Oregon must address drug costs and transparency (Guest opinion)

Prescribing drugs is good. So is deprescribing.

Rep. Bill Kennemer, R-Oregon City, points to two bills in the Oregon legislature that he says could really help Oregonians who rely on prescription drugs.

(Ranit Mishori Special to The Washington Post)

Bill Kennemer

The rising cost of prescription drugs in Oregon should worry us all. I often hear from neighbors and constituents about the real challenges of out-of-pocket costs for prescription medicines. Given that the clock usually resets for a patient's insurance deductible responsibility in January, this time of year can be especially difficult for Oregon families who depend on expensive prescription drug treatments.

Of course the problem is not just Oregon. The challenges with rising drug costs is national in scope. Recently, according to The Wall Street Journal and other sources, the median drug-price increase over last year, measured in January, was 8.9 percent. This compares to overall national inflation rate of about 2 percent. We have all heard the horror stories of the $200 bottle of insulin, even though therapeutic insulin was invented in 1922, or the $600 EpiPen used to treat severe allergic reactions. And, it should make us all angry to read recent news reports about a muscular dystrophy drug that costs $89,000 a year for treatment, even though the drug is decades old and sold at a fraction of that cost outside the United States.

Action is needed at the federal level, and I encourage federal lawmakers and the new administration to take a hard look at reforms. Encouraging more competition, while also using the buying power of the federal government to negotiate bulk prices is a good place to start.

Here in Oregon, there are also steps we must take. For starters, transparency in health care is vital. Patients, consumers, policy makers and others need to understand the true cost drivers within health care. This includes not only pharmaceutical costs, but insurance company and medical provider costs as well. This is why I am encouraged by several bills before the legislature this year. For example, Senate Bill 272, would empower patients by requiring disclosure of drug coverage and cost information, and would also prohibit any mid-year formulary changes. Another bill, SB 237, would set co-payment guidance and limits that may reduce some of the financial risks faced by patients. These offer steps to help consumers.

One bill that probably won't help is House Bill 2387. While this bill is expansive in scope, it is also overly complex, convoluted and potentially unconstitutional. Among other challenges, the bill creates a price-cap mechanism based on foreign drug prices to set maximum prices in Oregon. This will be very hard for the state, not to mention insurance companies, drug manufacturers and distribution channels, to manage. This bill would also require drug manufacturers to directly compensate insurance companies for pricing above the caps. This would certainly be good for those insurance companies, but provides no guaranteed benefit whatsoever for Oregon patients or consumers.

Finally, because drug companies are subject to "lowest market pricing" triggers within national Medicaid and veterans' drug purchase programs, HB 2387 may actually incentivize drug companies to avoid offering certain products and treatments in Oregon. This would be a disaster for Oregonians with diabetes, arthritis, multiple sclerosis, cancer or any other disease requiring extensive pharmaceutical therapy.

We have some potential tools to address these issues during this legislative session, including SB 272 and SB 237. Health care access and cost is a bipartisan issue, and must be a priority this legislative session.

Bill Kennemer, a Ph.D. in clinical psychology, represents District 39 in the Oregon House of Representatives. He currently serves on the House Health Care Committee.

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