Latest News | Jun 6, 2019

ICYMI: Real state budget battle about to begin

KEY POINT: “The Senate would give the state’s Health Policy Commission authority to demand information from drug companies that have failed to reach a negotiated price with the state secretary of health and human services…This provision has teeth — unlike the House version which was redrafted at the behest of MassBio, the chief lobbying group for the industry here.

The state budget is where the rubber meets the road of governing. And this week the real give and take begins between House and Senate budget negotiators not over mere dollars and cents — $42.8 billion is the bottom line in both versions — but about the policies that each branch has defined as critical in the year ahead.

Behind closed doors six legislators will exercise their powers to craft new laws, impose new taxes, and generally set the parameters for how much progress this state will make in the year ahead in such critical issues as education and health care.

Oh sure, at the end of the process the budget for the year that begins July 1 will go back to the full House and Senate for a final vote. But make no mistake, this is where the big decisions are being made. This is the proverbial sausage factory — a boutique operation, but one with the power to impact millions of lives.

Amid the thousands of budget line items and dozens of so-called outside sections — budget riders on policy issues — some stand out as being as critically important as they are contentious.

Prescription drug policies: Here we would urge the Senate side to stick to its well-crafted effort to rein in the prices of a relative handful of high-end drugs that threaten to drive up the cost of the state’s Medicaid program, which already consumes about 40 percent of the entire state budget.

The Senate would give the state’s Health Policy Commission authority to demand information from drug companies that have failed to reach a negotiated price with the state secretary of health and human services.

“If after review of records or documents the commission determines that a drug manufacturer’s pricing of a drug may be unreasonable or excessive, the commission shall hold a public hearing,” the Senate language says. Manufacturers would be required to appear, testify under oath and would face penalties for knowingly obstructing the commission’s efforts. Ultimately the case could be referred to the attorney general under the state’s consumer protection law. Net savings to the state are estimated at $28 million.

In other words, this provision has teeth — unlike the House version which was redrafted at the behest of MassBio, the chief lobbying group for the industry here.

Massachusetts is already far behind in drug regulatory and disclosure efforts long underway in neighboring Connecticut, Vermont and New York. To do nothing this year is to fall even farther behind.

New excise taxes: Here again the Senate budget tackles two critical issues the House choose to ignore. The Senate would impose a 75 percent excise tax on vaping materials — or as the budget calls them “electronic nicotine delivery systems.” This isn’t simply a revenue raiser, although it would raise an estimated $24 million a year. The real need is to make the product more expensive to an increasingly youthful cohort of vapers attracted by its bargain price and its flavored products (an aspect of the problem not tackled in the Senate budget).

The Senate also included a 15 percent excise tax on the gross receipts from sales of prescription opioids, the revenue from which — estimated at $14 million a year — would go into the state’s Substance Use Disorder Prevention and Treatment Fund.

UMass tuition freeze: Both the House and the Senate have agreed on the bottom line appropriation for the five-campus University of Massachusetts system. The Senate, however, frustrated with the university system’s regular tuition hikes, opted for the blunt instrument of a one-year freeze on undergraduate tuition and fees.

UMass President Marty Meehan argues that will lead to cuts in the short term and cost more in the long run. What might be a logical alternative is a suggestion in a recent Pioneer Institutereport on university spending — an audit of capital and operating budgets by the state comptroller’s office. After all, where’s the harm in that?

The budget dollars of line items are relatively easy to negotiate — splitting the difference has always been a tried and true tool. Policy issues represent a higher degree of difficulty, but in the cases mentioned above are clearly worth the effort — and the fight.

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WASHINGTON D.C. — Patients For Affordable Drugs Now launched a nearly $1 million campaign in support of the Department of Health and Human Services’ proposal to lower drug prices in Medicare Part B. Under the proposal, Medicare would pay only 26 percent more than other wealthy countries for drugs administered by physicians or in hospital settings — that’s compared to the 80 percent more it pays today. But Big Pharma is attacking the proposal because the changes could actually rein in outrageous drug prices. Patients For Affordable Drugs Now’s campaign will include digital advertisements, patient fly-ins, polling, and videos featuring patients who stand to access more affordable drugs under the proposal.
 
“American patients pay far more than people in other countries for prescription drugs, and it’s just plain wrong,” said David Mitchell, a cancer patient and the founder of Patients For Affordable Drugs Now. “Out-of-control drug prices force hard working Americans to choose between groceries and their medications. HHS has a promising plan to use an International Pricing Index to bring U.S. drug prices more in line with drug prices in other wealthy countries. We’re standing up in support of this change because America’s prescription drug pricing system is broken, and patients need change now.”

The nationwide ads on Facebook, Twitter, YouTube, and Google will urge Americans to contact their senators and representatives in support of the HHS Part B demonstration (examples below).

According to a recent poll, voters support the HHS proposal to lower drug prices by a
71-point margin (80 percent support vs. 9 percent oppose). Majorities from both parties agree that Democrats and Republicans in Congress should support the proposal.
 
Importantly, Americans find Big Pharma’s claim that the proposed reforms would hinder patient access to be wrong. Eight in 10 voters believe the proposal will result in better careor have no impact on the care they receive. That’s bolstered by the fact that nine out of 10 big pharmaceutical companies actually spend more on advertising and marketing than on research and development, according to the Washington Post. There is no evidence the proposed Part B changes would impact patient access to drugs unless drug corporations withhold drugs from patients.
 
Patients For Affordable Drugs Now recently released a petition signed by more than 1,500 patient advocates urging the administration to move forward with the proposal to lower drug prices in Medicare Part B. The letter was accompanied by a video featuring Ruth Rinehart, a patient with primary immune deficiency from Florida, and Mike Gaffney, a resident of Washington State who lives with a rare form of multiple myeloma called POEMS syndrome. In the video, the patients speak directly about what the Part B changes would mean for them.

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WASHINGTON, DC –– By a 71-point margin, voters support the Department of Health and Human Services’ proposal to lower drug prices in Medicare Part B by implementing an International Pricing Index (80 percent support vs. 9 percent oppose). Majorities from both parties believe Democrats and Republicans in Congress should support the proposal that would lower prices for infused drugs administered in physician offices and hospitals.Importantly, 8 in 10 voters believe the proposal will result in better care or have no impact on the care they receive. Click here to read the poll.

Support for the proposed Medicare Part B reforms are widely popular.

Voters say drug prices are too high and both Congress and the President should do more to lower them.

“Voters in this country are clamoring for reforms to lower drug prices and they want officials in Washington to take action to bring prices more in line with other wealthy nations,” said David Mitchell, a Medicare beneficiary, cancer patient, and the Founder of Patients For Affordable Drugs NOW. “This proposal will lower list prices and out-of-pocket costs for patients.”
 
75 percent of voters support—and 50 percent strongly support—the element of the proposal that will change the way doctors are paid to administer the drugs from a percentage to a fixed fee, thereby eliminating the incentive to prescribe more expensive drugs.

The telephone survey of 1,000 likely voters was conducted by GS Strategy Group from December 11-13, 2018. 50 percent of the interviews were completed via cell phone. It has a margin of error of +/- 3.2 percent at the 95 percent confidence level.

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