Bolstered by national efforts and the financial concerns of their constituents, legislators are pushing a measure that includes several provisions aimed at capping or lowering the price of prescription medication.
The sweeping drug bill features a plan to import medicine from Canada, a proposal to cap the monthly cost of prescription pharmaceuticals at $250 for people with fully insured health plans, a ban on “pay to delay” – a practice that postpones the introduction of cheaper, generic drugs into the market, and a prohibition on mid-year changes to drug formularies.
Lawmakers on the Insurance Committee heard public testimony on the bill Tuesday. The committee has until mid-March to vote on the measure.
Proponents of the legislation, including Rep. Sean Scanlon, a Guilford Democrat, have heard from residents across the state who say the rising cost of prescription drugs has become a serious problem. Some have rationed supplies or gone without.
In 2018, lawmakers passed a bill that aims to increase transparency around drug prices by imposing annual reporting requirements on insurers, pharmaceutical companies, and others. The earliest batch of data isn’t expected until next year, however, and legislators said they don’t want to delay action.
“It’s important for us to look at that data and find out why these costs are going up,” Scanlon said. “But in the meantime, we can’t just wait. We need to get people the relief they’re really looking for.”
“We need to get people the relief they’re really looking for.”
Rep. Sean Scanlon, D-Guilford
The bill now under consideration would cap the monthly cost of prescription drugs at $250 for people on traditional insurance plans. Connecticut would be the second state to undertake such an effort – New Jersey passed a similar measure last year. The Garden State capped the monthly cost of prescription medication at $150 for people on silver, gold, or platinum-level plans. It limited the monthly expense of the drugs to $250 for people with bronze-level coverage.
Connecticut’s bill also would allow the commissioner of consumer protection to seek federal approval to import prescription medication from Canada. An application for permission has already been drafted by the state, legislators said. The commissioner would be tasked with setting up a program for distribution of the imported drugs.
Four states – Vermont, Colorado, Florida and Maine – have passed legislation allowing them to pursue federal authorization, and the Trump administration has taken steps toward permitting drug importation.
Lawmakers also want to ban a practice known as “pay to delay” in which brand name drug makers compensate their generic counterparts for holding off on marketing their versions of the medications – causing longer delays in getting less expensive, generic drugs to consumers.
The proposal would require brand name drug companies that enter into those settlements with generic drug corporations to offer 50% discounts on their prescription medications – a penalty meant to discourage the practice. The drug makers would also have to notify the state insurance commissioner if they reach those deals. An identical effort failed last year.
In addition, legislators want to halt mid-year or mid-contract changes to drug formularies – the lists of prescription drugs that health plans will cover. In Connecticut, insurers may remove drugs from a formulary during a policy’s term.
The wide-ranging bill drew support from the AARP, the CT Alliance for Retired Americans, state Comptroller Kevin Lembo and Democratic legislative leaders.
Sen. Kevin Kelly, a ranking Republican on the Insurance Committee, said he supports the idea of drug importation and other strategies to lower the cost of prescription medication, but he worries capping monthly expenses will lead insurers to drive up premiums.
“We’ve really got to address the issue of the cost driver,” he said. “I want to rectify this problem for Connecticut families, but I think there are other avenues we can go down.”
Several groups submitted testimony opposing the bill, including the Connecticut Association of Health Plans and the Connecticut Pharmacists Association. Some of the proposals have also drawn dissension from the Connecticut Business and Industry Association and the insurance companies.
“The risk to patient safety, combined with the lack of cost savings, makes importation from Canada an unworkable solution for pharmacy patients and for Connecticut’s consumers in general,” Nathan Tinker, CEO of the Connecticut Pharmacists Association, wrote to lawmakers. “We urge you not to move forward.”