White House reform proposal saves seniors hundreds a month, and prevents ‘pay-for-delay’ settlements
This week, the White House unveiled several policy proposals that it would like to see included in national Health Care reform. See white house proposals here. Significantly, the White House strengthened the Senate’s earlier health reform bill by including a number of prescription drug provisions, including:
- an immediate $250 rebate for seniors that enter the ‘donut hole’ along with a plan to close the donut hole completely by 2020. The proposal notes that “Over 8 million seniors hit this gap in Medicare coverage, and for those who do not have other coverage, average drug costs are $340 per month, or $4,080 per year.”
- a provision giving FTC the authority to challenge ‘pay-for-delay’ or reverse-payment settlements that keep generic drugs off the market. This reform is estimated to save $35 billion over the next decade, while making generic forms of some drugs more readily available.
Even before these White House proposal were announced, the bill passed by the Senate and pending before the House included several significant reforms concerning prescription drugs, including:
- the expansion of prescription drug coverage to some 30 million newly covered people.
- a reform to promote needed transparency and reduce doctor’s potential conflicts of interest, through the “full transparency [of] all drug companies, device, and medical supply manufacturers . . . gifts . . . or financial arrangements” with doctors. This proposal follows the current reform in the Senate bill.
- a transparency provision to require all pharmacy benefit managers (PBMs) under Medicare or the exchange to report “information regarding any rebates, discounts, or price concessions they negotiate for prescription drugs” to help health plans reduce waste and losses caused by PBMs. And health plans would also be told how often available generic drugs are used.”
- a 50% discount off branded drugs for seniors in the donut hole.
- billions of dollars in fees on drugs and devices to help pay for this historic expansion of coverage.
Pay-for-delay legislation needed now more than ever.
Also this week, a Court dismissed an FTC and consumer challenge to the legality of a pay-for-delay settlement concerning the drug Androgel. The Court dismissed the FTC’s complaint asserting that the agreement was anti-competitive, despite the fact that the generic competitor.
An article in Today’s BNA Pharmaceutical Law and Industry Report describes the decision, including the efforts by drum maker Solvay to transfer the case from California’s Ninth Circuit, to the less-favorable 11th Circuit. The result of the case, following the precedent set in the 11th Circuit in Shering-Plough, is not as surprising. But comments by the Generic Pharmaceutical Association’s were. This group asserted that the FTC’s loss somehow demonstrates that the FTC’s existing authority “adequately protects consumers” and that new legislation would be “anti-consumer.”
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Keep fighting the good fight
Yesterday’s White House summit illustrated how economic hard times and continuing insurance industry abuses leave consumers without protection without comprehensive reform. (You can see highlight from CNN here, and Community Catalyst’s take on it here.)
Advocates need to continue to make the case for comprehensive reform. You can help by signing this online petition that is being sponsored by the American Cancer Society/ Cancer Action Network, Community Catalyst, and many other national organizations: www.healthcarepetition.org/10707_communitycatalyst