- Opioid Package Negotiations Conclude, Likely Vote This Week
- Senate Votes to End Pharmacy Gag Order, Protecting ‘Patients’ Right to Know’
- Midterms Loom for Republicans Looking to Change Perceptions of Stances on Pre-Existing Protections
- Former CMS Officials Discuss Pressure Officials Face in Negotiating Drug Prices
Last week, the Senate passed a comprehensive package of opioid legislation, The Opioid Crisis Response Act of 2018, by a vote of 99-1, and latest reports suggest House and Senate leaders have completed negotiations on their final opioid bill. Chairman of the Senate Health, Education, Labor and Pensions Committee Lamar Alexander (R-TN) said the goal is to have all the language in a combined bill ready vote on this week before heading to the President for signature.
The House and Senate will likely not include a PhRMA-backed provision to curb Medicare costs for pharmaceutical companies or any version of the CREATES Act, a bill intended to encourage the creation of cheaper biosimilar drugs, in the final version of their opioid bill, according to multiple sources with knowledge of the bill. Congress is still in the process of negotiating the two chambers’ versions of the bill before sending it to the president to be signed into law.
The opioid bills overwhelmingly passed each chamber, but the pharmaceutical manufacturers worked to get lawmakers to attach a provision opposed by many Democrats, plans and seniors’ advocates. The $4 billion measure would reduce the brands’ share of Part D donut-hole costs from 70 percent to 63 percent. PhRMA also is trying to avert the Part D cliff, which would benefit both drug makers and seniors.
The bill also reportedly included an IMD exclusion bill sponsored by Sen. Rob Portman (R-Ohio) allowing Medicaid dollars to temporarily fund treatment for substance use disorders in residential facilities. The legislation will not include a bill to roll back patient privacy rules that conceal addiction treatment history records, which had widespread support from hospitals and physicians.
The opioids legislation is expected to be voted on this week and Roundtable senior staff will keep members up to date on ongoing negotiations.
The Senate voted 98-to-2 late last Monday to pass a bill that would effectively end “gag clauses” that bar pharmacists from telling consumers when it would cost less to pay cash for a prescription without insurance. Drug companies will also be required to file biosimilars patent settlements with the FTC to increase the agency’s visibility into pay-for-delay agreements between makers of brand biologics and biosimilars.
The National Community Pharmacists Association (NCPA), and other groups who supported the Patient Right to Know Drug Prices Act (S.2554), have argued that the gag clauses interfere in their relationships with their patients. Douglas Hoey, Chief Executive Officer of the NCPA, said in a statement, “As trusted healthcare providers whose aim is to get and keep patients well, pharmacists should be free to properly advise their patients about medication costs. That cost-even an insurance copay-can often be an impediment to patient access and adherence.
Senators Mike Lee (R-UT) and Rand Paul (R-KY) opposed the bill, with Lee voting against because he does not believe the federal government should regulate commercial markets except for self-insured plans. Lee offered an amendment that would have limited the gag-order ban to self-insured plans, but that amendment was defeated.
The bill will move to the House, where representatives will vote on gag order bans in the Medicare and commercial markets. Although the House version of the gag order ban bill does not include the biosimilars proposal, Rep. John Sarbanes (D-MD) introduced a bill this summer to mandate the filings.