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Favor Equally Effective Drugs that are Less Expensive

“Gift Ban and Disclosure” — Reduce Costs, Ensure Safety and Accuracy in Prescribing Decisions: Key Facts, Polling, Best Practic

Policy Overview:  Require the industry to disclose information about advertising and marketing spending, and prohibit gifts and payments to health care practitioners from pharmaceutical and medical device manufacturers.

Rx Reforms to Address Budget Deficits and Ensure Quality of Medications

As part of our Shared Multi-State Agenda, the Progressive States Network is working with legislators, advocates and leading experts to promote Rx reforms in 2010 that will reduce health care costs for consumers, businesses, and state and local governments, and will help ensure access to safe and effective medications.  Through coordinated, strategic support, PSN and our allies will be working to introduce and advance Rx reforms that will help address state budget deficits and improve access to quality medications in as many states possible; providing model legislation, policy analysis, messaging and more - all of which has been gathered and will be constantly updated on our Prescription Drug Reform Shared Agenda web page.

Health Care for All: Policy Options for 2009

Download a copy of the report in PDF format here.  View the HTML version of the report here.

OVERVIEW

As NLARx reports, generic drugs cost $45 less on average than brand name drugs.  Over the next 4 years, numerous brand name drugs which account for $38 billion worth of sales are going to lose their patents, meaning generics will flood the market - and making this a good time to enact policies to promote their use, such as:
  • Preferred Drug Lists (PDL): States can reduce drug costs by prioritizing drugs proven to be safe, highly effective, and typically less expensive inexpensive over more expensive yet no more effective brand name drugs.  As Prescription Policy Choices (PPC) reports, at least 40 states have some sort of PDL policy regulating physicians' prescribing practices.  Maine's PDL has kept Medicaid drug cost increases to below 3% annually. During the same period, the federal government saw increases of 13%.  Texas' PDL saved the state's Medicaid and SCHIP programs $116 million in 2007.
  • Promoting Generics: Massachusetts saved more than $150 million annually by emphasizing generics over brand name drugs, and Texas saved $223 million by making it easier for doctors to prescribe generics.  Medicaid and other public programs should require that, when available, equally or more effective generics must be prescribed over more expensive celebrity drugs, except where a treating physician overrules this requirement. 
  • Evidence-Based Prescribing: The Drug Effectiveness Review Project is a public and private collaboration that compares and reports on the effectiveness and safety of drugs designed to treat similar conditions.  This program is used by at least 13 states' preferred drug lists.

Resources:

Prescription Policy Choices - Model Policy: Preferred Drug Lists, Prior Authorization, and Promoting Generics
Oregon Health and Science University - Drug Effectiveness Review Project

Focus on Prescription Drug Reform

$287 billion -- that is how much the U.S. spent on pharmaceuticals in 2007, representing a significant driver of health care costs.  While spending on hospital and physician care surpass spending on prescriptions, drugs still account for 14% of all health care expenditures. Combine this with polls that show 70% of Americans believe the drug industry puts profits ahead of people, and it's no wonder that in 2008, at least 540 bills and resolutions are being considered by states across the country to reduce prescription drug prices, ensure the quality of medications covered by public and private health plans, and reduce the undue influence of pharmaceutical industry marketing - which itself tops out at $30 billion each year.

Health-Care-for-All On the Installment Plan

Incremental steps to improve the health care system can lay the foundation for comprehensive reform that provides health care for all. Comprehensive reforms enacted in Massachusetts, Vermont, Maine and San Francisco were, in large part, the result of pragmatic incremental steps those states had already taken. For example, a Families USA report discusses the many reforms Massachusetts put in place over the years that led to its comprehensive 2006 reform. Not every state is as far along in moving comprehensive health care reform, but each state does have numerous options for increasing access to coverage, reducing the growth of health care costs, and improving the quality of care.