Lt. Gov. Wyman: Healthcare Cabinet Issues Final Recommendations On Containing Prescription Drug Costs
(HARTFORD, CT) – Lieutenant Governor Nancy Wyman, Chair of the state’s Healthcare Cabinet, today announced that the Cabinet has finished its report recommending cost containment strategies for prescription drugs. The report is the culmination of a year-long effort by the Cabinet and its working groups to examine the factors driving the increasing costs of prescription drugs and the impact of those rising costs.
“Prescription drugs are a significant part of overall healthcare costs. Connecticut can both improve oversight of how much consumers are paying at the pharmacy and how those costs are determined, and put in place initiatives that help patients understand and correctly take their prescription drugs so they get the full value of that medication,” said Lt. Governor Wyman. “These recommendations strengthen the transparency around how manufacturers price prescription drugs, improve resources to patients and providers, and offer short- and long-term cost containment strategies for both prescription drugs and healthcare as a whole.”
Public Act 15-146, enacted June 30, 2015, instructed the Healthcare Cabinet to submit an initial report to the legislature on healthcare cost containment strategies. The Recommended Strategies Report, released January 10, 2017, identified the importance of addressing prescription drug costs as part of the larger conversation around healthcare affordability.
After engaging industry leaders, healthcare advocates, providers, consumers, and other stakeholders to advise on the factors contributing to higher consumer prescription drug costs, the Cabinet released the Recommendations on Pharmaceutical Cost Containment Strategies report which prioritizes recommendations for legislative and administrative action that include:
• Establish a Drug Review Board
o Identify potential abuse in the pricing of both brand and generic drugs by creating a new Drug Review Board and empowering it to investigate manufacturer drug pricing decisions to determine if the prices are justified by market norms and clinical value.
• Require outside funding disclosure
o Require drug manufacturers, Pharmaceutical Benefit Managers, and health insurers to disclose to the Office of State Ethics the funding they provide to nonprofit advocacy groups and post such information on a publicly available website.
• Improve transparency in business practices
o Require that Pharmacy Benefit Managers doing business in Connecticut allow and cooperate with audits and establish minimum standards regarding the conduct of those audits.
• Align prescription price negotiation with industry standard in healthcare
o Ensure that the negotiated price of a drug passes through to the consumer by requiring that consumer co-pay and deductibles are based on an estimate of the negotiated price of the drug rather than the list price or price prior to rebate.
• Track the impact of prescription drug price increases
o Beginning in 2019, require that insurers report more granular prescription drug price increase information in their rate filing to the Connecticut Insurance Department and report the impacts of drug price increases on consumer health insurance premiums.
• Examine impact of medication counseling
o Direct the Connecticut State Innovation Model initiative to examine correlating a patient’s medication counseling to provider payments in an effort to increase the value of medical care to the consumer and improve healthcare outcomes.
• Eliminate barriers to prescription drug compliance
o Direct the State Innovation Model initiative and the Healthcare Cabinet to examine how providers can improve adherence to drug protocols by better communication with patients about the clinical value of prescription drugs to their healthcare.
• Improve provider technology
o Direct the State Innovation Model initiative to identify and promote opportunities to better use technology to help prescribers by incorporating a decision tool in electronic health records systems that flags prescription drug history and offers assistance to avoid unexpected drug interactions.
The Cabinet also outlined additional recommendations in the report, which will be sent to the legislature and to Governor Dannel P. Malloy for action.
Office of Lieutenant Governor Nancy Wyman