WITH A PHARMA-FRIENDLY amendment withdrawn from consideration, the Senate is on track to stick with its more hardline approach toward MassHealth drug pricing in the fiscal 2020 budget.
That would set up a big disagreement with the House, which amended the drug-pricing approach in its budget bill by plugging in language that was welcomed by the Massachusetts Biotechnology Council.
Sen. Joseph Boncore, a Winthrop Democrat whose district includes part of the biotech hotbed of Kendall Square, had proposed an amendment similar to what was adopted in the House. He confirmed he met with MassBio about it.
“The amendment that I filed gives us a different way to look at how to go after drug pricing and reconsider it in the grand scheme of overall health care costs,” Boncore said Tuesday. “It is similar to what the House did with a few minor changes.”
On Wednesday afternoon, however, Boncore withdrew his amendment, leaving the Senate budget language intact. With the budget debate ongoing, it’s still possible for other amendments dealing with drug pricing to be put forward, but Boncore’s decision was cheered by Health Care for All.
“That was an amendment that we strongly opposed, so we’re glad to see that thus far in the debate the Senate has retained the strong language,” said Alex Sheff, the co-director of policy and government relations for Health Care for All, on Wednesday evening. Health Care for All is part of a coalition, which includes the Massachusetts Medical Society and Massachusetts Senior Action Council, backing a tougher and more public approach to drug-pricing.
MassBio, whose members produce costly life-saving drugs and are powerful drivers of the state’s economy, had excoriated the budget language included in the budget by the Senate Ways and Means Committee, calling it a “radical, unproven policy with unrealistic cost saving estimates despite the significant risks it poses to sick patients who are waiting for a disease-changing therapy that works for them.”
After this story was published on Wednesday evening, MassBio President Bob Coughlin said he was disappointed and would advocate for the House language to be included in the final budget that goes to the governor.
“We’re disappointed the Senate was unwilling to compromise on the most far reaching Medicaid drug pricing reform in the country, one that would threaten our stature as the #1 life sciences cluster and harm the development of the next generation of breakthrough therapies,” Coughlin said. “It’s our partnership with academia and government that has supported the level of innovation we see today – innovation that is bringing cures to patients for the first time – and any approach to upend this should be thoughtful and cautious. As the issue moves to conference committee, we will be strongly advocating for inclusion of the House passed language in the final budget.”
MassHealth, the name for the state’s Medicaid program, accounts for the biggest chunk of spending in the state’s budget. Since 2012, MassHealth’s prescription costs have risen from $1.1 billion to $1.9 billion, according to the Baker administration.
Gov. Charlie Baker made the first foray this year into restraining the cost of drugs available through MassHealth, proposing through his budget bill a multistep process for MassHealth to negotiate prices with pharmaceutical companies. The budget bill put out by the Senate Committee on Ways and Means roughly tracks the governor’s language.
Under the governor’s proposal, if the initial price negotiations break down, MassHealth can set a target value for high-cost drugs, and if that approach fails to yield agreement, the matter would be referred to the Health Policy Commission, which could subject drug-makers to public scrutiny for their pricing decisions. If the commission determined particular drug prices were unreasonable, the matter could be referred to the attorney general for potential legal action under the consumer protection law.
Boncore’s amendment would have eliminated the ability for Health and Human Services to publicly post its estimate of the value of a drug, limited the amount of information the Health Policy Commission could collect, and removed the language authorizing referrals to the attorney general’s office, according to Sheff.
Sharon Torgerson, the assistant secretary for communications at the Office of Health and Human Services, said there are about 200 “really expensive” drugs for which the administration would want to negotiate prices.