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Wyoming legislature considers a couple of bills aimed at lowering the cost of prescription drugs for Wyomingites; interview with AARP Wyoming

Importing cheaper prescription drugs to Florida was one of the most hotly contested fights of...
Importing cheaper prescription drugs to Florida was one of the most hotly contested fights of the 2019 legislative session. (Tom Varco/ CC BY-SA 3.0)(WJHG)
Published: Feb. 20, 2020 at 8:22 AM CST
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The cost of prescription drugs continues to rise, with Americans paying up to 10 times more than the rest of the world for the same drugs. Wyomingites who are feeling the pinch at the pharmacy counter are speaking up, and legislators are listening.

The Wyoming legislature is considering a couple of bills aimed at lowering the cost of prescription drugs for Wyomingites.

Sam Shumway with AARP Wyoming visits Wyoming News Now to talk about this effort.

House Bill 113 would direct the Wyoming Department of Health to study the feasibility of importing Rx drugs from Canada to both Wyoming Pharmacies, as well into state programs such as Medicaid.

House Bill 143 would direct the Wyoming Department of Health to study a number of issues around prescription drug prices including:

· Quantify the impacts of prescription drug pricing in Wyoming to both private citizens as well as the budgets of various state entities such as Medicaid and the Department of Corrections;

· Examine the supply chain for prescription drugs;

· The impacts of PBM’s and health insurers on prescription drug costs;

· Manufacturer rebates and discounts;

· The impact of high prescription costs on health insurance premiums;

· The Feasibility of establishing a wholesale prescription drug program in Wyoming;

· And the feasibility of a prescription drug importation program in Wyoming.

· Other arrangements to increase prescription drug access and decrease prices.

Background:

· In December, The Trump administration Wednesday outlined a framework for allowing prescription drugs to be imported from Canada and other foreign countries.

· The Department of Health and Human Services (HHS) and the Food and Drug Administration (FDA) released a two-pronged approach to importing cheaper drugs from abroad. The Safe Importation Action Plan does not include a specific timetable.

· According to the guidance, eligible prescription drugs would have to be relabeled with the required U.S. labeling prior to importation and undergo testing for authenticity, degradation, and to ensure that the drugs meet established specifications and standards.

Financial Impacts

· Though not a complete solution to the problem of high drug prices, safe and legal importation will help put downward pressure on prices.

· Similar Legislation has already passed state legislatures in Vermont, Florida, Maine and Colorado and is also being considered this year in Illinois, Oklahoma, New Mexico.

· The size of savings and the number of consumers who will benefit will depend on how a state’s program is structured.

o State officials in Vermont have estimated a possible savings of $5 million annually based on a list of specific birth control, insulin and pricey medications for HIV and multiple sclerosis that might be included in the program. However, those drugs are likely not to be allowed for importation by HHS Guidance.

o Working with NASHP and stakeholders, Vermont’s Agency of Human Services determined that participating Vermont commercial insurers could see savings of between $1-5 million dollars by purchasing prescription drugs imported from Canada. Such drugs would be made available through licensed Canadian drug suppliers and state-based, licensed wholesalers.

o Similarly, Florida projects that its program would save over $150 million dollars annually when fully operational.

· As of 2017, one capsule of Lyrica, a common treatment for nerve damage, cost $6.04 in the United States, compared with 63 cents in Canada. And the price of one tablet of Xarelto, used to prevent and treat blood clots, was $12.44 in the U.S. and $2.11 in Canada.

· Nearly 80% of every Big Pharma dollar goes to something other than R&D.

Wyoming impacts

· In Wyoming 35% of residents stopped taking medication as prescribed due to cost in 2017.

· In Wyoming the annual cost of prescription drug treatment increased 57% between 2012-17, while annual income for Wyomingites increased 2.7%

· In Wyoming, 56,663 Wyoming Residents have been diagnosed with cancer.

· Between 2012 and 2017, the price of cancer drug Revlimid increased from $147,413/yr

· to $247,496/yr.

· Over that same time period, Lantus, a drug commonly used to treat diabetes in the 44,000 diabetes patients in Wyoming, saw its price raise from $2,907/yr to $4,702/yr.

· So-called specialty drugs, used to treat complex, chronic conditions, are among the most expensive medicines on the market. In 2017, retail prices for 97 of those widely used medications increased by an average of 7 percent — more than three times the overall rate of inflation, according to AARP's new Rx Price Watch report, released in June of 2019. The average annual price for one of these specialty medications was $78,781.

· The state’s Medicaid program spent $50 million in 2015 on prescription drug prices.

· An importation program may also be beneficial to state budgets as cheaper drugs, would mean savings in the state’s Medicaid, and Department of Corrections programs.

Safety Concerns

· State importation legislation would authorize a state to seek federal approval to import prescription medication on a wholesale basis from Canada or other countries with similar safety and quality standards.

· Many Wyomingites are already purchasing prescriptions from Canada and Mexico either online or crossing the border. There is virtually no consumer protections available to protect these consumers from counterfeit drugs or scams. State importation would not only keep this revenue in Wyoming, but would protect consumers.

· Drug manufacturing is already global. EU regulatory inspections of drug manufacturing facilities in Europe meet US safety standards.

· 40% of prescription drugs sold in the US are produced abroad.

· Enacted in 2013, the Drug Supply Chain Security Act (DSCSA) created an electronic, interoperable system to identify and trace certain prescription drugs as they are distributed in the United States. This law was designed to protect consumers from counterfeit drugs and to remove potentially dangerous drugs from the supply chain. By extending DSCSA requirements deeper into the international supply chain, the same regulatory mechanism currently used for ensuring proper labeling, safety, and effectiveness of drugs will be used to ensure the safety and quality of drugs imported under a state importation program.

· 80 percent of the raw materials in US drugs come from abroad.

· More than 30 Canadian drug manufacturers are registered with the US Food and Drug Administration (FDA) to produce drugs for US markets, and safety standards in Canada are comparable to those in the United States.