Transparency is a good place to start....
Margaret Laggis, Board Member and owner of Laggistics
Prescription drug pricing has been in the news for many years because of the ever increasing share of health care spending required by this cost sector. This past spring, Governor Shumlin signed S.216 and Vermont became the first state to attempt to control prescription drug costs.
The policy question surrounding what to do about the overall cost of prescription drugs is really twofold. On the one hand, new and novel drugs are changing the health care landscape in huge ways that benefit patients and their families. Since most new drugs fail in development, the cost of developing all approved drugs that eventually reach the market reflects the billions of dollars spent by the drug company in research and development. Patients want these new drugs and their significantly improved outcomes but their price tag is costing all health care consumers some big headaches. On the other hand, there is concern that some drugs that have been on the market for many years and are seeing a doubling of their price. What is causing these tried and true drugs to become so much more expensive and is it necessary or just greed on the part of the manufacturer? Are these drugs helping to offset the huge cost of developing new drugs?
Without some level of transparency, there is no way of knowing what is really going on and no way to either predict the future costs of prescription drugs as a part of overall health care, or make smart policy decisions on how to use or restrict the use of some of these drugs.
Vermont's new bill will require the Green Mountain Care Board, in conjunction with Vermont's Department of Health Access, to draw up a list of 15 drugs representing a significant volume or dollar amount spent by Vermonters. This list will be comprised of drugs whose prices have risen by more than 50% over 5 years or 15% over one year. The list will be given to the Attorney General and the Attorney General will require the manufacturer of these drugs to give a detailed reason why these price increases have occurred.
Even though pharmaceutical manufacturers oppose these kinds of bills as they worry about stifling innovation and potential price controls, they have also admitted that a lack of transparency has led to distrust. In the end, difficult policy decisions will have to be made. Patients want new, novel, and low risk approaches to disease. Those paying for health care want affordable policies and effective treatments. There will have to be an understanding that there might not be enough money to pay for what researchers are capable of developing. This bill, a small step in the direction of transparency, will hopefully create a discussion around this issue that is meaningful and helpful, not just accusatory and destructive of those companies (including some members of the Vermont Biosciences Alliance) committed to the pursuit of new drugs for human health.