By FOCUS, a Leonine Business
Over the past several years, the focus on healthcare policy in both state capitols and the media has shifted largely towards curbing the rise of prescription drug prices. Legislators, emboldened by news stories of skyrocketing prices for brand name and generic drugs, have been tackling the issue head on, in defiance of the powerful pharmaceutical lobby. While state policy often varies wildly from state to state depending on the overall partisan makeup of the state, prescription drug pricing has emerged this year as a bright spot of bipartisanism, with lawmakers on both side of the aisle taking significant steps to combat increased prices.
The movement has been further buttressed by the support of President Donald Trump who has, on several occasions, used the bully pulpit of his office to criticize high drug prices and promise reform to bring prices down. Most recently he has voiced his support for a Florida proposal which would allow the importation of prescription drugs from outside the country in the state. In the same speech, the president also vowed to end “surprise medical bills,” a controversial practice also known as balance billing, where a patient is billed the difference between what a provider charges and what insurance is willing to cover.
The president is not alone in noticing the rising cost of prescription drugs. According to a report from NPR, the price of brand-name prescription drugs rose by nine percent per year from 2008 to 2016. Total spending on prescription drugs accounts for between 10 and 20 percent of healthcare spending in the U.S., by some estimates. These dramatic increases, which have major consequences on individuals and the economy as a whole, have pushed the issue towards the center, a consensus that few policy issues are able to achieve.
The open Republican embrace of these typically left-leaning policies highlights the importance of medical pricing to voters regardless of party, and the importance of politics over policy for pragmatic lawmakers; Republican voters tend to skew older, and as such are much more affected by any increase in pharmaceutical pricing than younger generations. With this newfound bipartisan support, a number of states have begun to take action to rein in drug prices.
In Oklahoma, lawmakers are poised to override the wishes of Republican Gov. Kevin Stitt, according to Tulsa World. HB 2632 passed both chambers of the legislature unanimously, in spite of the fact that the governor recently vetoed a similar bill. This bill would direct pharmacy benefit managers (PBMs) to open their pharmacy networks to any pharmacist who is able to meet the networks’ terms and conditions. While PBMs claim that the move will drive up prescription prices, lawmakers unequivocally see it the other way, that opening up such networks will drive prices down.
Data from the National Academy for State Health Policy, shows that 103 PBM bills similar to the Oklahoma proposal have been introduced or enacted in 41 states. In addition, 27 prescription drug importation bills, including the federally-touted Florida initiative, have been introduced or enacted in 16 states. While these two types of proposals form the lion’s share of this year’s legislation, a number of bills relating to pricing transparency, bulk purchasing, price gouging, and study committees have been introduced to tackle the issue in nearly every state.
With healthcare costs across the board continuing to vastly outstrip both inflation and wages, cost containment and pricing will continue to be on top of the agenda for lawmakers around the nation, regardless of state or party. As states continue to experiment with policies to “get it right” trends including drug importation and PBM regulation will continue to spread regardless of political ideology.