Who is pushing for price controls? The answer may surprise you

Progress in medical innovation over the past few years has been nothing short of remarkable.

• A once incurable disease – hepatitis C – now has cure rates above 90 percent.
• Patients previously unable to effectively manage their cholesterol with existing treatments now have new therapies that can help control their cholesterol and reduce their risk of heart disease or stroke.
• HIV/AIDs has gone from a death sentence to a chronic manageable condition.
• And new medicines are taking on the fight against cancer in ways that were once thought impossible. With more than 7,000 medicines in development around the world today, patients have more reason to be hopeful than ever before.

These advancements are possible because we have a health care system that recognizes and rewards risk-taking. After all, the science of drug development is hard and only getting harder as researchers tackle the most intractable diseases and develop treatments tailored to the unique needs of individual patients. In fact, just 12 percent of medicines that enter clinical trials ever make it to patients and for some diseases, the odds of success are even lower.
 
To the detriment of patients, there is a concerted effort to downplay the challenges of developing new medicines and dramatically overstate the cost impact of this innovation – all in an effort to advance a legislative agenda that would have serious and harmful consequences for patients.
 
Despite the federal government recently projecting that spending on medicines will grow in line with overall health care spending through at least the next decade, the insurance industry – which has historically been opposed to price controls – is aggressively pushing legislation in certain states that would place arbitrary caps on medicine prices. For example:

• Massachusetts is considering bill S1048, which would set up a commission to do the following:  “If the commission determines that a prescription drug is significantly high, then the commission may set the maximum allowable price that the manufacturer can charge for that prescription drug that is sold for use in the commonwealth.”
• Pennsylvania is considering senate bill No. 893, which would do the following: “Review pharmaceutical retail pricing and determine whether those prices are reasonably related to the costs set forth in subsection (c)(1)(i)(A), (B), (C), (D) and (E). Prices in excess of twenty per centum (20%) of those costs shall be presumed to not be in reasonable relation to those costs. Absent a finding by the commission that such prices are nonetheless reasonable, an insurer shall not be required to pay the price of any prescription medication exceeding twenty per centum (20%) of those costs.”

The Boston Globe, Boston Herald, and WBUR in Boston all recently reported that the health insurance industry is a driving force behind the Massachusetts legislation. And Capitol Wire in Pennsylvania recently highlighted how insurance industry representatives’ are backing the price control legislation in that state.
 
Medicines are the solution to the cost challenges facing the nation’s health care system, not the cause. Without new medicines to treat Alzheimer’s disease, Parkinson’s, cancer and other conditions, the cost to treat these diseases could bankrupt our health care system.
 
Legislation to arbitrarily cap prescription drug prices would have a devastating impact on medical innovation, threatening to turn back the clock on progress that is being made against some of the most challenging and debilitating diseases of our lifetime.
 
Patients deserve better.

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