Democratic state lawmakers on Monday took aim at prescription drug prices, introducing a measure that would create a board to review the prices of high-cost medications while also passing a bill expanding a drug importation program out of a Senate committee on a party-line vote.
The latter bill from Sens. Joann Ginal, D-Fort Collins, and Don Coram, R-Montrose, seeks to expand on a program signed into law in 2019 that would allow Coloradans to import prescription drugs from Canada. The state Department of Health Care Policy and Financing estimates that would give consumers access to medications that would be on average 61% cheaper than in the United States. But that program has yet to be fully implemented in the state with a holdup based largely at the federal level.
Congress in 2003 approved a proposal allowing certain drugs to be imported from Canada if the secretary of the federal Department of Health and Human Services deemed it could be done safely. Heads of that agency, under Presidents George W. Bush and Barack Obama, opted against taking that measure but former Secretary Alex Azar, who ran HHS under President Donald Trump, approved a rule on the program in September. It’s unclear whether the new administration will move forward with that plan, but President Joe Biden expressed support for the concept on the campaign trail, and his nominee to lead HHS, Xavier Becerra, voted for the Canadian drug importation proposal as a member of Congress in 2003.
As the federal government wrestles with the final steps in approving the Canadian program, Ginal told the Senate Health and Human Services Committee the bill expanding the program would allow the state to be among the first to reach foreign drug markets should federal law ever allow it.
“The legislation simply sets our state up to move swiftly in expanding our current program, allowing Coloradans to achieve even greater savings than we expected” in the original Canadian importation legislation, Ginal said.
The bill faced opposition from a pair of organizations: The Partnership for Safe Medicines, a nonprofit that Kaiser Health News reported has deep ties to the pharmaceutical industry, and the Colorado Pharmacists Society. Both groups raised concerns about the safety of imported drugs.
“The proposals that we've seen so far to do importation, even from Canada, do not possess the safety features necessary that would make them as safe as the medicine we use today in the U.S.,” said Shabbir Safdar, PSM’s executive director.
But HCPF executive director Kim Bimestefer countered that 80% of active pharmaceutical ingredient manufacturers and 60% of completed drugs already come from outside the country. She said the factories and drugs have already been approved by the FDA, adding “what we're actually importing is the prices.”
“What we're working so hard to do is import the prices because those countries don't tolerate what our country does,” Bimestefer said. “They can negotiate prices in other countries, and they do; they can stop patent protections that shouldn't be past seven years instead of 23 years; they don't allow the marketing.”
Coram, meanwhile, closed the hearing by emphasizing that the drugs imported under the program would largely be the same as those already in pharmacies.
“I find it ironic that some may think that because the drug is manufactured in France and you buy your prescription at your local pharmacy supermarket chain, you pay this price, it's OK, it's safe,” he said. “But if you buy it on a negotiated price and it only cost you this, something's got to be wrong.”
Still, that didn’t win over any of the panel’s Republicans. Sen. Barbara Kirkmeyer, R-Brighton, said she had concerns over the transparency of the bill’s fiscal note, which would see HCPF draw funds from those allocated in the original Canadian expansion if the federal government enacted a law allowing a drug importation expansion.
“Either in 2019 it was severely overestimated or it's been underestimated today,” she said.
Republican Sens. Cleave Simpson of Alamosa and Jim Smallwood of Parker also voted against the bill as Democrats advanced it to the full Senate.
Gov. Jared Polis earlier in the day said that bill “is going to be part of the solution” for bringing down prescription drug costs. But he touted another piece of legislation introduced on Monday seeking to create a board to review the cost of the highest-priced prescription drugs as a “better and longer-term solution.”
That bill, from Sens. Sonya Jaquez Lewis, D-Longmont, and Julie Gonzales, D-Denver, would see a board appointed by the governor research, review and establish payment limits for drugs deemed unaffordable.
While in the House, Jaquez Lewis sponsored the original Canadian drug importation bill. But she said that measure had drawbacks, including its narrow scope that doesn’t include specialty drugs or biologics.
“That's why we need this prescription drug affordability board bill,” she said.
Meanwhile, Rep. Yadira Caraveo said she knew from experience “we are well past time needing to bring prescription costs down.” The Thornton Democrat and pediatrician is sponsoring the bill in the House along with Rep. Chris Kennedy, D-Lakewood.
“It really is shameful that I have to have conversations in clinic about whether families can afford to pay for prescription medication or put food on the table for their children,” she said. “There's no reason why we should be paying more for prescription drugs than consumers in other countries, but we are and it's not even close.”
The measure will likely face opposition from Republicans. Senate Minority Leader Chris Holbert, R-Douglas County, last month said while some might appreciate the price controls in the short term, he believed it would have long-term effects on the pharmaceutical industry’s capacity for research and development.
“If there is a board for Colorado that is controlling prices, I don't think it would be a surprise if a drug isn't available in Colorado,” he said at a panel hosted by Colorado Politics before the bill was introduced. “We've seen people come to Colorado for cannabis-based medicine. I don't think over time, it'll be surprising that people would be leaving Colorado and going to a state where they could access a particular pharmaceutical that they need."
A spokesman for PhRMA, the trade group representing the pharmaceutical industry, in a statement to Colorado Politics said, “Creating a board of unelected bureaucrats with the authority to arbitrarily decide what medicines are worth and what medicines patients can get would be a disaster for patients.
“While Colorado policymakers are attempting to brand this government board as way to make medicines more affordable, there is no guarantee that the policy would provide any sort of meaningful savings for patients,” said Nick McGee, PhRMA’s senior director of public affairs. “Even more, in practice, this policy could make it more difficult for individuals to access the medicines they need now and in the future and could lead to discrimination against seniors, those with disabilities and the chronically ill.”
This story has been updated with comments from PhRMA.