Editor’s note: A version of this story first ran in the Vail Daily on May 20, 2019.
Colorado Sens. Cory Gardner and Michael Bennet are setting partisanship aside and battling alongside each other to lower the runaway costs of prescription drugs – cosponsoring a bill last month to increase access to generics – but they disagree on at least one Trump policy plan.
Recent Senate hearings have zeroed in on pharmacy benefit managers (PBMs) – companies that negotiate payments between pharmaceutical manufacturers and insurers. President Donald Trump and Health and Human Services Secretary Alex Azar have taken aim at PBMs for unnecessarily jacking up drug prices and want to ban the rebate system.
Organizations representing PBMs have fired back that PBMs actually help bring down drug costs by negotiating better deals with manufacturers and keeping those companies from setting even higher prices for consumers. In fact, the Congressional Budget Office (CBO) recently said a rebate ban would cost Medicare and Medicaid $177 billion over the next 10 years.
“We are working with the [Senate] Finance Committee on measures to increase transparency and lower costs for Medicare beneficiaries,” said Courtney Gidner, a spokeswoman for Democratic Sen. Bennet. “Though the drug supply chain is in dire need of reform, including how rebates are structured, Michael is concerned with the Congressional Budget Office’s estimate that the rebate rule would cost taxpayers $170 billion over the next 10 years.
“Solutions to lower drug prices should result in savings for taxpayers and consumers,” Gidner added.
Jerrod Dobkin, a spokesman for Republican Sen. Gardner, said he was not aware of the CBO report but offered this take:
“With regards to rebates, Sen. Gardner is supportive of making drug pricing transparent and ensuring patients are provided the savings of a discount instead of savings money going to a middleman,” Dobkin said. He then offered a statement from Gardner on his generics bill.
“I hear frequently from families in Colorado, and across the nation, who are suffering from the rising cost of prescription drugs, including life-saving medications like insulin and opioid addiction treatment,” Gardner said.
“Bipartisan legislation I authored known as the Ensuring Timely Access to Generics Act of 2019 would lower the cost of care by removing obstacles to increase competition and prevent brand name drug companies from gaming the system,” Gardner added.
Bennet is also a sponsor of the generics bill, which would increase oversight of the Food and Drug Administration’s (FDA) citizen petition process, which allows stakeholders — including drug companies — to raise concerns with the FDA during pending applications.
According to Gardner’s office, “bad actors have discovered how to exploit this process by filing citizen petitions in order to delay the approval of generic competitors and extend their patent protections.”
This generics bill, if passed, would allow the FDA to reject citizen petitions if the agency feels the only reason for the petition is to cause a delay in the approval of an application for a generic version of a drug, which is inevitably cheaper than the name-brand version.
Gardner’s office said the senator will continue to search for other solutions.
“No American should be forced to choose between critical medications and basic essentials, like groceries, which is why I will continue to work alongside my colleagues to help alleviate the financial burden of prescription drug costs,” Gardner said.
Bennets’ office, meanwhile, touted much broader health care and health insurance reforms.
“With respect to other proposals, Michael’s Medicare-X bill would require the federal government to negotiate drug prices, in addition to creating a public option and increasing competition,” said Gidner, whose boss is also among 23 Democrats seeking the nomination to take on Trump for the White House in 2020.
At the state level, Gov. Jared Polis on Friday signed a public option health insurance bill into law in Vail that was sponsored by local state Rep. Dylan Roberts, D-Avon, who hopes that with federal approval the state public option will increase competition for Affordable Care Act plans on the individual market in underserved rural Colorado counties like Eagle and Routt, where there are often only one or two insurance carriers and premiums are astronomical.
The public option will take at least until 2021 to go into effect. Roberts and state Sen. Kerry Donovan also backed a reinsurance law that could bring rates down starting in 2020 and a law to cap how much Coloradans pay on a monthly basis for insulin.
Finally, state lawmakers passed a law that would allow for lower-cost Canadian prescription drug imports. It got a nod of approval from Trump, according to the Colorado Sun, but still needs to work its way through HHS and get the final logistical OK from Secretary Azar.