Healthcare cost pills money prescription drugs

Claudia Curry Hill came to a news conference at the state Capitol Thursday in a motorized wheelchair. She struggled to leave the chair to stand at a podium in the Capitol’s West Foyer to talk about what her life with multiple sclerosis has been like.

It shouldn’t have had to be that way.

Curry Hill was once on medication that helped her stand and even to walk, more than 30 years after her original diagnosis.

But the co-pays for that drug escalated from $200 per month to more than $500 per month, and it wasn’t the only drug she was taking.

She could afford it when her husband worked for the federal government and they had great health insurance, she said. But once he retired, living on a fixed income meant they had to choose between drugs and other essentials.

“My drug copays could go anywhere from $700 to $3,000 a month,” Curry Hill said Thursday. “I made the difficult decision to stop taking my drugs, and my MS progressed. No one should have to choose between taking the medication they need and draining their savings.”

It’s stories like Curry Hill’s that have prompted lawmakers in recent years to start tackling the cost of prescription drugs, with middling success.

In the 2019 session, that resulted in a law legalizing the importation of less-expensive prescription drugs from Canada, and a law to reduce the cost of insulin. But measures around price transparency (in 2018) and how to deal with prescription drug rebates (in 2019) both have gone nowhere. 

The Colorado Department of Health Care Policy and Financing (HCPF) on Thursday released a report around possible solutions on prescription drug costs, but it contained little new on the issue and recommended some of the same solutions that have failed to gather sufficient support among lawmakers in the past.

Kim Bimestefer, HCPF executive director, said Thursday that trends in prescription drug price costs indicate those costs will outpace all other areas of healthcare in the coming decade. Her agency, which includes Medicaid, pays out $1 billion per year in prescription drug expenses; she estimated no one in the state pays a higher cost.

At the same time, drug companies spend far more on marketing — those TV ads that you see a hundred times a day — than on research for new treatments, she said. Another cost driver is lobbying, estimated by the Center for Responsive Politics at $300 million. The HCPF report said lobbying costs benefit the industry to the detriment of consumers, employers or public payers.

And there’s a lack of transparency into the causes for why prescription drugs are becoming so expensive, Bimestefer said. “Is it research? Marketing? Payment to middlemen? That becomes a perfect storm when it’s combined with the fact that the FDA has no authority over pricing nor can Medicare negotiate drug [pricing].”

State and federal solutions are needed, the report said, and listed a host of solutions, including several that have been tried and failed to make it through the General Assembly in recent years, such as passing drug rebates to consumers and employers and requiring more transparency around prescription drug prices.

The report also suggested an “affordability” board, public-private partnerships that support hospitals or public entities in direct price negotiations, and the purchasing or manufacturing of drugs and “innovative” reimbursement methods that “focus on achievement of intended outcomes and quality of life.”

Among the federal solutions suggested by the report: limited direct-to-consumer advertising, revisiting FDA regulations on accountability, expediting FDA reviews and approval for generic drugs, and expanding drug importation beyond Canada to countries with strong safety standards.

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