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Battling the specter of high prescription drug prices

By ADAM URQUHART - Staff Writer | Jan 7, 2020

NASHUA – The pharmaceutical industry is profiting while nearly one-quarter of New Hampshire seniors have reported cutting out a prescribed drug due to its high cost, according to officials speaking at the Nashua Senior Activity Center on Monday.

New Futures and New Hampshire Alliance for Healthy Aging delivered a presentation about the impacts rising drug prices are posing for some living in New Hampshire, as well as multiple bills that will considered by the Legislature. As New Futures Health Policy Coordinator Holly Stevens led attendees through a presentation on rising drug prices, she cited statistics from AARP. She was joined by alliance Community Engagement Coordinator Martha McLeod.

One statistic Stevens sourced from AARP is that in 2017, 22% of New Hampshire residents stopped taking their medication as prescribed due to cost. This figure ranges from those who are importing their medications from another country without permission, those who may ration their medications, and others who stop taking them entirely.

“In some way, they stopped taking the recommended prescription as prescribed because they could not afford the drugs, which again, that’s one-fifth of New Hampshire residents that take drugs,” Stevens said.

As far as the reason behind these prescription drug increases go, she admits officials do not know, although Stevens also said recent research suggests that pharmaceutical companies are pricing what the market will bear.

“They’re pricing them as high as they can before people will stop using their medications,” Stevens said.

Stevens said that these pharmaceutical companies claim they are pricing the drug that high due to high research and development costs to develop these pharmaceuticals – both the ones that come to market and those that do not. On the other hand, Stevens further said insurers and pharmacy benefit managers claim it is due to the manufacturer.

An example of rising drug costs influencing the state can be seen on the price tag attached to the life-saving drug Naloxone – or Narcan – that treats narcotic overdoses in an emergency situation. Stevens said the drug was invented in the 1970s. She claimed “big pharma” was able to raise the price by as much as 500% by claiming it involved new technology.

Stevens said the cost of Narcan (Naloxone auto-injector) jumped from $690 in 2014 to $4,500 in 2016.

“They’re essentially exploiting the market,” Stevens said. “They knew that state and local governments would have to buy Naloxone, or Narcan, in order to be able to treat and save their residents who are suffering from overdoses.”

Legislators are working on a number of bills this year at the State House in Concord, with four of these discussed during Monday’s presentation.

One of these bills would direct the state to develop a plan and program to import drugs from Canada. This would not include all drugs, rather it would just be for those prescription drugs that the state would see a substantial savings to consumers. Secondly, another bill seeks to prohibit insurance companies from removing drugs from the formulary, or moving them to a higher cost sharing tier. This is what is known as non-medical switching, which makes a person switch to medication for non-medical reasons.

The third bill discussed is relative to transparency in drug pricing, as it aims to create a prescription drug affordability board that would require manufacturers to report drug cost increases from the prior year to the state. The board would look at what the state spends on drugs and be tasked with trying to determine the 25 highest-cost drugs, and the top 25 most utilized drugs to get a sense of what people in New Hampshire are spending.

The last bill discussed during Monday’s presentation is relative to rebates paid to pharmacy benefits managers, and aims to protect consumers from unfair practices. New Hampshire Sen. Cindy Rosenwald, D-Nashua, is sponsoring this bill.

“This is a segment of the prescription drug industry that is the most opaque,” Rosenwald said. “There are middle men between drug manufacturers and pharmacies and consumers, and so they’re in there in the chain in various places.”

“We would require the pharmacy benefits manager to act in the best interest of the insurance company that hired them to implement and manage their prescription drug benefit,” Rosenwald said. “The bill also has some other regulations. It treats pharmacies more fairly and it ensures that the consumer will pay the lowest price,” Rosenwald added.

Pharmacy benefits managers are companies that will administer prescription drug benefits for insurance carriers. This company then negotiates with manufacturers and pharmacies.

They are making what Rosenwald describes as an incredible amount of money. Rosenwald said these pharmacy benefits managers are not required to work in the best interests of the company that hired them.

The senator believes higher prescription prices are driving the growing cost of health care. While these costs are driven to more expensive prices, Rosenwald acknowledged how this can impact taxpayers because public employees, and those public employees that retire, have health care costs.

“In Nashua, for example, the mayor just vetoed the civilian police contract because the cost of the health care was rising by double digits for the second year in a row,” Rosenwald said. “That was overridden, but I believe you can trace that directly back to the growing cost of prescription drugs.”

Rosenwald, along with New Futures and NHAHA organizers, encourage the public to get involved, whether that be by contacting their elected officials, testifying before the Legislature or sharing their stories to advocate for change. Rosenwald said officials enjoy hearing from members of the public because otherwise, they only hear from lobbyists.

Adam Urquhart may be contacted at 594-1206, or at aurquhart@nashuatelegraph.com.


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