Magazine article Drug Topics

State Lawmakers Wrestling with Rx Costs and Access

Magazine article Drug Topics

State Lawmakers Wrestling with Rx Costs and Access

Article excerpt

States aren't waiting for Congress to enact drug price and coverage legislation, but most aren't finding it easy to move from rhetoric to reality. In state capitals and Washington, D.C., the focus is on senior citizens-especially the 31% who must pay for all of their medicines out of pocket. While election-year politics is pushing the issue to the front of the line, campaign concerns also are making it more difficult to forge the kind of bipartisan compromises usually crucial for legislative success.

One particular hotbed of state activity is the Northeast. In Maine, Gov. Angus King is considering whether to sign a bill that could lead to state-imposed price controls on Rxs-a first in this country. The bill sailed through the state legislature by veto-proof margins, but is losing some supporters. King, an Independent, has voiced concerns; and the pharmaceutical industry is waging an aggressive lobbying effort to prevent enactment. The measure would create a drug-pricing board charged with negotiating with Rx makers to get their prices in Maine at least as low as those in neighboring Canada. If deals aren't done by October 2001, the board could set prices.

"I think the tidal wave is starting here," said Sen. Chellie Pingree (D), the bill's sponsor and state senate majority leader. "We've been getting calls from other states." A similar measure cleared Vermont's senate and is pending in the house. (Legislation that would have capped Rx prices in California at the lowest rate charged worldwide was killed in a state senate committee last month.)

In New York, legislators are working to expand the state-run Rx aid program for seniors, EPIC (Elderly Pharmaceutical Insurance Coverage). Annual income eligibility limits would be increased to $35,000 for singles and $50,000 for married couples. That would raise the rolls from 115,00 to 215,000 over three years, at an additional cost of $180 million annually. Rhode Island, another of the 16 states with senior Rx aid programs, also is weighing an expansion (Drug Topics, April 3). Late last year, Massachusetts enacted a law that authorizes organization of a 1.5 millionmember buying pool consisting of state employees, Medicaid and state aid recipients, and persons without Rx insurance. A state-- appointed pharmacy benefit manager would run the pool and negotiate discounts. This has yet to get off the ground.

New Hampshire is sponsoring a state discount card plan for seniors run by National Prescription Administrators that has riled several chains and many independents into nonparticipation. …

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