In Comments Submitted February 16, NLARx Working Group on Trade Warns USTR Trade Policies Threaten State-Level Drug Price Negotiation and Medicaid Programs
National Legislative Association on Prescription Drug Prices
February 16, 2010
Today the National Legislative Association on Prescription Drug Prices
(NLARx) Working Group on Trade submitted comments to the US Trade
Representative opposing the expansion of the Special 301 report into
the realm of disciplining countries for implementing effective and
non-discriminatory pharmaceutical pricing policies, and a recent trend
to use trade agreements to restrict evidence-based domestic drug
pricing programs.
"These initiatives will directly and
negatively affect the capacity of states to provide health care and
pharmaceuticals to their residents through existing Medicaid and
state-funded programs, and will cripple the ability of states to expand
access to health care in the future," said Sharon Treat, NLARx
Executive Director and a Maine State Representative.
The Working
Group on Trade has been actively involved in providing comments on
trade policy related to pharmaceutical purchasing and intellectual
property over the past several years, with a particular focus on the
implications of that policy for state-implemented Medicaid and health
access programs. The Working Group has sought specific guarantees that
any chapter on pharmaceuticals in a new trade agreement would not
threaten states' ability to manage drug costs through formularies and
preferred drug lists (PDLs). USTR staff took up this issue and honored
the request from states to clarify in the text of the US-Korea Free
Trade Agreement a specific exception for Medicaid.
"Especially
in light of USTR's prior willingness to take states' concerns into
consideration, we find it disheartening and disturbing that the USTR is
now moving forward with efforts to promote new international standards
restraining domestic medicine pricing regulations both in the U.S. and
abroad," said Connecticut Representative Kevin Ryan, co-chair of the
Working Group. "We call on USTR to alter course and publicly announce
that it is not in support of such initiatives and halt this use of
Special 301."
More than forty states use PDLs for Medicaid and
other programs, including state-funded prescription drug benefits for
the elderly that “wrap around” Medicare Part D, and discount drug
programs that are available to the non-elderly who do not qualify for
Medicaid but who lack insurance that provides pharmaceutical coverage.
In U.S. states, as in other countries, these policies are being used
effectively to reduce costs and promote public health by influencing
prescribing decisions with evidence.
Arizona Senator Meg Burton
Cahill stated, "Without access to these tools, states would simply be
unable to provide comprehensive access to medicines in their Medicaid
and other health insurance programs." Burton Cahill is co-chair of the
Working Group. She noted that pharmaceutical costs can account for from
10-25% of the cost of Medicaid and other public health insurance
programs, even with the rebates and pricing tools currently available.
“At
a time when states including Arizona, New Mexico, Washington State and
Maine have announced plans to cut these same programs to address the
severe budget shortfalls caused by the recession, Burton Cahill said,
"USTR’s initiatives are both ill-timed and incomprehensible."
"It
is difficult in the extreme for states to understand how the USTR’s
efforts to promote new international standards restraining domestic
medicine pricing regulations, which will severely increase the cost of
public health programs and limit the use of evidence-based tools,
square with the Administration's effort to extend health insurance to
all Americans," said Rep. Treat.
The National Legislative
Association on Prescription Drug Prices' Working Group on Trade helps
states establish institutional mechanisms both to provide ongoing
oversight over trade policy, and to educate their citizenry and policy
makers about the connection between international trade policy and
affordable prescription drugs. It is a comprised of state legislators,
trade and Medicaid experts, and representatives of state attorneys
general. The Working Group is co-chaired by Arizona State Senator Meg
Burton-Cahill and Connecticut State Representative Kevin Ryan.
 | PDF of NLARx Press Release (115 KB PDF) |
