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Pharma pressure against drug pricing transparency bill denounced

By on December 14, 2017

SAN JUAN – Popular Democratic Party minority Rep. Jesús Manuel Ortiz said he was hopeful about Puerto Rico Senate Bill 371, which would create the Drug Pricing Transparency Act to guarantee public access to information about which factors influence the price increases of medicines.

The Health Committee member said the measure will be evaluated this week by a conference committee to try to reconcile the amendments made by both legislative bodies. The representative said there is willingness to pass legislation that addresses the need for patients to have access to medicines at fair prices.

“I believe there is consensus,” Ortiz said in an interview with Caribbean Business. “There is a bill of mine, which is that of the minority; there is a Fortaleza bill, which was approved in the Senate; so I think the conditions are favorable to have a measure approved that improves that process.”

However, CB sources in the Capitol indicated that the pharmaceutical industry is lobbying fiercely in opposition of the measure.

“The problem is a complex one and we know it’s not easy to solve because there are many manufacturers that aren’t in Puerto Rico and, therefore, for those that are abroad, we don’t have jurisdiction,” Rep. Jesús Ortiz explained. (iStock)

House Health Committee Chairman Juan Oscar Morales said there is pressure for the bill to not be passed and assured he was not aware of potential differences between the language in both measures that required it be discussed by the conference committee.

“I didn’t know there were discrepancies between the House and the Senate. I thought that bill was very clear. But it seems to me there are sinister hands holding this bill back because I’m not a fool and I know the pharmaceuticals are opposed and I saw them roaming around, which makes me think they took it to conference to sit us down to talk,” the Health Committee chairman said. “If we achieve [passing] that bill, we don’t resolve the situation, but at least we begin to work on it.”

Morales also noted that Speaker Carlos Méndez gave instructions to do everything within the reach of legislators to pass the bill without amendments that distort its original purpose.

“This is a bill that benefits patients. There are some doubts, and I’m the first to have doubts regarding brand-name drugs. I would like to be clear on whether we, as the government, are going to have jurisdiction when requesting information on these brand-name drugs from these pharmaceutical companies. Some of these companies do not have offices here in Puerto Rico and those doubts exist, but there are other options. The drugstores, for example. The information would then be supplied by the drugstores, which are in our jurisdiction,” the legislator added.

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According to the bills’ preamble, an American Association of Retired Persons (AARP) survey of 1,834 adults ages 50 and older, revealed that 86% of adults 65 years or older take prescription medication regularly and more than half did not acquire medication that had been prescribed in the past two years. The patients said their cost was a determining factor in that decision.

The survey also found, according to the bill, that people 50 to 64 years of age who are not yet enrolled in Medicare face more difficulty in paying for their prescription drugs and have to make difficult decisions. Sometimes they skip doses or simply do not take their medications to save money, which could lead to a health crisis in that population.

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The bill also explains that since 2015 measures have been introduced, in at least 13 U.S. jurisdictions, that try to establish greater transparency in the increase of drug prices. According to a report prepared by the National Conference of State Legislatures, measures have been introduced in California, Colorado, Louisiana, Massachusetts, New Jersey, New York, North Carolina, Minnesota, Oregon, Pennsylvania, Rhode Island, Texas, Washington and West Virginia, among others.

In June 2016, Vermont became the first to approve this type of law when the governor signed Act 165 of 2016.

As further stated in the island bill’s preamble, most of these measures require manufacturers to report wholesale acquisition cost or the average wholesale price. However, it adds, some critics say these figurers are not representative of the real cost of the medicines.

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“The problem is a complex one and we know it’s not easy to solve because there are many manufacturers that aren’t in Puerto Rico and, therefore, for those abroad, we don’t have jurisdiction,” Ortiz said.

“But in general terms, I believe the bill, firstly presents tools that give transparency to the process and, secondly, the government will be able, with that bill approved as it is now, to begin to supervise, in my opinion, more effectively, and that can provide the country with more information about how much prices vary from year to year and some of the reasons why this happens,” the representative added.

The measure establishes that the Senate is responsible for ensuring the quality and availability of health services and categorically states that access to medicine is of vital importance.

“I think we should aspire to, at some point, be able to establish measures that help the government control those prices more, especially of medicines that treat the highest prevailing conditions on the island. It seems to me that this is a positive first step, specifically because it opens up the process and gives transparency to the whole process of how fluctuations and prices are set in the market,” Ortiz said.

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