Governor calls for task force to work on cutting Rx prices

Kathleen Gray, Detroit Free Press

LANSING – While Gov. Gretchen Whitmer will target fixing the roads during her State of the State address Wednesday, at least one pocketbook issue — tackling the spiraling costs of prescription drugs — will be on the agenda as well.

“We want to show that we're taking this seriously — we know that the increase in prescription drug costs has just been skyrocketing. It's a bigger part of our budget,” she said. “And it’s costing people in ways that are really impacting their ability to just make their rent payment or take care of their kids.”

Whitmer will announce the creation of a Prescription Drug Advisory Task Force, made up of five bipartisan members of the Legislature who will be expected to come up with a report by Aug. 15 on ways to make prescription drugs more affordable for Michiganders.

“It could be something like ensuring that we have a preferred drug list,” Whitmer said in an interview Tuesday with the Detroit Free Press. “That’s a way that we can bring down the cost of prescriptions for people who get their health care through Medicaid."

While Medicaid is a federal program, Michigan administers the program for 2½ million Michigan residents. Other states also are looking at developing lower cost preferred drug lists for Medicaid recipients.

Or the task force could look at ways to make it easier for people to buy prescription drugs in Canada, where prices are markedly lower. A bill has already been introduced in the state Senate to have the state work with federal and Canadian officials to create a wholesale prescription drug importation program.

Last year, 33 states enacted a record 51 laws to address drug prices, affordability and access, according to Kaiser Health News. That tops the previous record of 45 laws enacted in 28 states set in 2018, according to the National Academy for State Health Policy, a nonprofit advocacy group that develops model legislation and promotes such laws.

Among the new measures are authorizing the importation of prescription drugs, screening for excessive price increases by drug companies and setting up oversight boards to set prices that states will pay for drugs.

So far this year, 93 bills have been introduced across the country, including three in Michigan that require pharmacies to be more transparent about the costs they charge for prescription drugs.
Whitmer will work with the legislative leaders to choose task force members interested in the problem of high prescription drug costs.

Her charge to the task force:
•Examine the problem of high-cost drugs and its impact
•Review high-cost prescription drugs and make recommendations on strategies to bring down costs
•Develop transparency standards to disclose how much drug companies pay for research, manufacturing, and marketing
•Consider policies to require pharmaceutical manufacturers to demonstrate a rationale for price increases above a certain percentage
• Examine a broad range of economic factors along the entire pharmaceutical supply chain, including spending on advertising, public research investment and the actions of middlemen who negotiate prices.

There are some things she'll be able to do, such as the preferred drug list and others she won't, said Marianne Udow-Phillips, executive director of the Center for Health and Research Transformation in Ann Arbor. Whitmer won't be able to dictate the cost of some prescription drugs because of patent protection laws.
And while a federal solution to the issue would be a more comprehensive goal than a patchwork of different state regulations, Udow-Phillips, said the prospect of federal action is uncertain in these divisive political times.
"There have been proposals at the federal level from the U.S. Senate, House and president and they haven’t been able to get them over the finish line," she said. "And I can tell you that that Pharmaceutical Manufacturing Association is the No. 1 lobby in Washington D.C. and they have increased their lobbying greatly as everyone is talking about this."
Absent federal action, states across the nation are looking at ways to lower prescription drug costs, Udow-Phillips said. It's crucial for the state to work on the problem because it constitutes a recurring — and often expensive — cost for people, who often have to cope with high deductibles on their insurance.
"Other medical issues, like doctor visits, are episodic. For some consumers, prescription drugs are a lifesaving issue for them," she said. "It's very important for the state to do whatever they can."
It can be as simple as providing more information to consumers in the state about generic drugs to a more complex model of "predictive modeling" that identifies people who need the high-cost prescription drugs and those who have been prescribed those pricey alternatives, but could benefit from lower cost generic drugs.
"There are specialty drugs in every class where people might be just as well served by having lower-cost drugs," Udow-Phillips said, noting that lower cost alternatives for ailments such as diabetes, irritable bowel syndrome and even insulin are available.
"Even with insulin, we know that the cost difference between older generic drugs and the newer, high-cost ones is huge," she said.
Whitmer said she's confident that this task force won't replicate other groups convened to study an issue that have shown scant results.
"Instead of having 30 people from every single industry who aren't in the Legislature, who are bright people with expertise, versus having five people from the Legislature who can study and listen to all of these experts and craft what we really could do, that's what this is about," she said. "In the past, we created task forces so they could check off every interest group, but I want to get something done here. And that's why I think a bipartisan task force is really the best way to go."
Whitmer said she has no preconceived notions about how much she'll be able to bring down prescription drug costs for Michiganders.

"There are a lot of opportunities here, but I'm going to need partners in the Legislature. And that's why we're going to lean on them pretty heavily and partner with them to make sure we're looking at what we can do right now."
Whitmer's second State of the State address begins at 7 p.m. Wednesday. It will be available to watch online at: https://tinyurl.com/urvj53r