By Jill Zorn
Comptroller Kevin Lembo and the Connecticut State Medical Society (CSMS) co-hosted an event on May 17 at the Legislative Office Building (LOB), Connecticut Pharmaceutical Forum: Access, Affordability and Better Health, which focused on the crisis of medication costs in our health care system.
What proceeded was an apt illustration of how difficult it is to have a constructive conversation among stakeholders when discussing high health care costs. What is cost savings to some, is lost profits and jobs to others.
There is no doubt that the issue of drug prices has become a burning platform affecting government, health care stakeholders, employers and the public.
As Dr. Henry Jacobs, President of CSMS, said when he opened the forum,
“The soaring cost of prescription drugs has created hardships for patients and families and employers and government…. As a physician, I see the impact on my patients. 20 percent of cancer patients are choosing to die rather than bankrupting their families by participating in programs of treatment that are completely unaffordable, ranging as high as $300,000-400,000 a year.”
Comptroller Lembo echoed these remarks with data, explaining that, while overall medical costs for the health plan covering state employees and retirees rose by 2.9 percent in 2015, pharmaceutical costs rose by a whopping 20 percent.
Lembo also recognized that pharmaceutical research is a significant economic driver in Connecticut and many patients benefit from new drug discoveries. He spoke about the need to balance the cost and benefit of pharmaceuticals, and said that,
“The first step is getting every stakeholder in the room… we may have different challenges and perspectives, but we can all agree to come to the table and work toward the best solution possible that best protects consumers, business and tax payers.”
But on the first panel, Industry Perspective on Cost Growth, panelists representing the pharmaceutical industry spent most of their time presenting their own version of reality, downplaying the impact of high medication costs as a significant driver of overall health care expenditures. While attempting to explain their perspectives, they also managed to get in digs against both the insurance industry and the hospital industry.
Two other panelists, C. Michael White, the Dean of the UConn School of Pharmacy and Dr. Troy Brennan Chief Medical Officer at CVS/Caremark, the Pharmacy Benefits Manager for the state employee health plan, presented their own very different statistics and arguments. They mentioned the ever increasing launch prices of new brand-name drugs and the major price hikes that follow. The relatively recent problem of growing prices of generic drugs was also cited. There was also discussion about the lack of price transparency with regard to pharmaceutical prices-both the actual prices and the many possible discounts and rebates that each payer negotiates.
When stakeholders engage in finger pointing and can’t even agree on whether there IS a problem, you know patients are going to lose. Consumers are the least able to negotiate with large stakeholders – a point driven home by Vicki Veltri, Connecticut’s Healthcare Advocate.
“The consumer is just stuck, they have no bargaining power,” Veltri said at the forum.
While a second panel, Impact and Options to Limit Cost Growth, attempted to pivot toward solutions, the audience was left wondering if progress could truly be made on this extremely important issue.
Perhaps symbolically, the forum ended abruptly when the fire alarm went off and we all had to evacuate the building due to a small fire that had broken out in the LOB; illustrating the burning platform a bit too literally.
Connecticut New Junkie covered the forum here.
CT-N has archived a video of the program here.
Consumers Union webinar and resources on high drug spending here.
The forum included information about two innovative programs that are attempting to limit medication price growth. The Institute for Clinical and Economic Review, ICER, “evaluates evidence on the value of medical tests, treatments and delivery system innovations”. Maine Independent Clinical Information Services is a program mandated by the Maine Legislature and operated under contract with Maine Medical Association that “delivers up-to-date, evidence-based prescribing information to health care providers… where physicians and other providers (are) exposed to clinical content created by an independent group of experts not swayed by financial concerns.”