CEDAR RAPIDS — Policy experts said Thursday they are optimistic that state and federal governments are going to keep working to lower the cost of prescription drugs despite some derailments due to the COVID-19 pandemic,
Panelists with backgrounds in health policy and insurance weighed in on the costs of prescription drugs and the work being done to lower them at The Gazette’s Iowa Ideas conference, held virtually this year amid the spread of the novel coronavirus.
AARP Associate State Director for Advocacy Anthony Carroll, Henry J. Kaiser Family Foundation Senior Vice President Tricia Neuman, Iowa Pharmacy Association Director of Public Affairs Casey Ficek and Iowa Insurance Commissioner Doug Ommen each spoke about their perspectives on the roles that drug manufacturers and Pharmacy Benefit Managers play in rising prescription drug prices, and how to move forward with regulations of the industry.
When asked by Randy Evans, panel moderator and executive director of the Iowa Freedom of Information Council, whether the Iowa Insurance Division has any authority over prescription drug prices, Ommen said the reality is that the division has little regulatory power.
PBMs have taken the division in Iowa and other states to court in response to regulation, Ommen said, and one such case from Arkansas has reached the U.S. Supreme Court. Oral arguments for Rutledge v. Pharmaceutical Care Management Association began Oct. 6.
“By and large our efforts to require more transparency, our efforts to require — that is in terms of drug pricing — our efforts to make sure that the behavior of the PBMs does not unfairly compete or discriminate against local pharmacies has been struck down,” Ommen said.
PBMs administer prescription drug plans for millions of people on behalf of a variety of health insurance providers. While the industry says it saves consumers money by negotiating with drugmakers and taking other steps, critics say PBMs are too opaque to consumers and actually have an incentive to favor high-priced drugs because they earn lucrative rebates from them.
The Pharmacy Assocation’s Ficek said currently three PBMs control about 76 percent of the market. Ficek said the companies use practices that ensure profit for themselves and higher prices for customers.
This has caused pharmacies across the country to lose money and go out of business, leaving medicine less accessible and possibly more expensive to get.
“There’s been a lot of frustration,” Ficek said. “This has gone on for years, with PBMs in the certainly unnoticed role they’ve had in driving up prescription drug prices.”
Before the COVID-19 pandemic began, Neuman said drug prices were at the forefront of people’s minds. U.S. Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., held hearings with drug companies in February to examine drug prices, in which Carroll said corporations pointed the blame for high costs elsewhere.
However, despite plans being talked over in both the House and Senate, they haven’t been able to come together with a passable plan.
In July, Grassley and Wyden reintroduced legislation that had made it out of the Senate Finance Committee before Democrats backed out of negotiations.
“With all the talk, there hasn’t been much action,” Neuman said.
Still, the topic of high drug costs still is an important one, and each panelist agreed that there is hope for the future. Interest from before the pandemic still is there — it has just been put on the back burner for now, Neuman said.
Anthony said a bipartisan bill is possible, and while there won’t ever be a single perfect fix, steps can be taken to make medicine more affordable.
“Costs have not gone away,” Carroll said. “In fact, the urgency to make sure people are still adequately using, and properly getting, their prescription drugs (is) heightened.”