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Battle over health care reform stalls efforts to lower runaway drug prices 

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click to enlarge Prescription drug prices aren't likely to go down any time soon. - LENETSTAN / SHUTTERSTOCK.COM
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  • Prescription drug prices aren't likely to go down any time soon.

As lawmakers and the White House wrangle over the Affordable Care Act and its proposed Republican replacement, efforts to corral one of the most talked-about components of health care — the rising cost of prescription drugs — have largely stalled both in Washington, D.C., and Colorado.

Meanwhile, many prescription drug prices are continuing to spiral upward. In early May, for example, the Indianapolis-based drug giant Eli Lilly and Co. raised the prices of nine of its medicines between 6 and 10 percent, according to data obtained by CNBC. The increases included a 9.9 percent hike for the blood thinner Effient; 7.8 percent increases for the insulin medications Humalog and Humulin; and a 6.9 percent increase for the psoriasis drug Taltz.

According to the D.C.-based Campaign for Sustainable Rx Pricing, in 2015 the prices of prescription drugs saw the largest increases in 24 years. Overall, prescription drug prices have risen more than 7 percent since last year, the largest one-year hike since 1992.

The increases have been across the board. The prices for insulin, used to treat diabetes, have skyrocketed in the past few years. Last year the price of the EpiPen drug, used to treat life-threatening allergic reactions, made headlines when it jumped from about $100 for a two-pack dosage in 2009 to more than $600 in some cases.

Lawmakers in Washington and in Colorado have vowed to crack down, and President Donald Trump made the rising costs of prescription drugs one of his signature campaign issues. However, observers often cite the pharmaceutical industry and its powerful lobbying network for thwarting any real progress.

"The market for prescription drugs in this country is out of control and fundamentally broken," said Will Holley, spokesman for the Campaign for Sustainable Rx Pricing. The nonpartisan coalition includes organizations ranging from AARP to the American Hospital Association to Walmart to Kaiser Permanente, and seeks to find market-based solutions to lower drug prices in the U.S.

Campaign for Sustainable Rx Pricing is currently engaged in a public information campaign to highlight drug-pricing practices across the country, including Colorado.

"We want to make sure everyone understands what's happening, and what they can do," Holley said. Whether the drug is sold in a pharmacy or being dispensed in a hospital, clinic or nursing home, patients, he said, should know what is being charged and notified of price hikes.

In the last Congress, two bipartisan bills were introduced that were, Holley said, designed to fast-track generic drugs into the marketplace.

The Fair Access for Safe and Timely ("FAST") Generics Act would have, according to the Campaign for Sustainable Rx Pricing and a number of partner groups, "provided a clear solution to abusive, anticompetitive business practices that increase costs to the American health care system by impeding patient access to generic and biosimilar medicines."

The Senate version of that bill was called the CREATES Act: Creating and Restoring Equal Access to Equivalent Samples. However, in recent months, neither of those bills has advanced. Holley cited the distraction of GOP efforts to repeal and replace the Affordable Care Act.

U.S. Rep. Diana DeGette, D-Denver, a co-sponsor of last year's FAST Generics Act, said she plans to add her name again to the bill when it is reintroduced this year.

"Rep. DeGette believes Congress should devote much more time to the issue of high drug prices, and she would strongly support efforts to reduce the cost burden on consumers where possible," said her spokeswoman, Lynne Weil. "If this could be done in the context of a bipartisan effort to improve the Affordable Care Act, she would be supportive — but because Republican House members this year have not been good partners on health care reform, much less the issue of rising drug prices, it's difficult to say how this can be achieved on a bipartisan basis."

The House narrowly passed its unpopular American Health Care Act in May — with most Coloradans and many health care groups opposed to the bill. The Senate delayed voting on its version, the Better Care Reconciliation Act, before heading home for the Fourth of July break. Prescription drug prices were not a central part of the debate.

U.S. Rep. Doug Lamborn, R-Colorado Springs, voted along with two other Colorado Republicans in favor of the AHCA, which was opposed by all three Colorado House Democrats. Lamborn would not make any predictions about the Senate version of the bill, which would then have to be reconciled with the House bill if it ever passes. But he says he doesn't support the FAST Generics Act.

"The Risk Evaluation and Mitigation Strategies [REMS] system is set up by the [Food and Drug Administration] in order to ensure that access, innovation and patient safety are all considered with regard to FDA user fees for prescription drugs and medical devices," Lamborn stated in an email, adding that the bill could increase "frivolous litigation, [gut] intellectual property protection and [endanger] the safety of both researchers and patients."

But Congressman Jared Polis, D-Boulder, who is running for governor in 2018, said in a phone interview that he supports state and federal efforts to allow for re-importing prescription drugs.

"The state [Colorado] passed a Right to Try Bill and we need to clarify the federal statutes to ensure that there's not additional liability when people re-import for their own use prescription drugs, which allows them to save considerable amounts of money on prescription drugs from Canada, Mexico and other countries," Polis said.

"At the federal level as well, we need to look at reducing the costs of the FDA approval process," he continued. "It costs over a billion dollars to bring a drug to market, particularly for a targeted drug. If there's only 10,000 or 20,000 people who would benefit from it, that billion dollars in costs plus the profit margin for the drug company has to be spread among a very small number of people, so you wind up with ridiculously expensive drugs."

And it's not just Democrats looking for ways to lower costs. Kyle Huwa, spokesman for U.S. Rep. Ken Buck, R-Windsor, said the congressman will assess the Fast Generics Act, and is supportive of finding ways to make pharmaceuticals affordable and "positively reform the FDA approval process." Buck, Huwa says, believes, "There's no reason why a conversation about drug costs shouldn't be part of the broader conversation of health care reform."

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In Colorado, efforts to target runaway drug prices have failed in the last two legislative sessions.

In 2016, several Colorado lawmakers introduced House Bill 1102, which would have required pharmaceutical companies to detail the costs to research, develop and produce drugs that are priced at more than $50,000 per year or per course of treatment. Nearly 100 drugs would have qualified, including a 12-week drug treatment for Hepatitis C, most treatments for multiple sclerosis, and many cancer therapies. However, the bill died in the state House.

This year, HB 1318 would have created a database for pharmaceutical costs, requiring health insurers to submit costs to the Colorado Division of Insurance. The bill was supported by the governor's office, but ultimately died in the Republican-controlled state Senate.

Tim Gaudette, Colorado outreach manager for Small Business Majority, highlighted a recent poll that was conducted by his organization, showing the rising cost of prescription drugs is becoming "a major concern ... and many feel that drug costs are impacting their bottom line."

The poll, released in December, included 504 owners of businesses of up to 100 employees. The vast majority supported a range of policy proposals to address rising prescription costs.

For example, 88 percent of them agreed that, "it should be illegal for a drug company to pay another company that makes generic drugs to delay the release of a generic drug."

Fully 90 percent of those polled agreed that prescription drugs that are developed with taxpayer dollars should be made affordable to every American. And 85 percent agreed that Americans should be able to purchase prescription drugs from Canada and that the federal government should be allowed to negotiate lower Medicare drug prices.

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