Rosenthal says pharma must do its part

It isn’t surprising that Amy Rosenthal, the executive director of Health Care for All, wants to rein in the cost of prescription drugs. She’s been quite clear that breakthrough drugs don’t have much of an impact if people can’t afford them.

But her talk of shared responsibility on the Health or Consequences Codcast with Paul Hattis and John McDonough took the debate in a new direction. She said she has made the rounds with all of the players in the Massachusetts health care system and discovered a shared pride in all that has been accomplished in terms of near-universal coverage and moderating prices. Each of the players has contributed.

“Individuals were required to start buying health insurance, the individual mandate,” she said. “Employers had an employer assessment. Hospitals and insurers have to go before the Health Policy Commission. All of these things were not easy. People had to put some serious skin in the game. And all we’re saying at this point is that it’s time for pharma to do their part in this.”

Like everyone else, Rosenthal is waiting to see what emerges from the fiscal 2020 budget deliberations on Beacon Hill. Gov. Charlie Baker, the House, and the Senate have all included provisions in their budget proposals addressing the rising cost of prescription drugs, but the approaches adopted by the governor and Senate are more aggressive. They would pressure drug manufacturers to negotiate lower prices for their products by threatening public disclosure of pricing information and referring instances of excessive prices to the attorney general for investigation under the state’s consumer protection law.

Rosenthal said she isn’t putting all her eggs in the budget basket. She is also talking to the chairs of the Legislature’s Health Care Financing Committee, pushing for legislation that would require more transparency and accountability around drug pricing.

“There’s really very little transparency around the actual cost it takes to produce a particular drug. It’s kind of like a black box where people outside the industry really don’t understand it,” she said.

But Rosenthal says transparency isn’t enough. She also supports accountability. She wants to give the Health Policy Commission the power to set upper payment limits for what she describes as a small group of drugs – those undergoing a rapid increase in price (insulin and Epipens) or those with very high prices but limited value.

McDonough asked Rosenthal whether her version of accountability was just a metaphor for price controls.

“No,” she said. “What this is is really incentives to bring manufacturers to the table.”



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