill's provisions built on pieces they approved in 2017.

Sen. Cindy Friedman, an Arlington Democrat who co-chairs the Health Care Financing Committee, said in a statement that the bill "will bring us one step closer toward addressing rising costs within our healthcare system that continually impact patients' ability to access the care they need."

Total health care expenditures in Massachusetts hit $60.9 billion in 2018, or $8,827 per capita.

The bill, which faces an uncertain fate and timeline in the House, would limit consumers' out-of-pocket insulin costs to $25 a month and require pharmacies to notify consumers when a prescription drug is available at a lower price.

It would also authorize the state Health Policy Commission to analyze the price of certain drugs -- those that cost more than $50,000 a year per patient or fall on the World Health Organization's list of essential medicines. If the HPC determines the value of the drug is lower than its manufacturer price, the agency would be empowered to work with the drug maker privately to lower cost, with the estimated value becoming public if the manufacturer does not cooperate.

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