Senate Democrats and health policy advocates on Wednesday made their case for a suite of bills that aim to lower the cost of prescription drugs, including a measure that would create a state commission to regulate insurance reimbursements for prescription drugs.
But critics said some elements of the bills could compromise patient safety.
The other bills would allow bulk importation of medications from Canada , regulate pharmacy benefit managers – middlemen that can exclude certain medications from insurance coverage – create more transparency in drug prices, and allow individual Maine residents to import drugs from Canada.
The bills were heard by the Legislature’s Health Coverage, Insurance and Financial Services Committee.
Michele Dehetre, 48, of Lewiston said she has Type 1 diabetes, and her prescriptions cost her $300 per month, so she’s in favor of proposals that could lower her bills.
“In addition to buying food, paying the electric bill, and other monthly bills for my household, spending at least $300 per month for my diabetes medicine is a major financial strain,” Dehetre said. “Treating my diabetes is a matter of life and death.”
A recent federal study of Medicare Part D drug prices showed that from 2012 to 2017, prices of the 20 most commonly prescribed brand-name drugs increased an average of 12 percent per year.
The United States has higher prescription drug prices than nine other developed nations, including Canada, Australia, Norway and the United Kingdom, according to a 2016 survey by the Commonwealth Fund.
If it’s approved, Maine will become the second state, after Vermont, to allow bulk importation of Canadian drugs. Vermont’s law hasn’t been implemented because it first needs a waiver from the federal government. Maine would also need a federal waiver.
Amelia Arnold, president of the Maine Pharmacy Association, said the trade group opposes the bulk importation of Canadian drugs because the safety of those drugs could be compromised and come from “third-party brokers” and not from Canada’s national health system.
“Canadian pharmacists are only legally allowed to fill prescriptions written by Canadian doctors, so no reputable pharmacy could sell Health Canada-approved medicines to patients in the U.S.,” Arnold said. “A country with one-ninth the population of the United States cannot meet the additional needs of American patients. We have years of evidence that third-party drug brokers are selling Americans unreliable and dangerous medicine.”
And Bryan Lowe, senior director of state government affairs for the Healthcare Distribution Alliance, a national trade organization representing wholesale pharmaceutical distributors, said that the bill would be a “potential risk to patient safety.”
Lowe said drugs sold in other countries, including Canada, may not meet U.S. Food and Drug Administration safety standards.
“The FDA cannot guarantee to an American consumer that a drug marketed and available abroad will be the same product his or her physician had written the prescription for, nor can it fully attest to its safety,” Lowe said. “Both branded and generic drugs are susceptible to counterfeiting, containing insufficient or too much of an approved medicine’s active ingredient or to being contaminated by unsanitary manufacturing conditions.”
But Senate President Troy Jackson, D-Allagash, said that the bills, if enacted, should lower prices substantially, and he said he doubts that Canadian drugs are inherently less safe than those sold in the U.S. Jackson, the sponsor of several of the bills, said many Mainers who live in border towns go to Canada to get their drugs, and “right now they feel like they’re doing something wrong.”
“People throughout the state of Maine should get that same benefit of importing drugs from Canada,” he said.
Jackson said a vial of insulin costs about $450 in Maine, while “across the St. John River in Canada, the same vial of insulin costs about $20.”
In another measure that attempts to control drug prices, the Maine Prescription Drug Board would operate similar to a public utility commission for prescription drugs, and would regulate the amount paid by insurers and others for drugs that are considered unaffordable. A similar bill is pending in the Maryland legislature.
The five-member board would review drug prices that exceed certain thresholds. Drug manufacturers would be required to notify the board if price increases exceed certain percentages and justify such increases in a hearing before the board.
“This independent board would consist of members with expertise in health care economics or clinical medicine who would review the cost of drugs posing an affordability problem for the state,” said Ann Woloson, executive director for Consumers for Affordable Health Care, a health policy advocacy nonprofit. “It would have the authority to set fair limits on how much Maine purchasers, employers and insurance carriers should have to pay for a specific drug. If increases are not adequately justified, the board could cap the reimbursement rate for those drugs for all payers.”
But Tiffany Haverly, spokeswoman for the Pharmaceutical Research and Manufacturers Association of America, said that the bill’s “government price control schemes” could reduce access to some drugs and treatments.
Certain drugs that have seen dramatic price spikes have made national news and spurred calls for more regulation. For instance, the life-saving allergy antidote EpiPen increased in price from about $100 in 2009 to $600 in 2016 for a two-pack of the injectors, according to news reports.
Joe Lawlor can be contacted at 791-6376 or at:
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