Bill aims to lower cost of prescriptions

Polling shows strong support for a proposal to create a state board that would evaluate whether prescriptions drugs and medications are affordable. The governor-appointed board would be able to set an upper payment limit on drugs deemed unaffordable to control the costs through all payers in Colorado.

The Colorado Consumer Health Initiative commissioned Magellan Strategies and RBI Strategies to gauge support for such a board. A bipartisan 71% of Coloradans support the creation of a Prescription Drug Affordability Board, with 53% of Coloradans saying they are worried or very worried about the cost of prescription drugs.

Democrats are banking on this popular support to push Senate Bill 21-175 despite no Republican co-sponsoring the legislation to establish the new board. But the cost issue resonates across party lines, said David Flaherty of Magellan Strategies, a Republican-leaning polling firm.

Health care consistently ranks as a top-three voter issue and when people are asked what can be done to improve health care, “people think of prescription drugs,” Flaherty said. “They understand the issue and they have experience with it. They really believe this is a logical and reasonable way to address the problem. Voters believe and clearly understand that pharmaceutical companies, perhaps, are charging too much.”

Colorado Health Institute data shows up to 8% of people in Mesa County reported not filling a prescription because of costs, while up to 12% of people in Delta and Montrose counties and up to 18% of people in Garfield County reported not filling a prescription because of cost.

Those are figures pulled together by CCHI, which is leading a coalition in support of SB175. CCHI is in the midst of an awareness campaign juxtaposing the struggle to afford medications against pharmaceutical profits.

For example, top pharmaceutical corporations, which measure their profits in the billions and combined trillions, spent nearly twice as much on advertising and marketing as they did on research and development in 2019. And taxpayers invested $100 billion in the research and development of every one of the 210 drugs approved by the FDA from 2010-2016, according to CCHI.

The CEOs from these companies averaged around $15 million in compensation in 2019. Meanwhile prescription drugs account for more than 20 percent of health insurance premium costs, so reining them in is part of a larger strategy to make overall care more affordable.

One of the bill’s sponsors, Sen. Sonya Jaquez Lewis, D-Lafayette, is the first pharmacist ever elected to the General Assembly.

“We pay the most of any country in the world for medication,” she told the Sentinel’s editorial board last week. “Why? Because we are subsidizing the rest of the world. We’re one of only two countries not able to negotiate drug prices and we can’t fix that in the state of Colorado. What we can do is look at establishing a prescription drug affordability board.”

Two years ago, the legislature passed a cap on insulin prices. This bill would set up a board to do the same thing — look at what is affordable in life-saving medication, Sen. Jaquez Lewis said, adding that “this is not price setting.”

The board would research, review and establish more affordable costs by looking at perhaps a dozen drugs initially. The board would set up the metrics of affordability through a rulemaking process with public input.

For brand name drugs, the board would review drugs that have a $30,000 list price or a $3,000 increase in price and for generic drugs, the board would review any drugs over $100 or that see a 200% increase. While this won’t impact most Coloradoans, it will make a difference to those of us who depend on extremely costly, life-saving drugs.

The window may be narrow, but the intent of the legislation is message-sending as much as it is concrete controls. Jaquez Lewis said. If enough states set up affordability boards, it becomes that much easier for Congress to take a run at a federal solution.

CCHI estimates that this proposal will create savings as high as 75% on the current costs of the most unaffordable drugs.

Republican hesitancy seems to center on how or if the legislation would impact innovation. We’ve seen a rollout of three COVID-19 vaccines in America that were developed in less than a year’s time, though CCHI is quick to point out that the taxpayer-funded National Institutes of Health played a role in underwriting some of those development costs.

Clearly consumers want some relief. An earlier legislative proposal to import Canadian drugs stalled because of federal approval, though it remains an option in Colorado this legislative session. On balance, we think SB175 is a good idea when we consider that Coloradans pay 65% to 85% more than people in other countries for the same drugs. At the very least, we hope that it will get the ball rolling on addressing the cost of prescription drugs in Colorado.