Despite promises and prospects, what has transpired with House Bill 22-1370 in the state legislature has fallen far short of delivering the kind of relief on prescription drug prices that Colorado patients so sorely need.
HB 22-1370 was supposed to be a bill that would have far-reaching impacts on drug patients’ rights. But amendments weakened the legislation. In fact, the bill’s final language means it no longer answers the calls of drug patients around the state to make real, meaningful changes to the price a patient pays at the pharmacy counter.
One critical issue is how and where to apply rebates offered by drug manufacturers. Those rebates could be used at the point-of-sale to directly help consumers. The potential savings for a full pass-through to patients are significant. One report from CVS touts the average savings of more than $670 per person per month for specialty medications and $155 per month for non-specialty prescriptions.
However, an amendment approved by the state House of Representatives invalidated these point-of-sale pass-through provisions. This is a glaring hole in a bill that otherwise represented some progress on behalf of patients. But patients seeking access to life-saving, but costly, specialty medications — like those I have worked with as a former board member of the Rocky Mountain Crohn’s & Colitis Foundation — can’t afford half measures or delayed progress. The most important issue facing patients, confirmed time and again in public opinion research, is the skyrocketing out-of-pocket costs they pay for health care.
Which makes the arguments put forth by policy makers for NOT including the rebate pass-through all the more perplexing. They said that health insurance premiums could — emphasize could — go up slightly if a significant rebate pass-through rule becomes law (one credible analysis says premiums could possibly go up between $0 and $2.60 per month). Setting aside the brazen arguments of insurance companies and Pharmacy Benefit Managers (PBMs) that they MUST raise premiums and fees if they lose rebate revenue, the minute increase pales in comparison to the savings patients would realize.
Faced with the possibility of those insurance rates rising, chronic disease patients and a majority of Colorado voters prefer the right to access rebates at the pharmacy counter. In fact, according to polling data from Keating Research, 61% of Coloradans support point-of-sale rebates even if health-insurance premiums increase by $3 or less per month. Given the potential to save hundreds and hundreds of dollars when paying for prescriptions, the poll results are no surprise. That’s an easy choice to make.
While many aspects of H.B. 22-1370 were good ideas, the core concept of full rebate pass-through should have been retained so patients could feel genuine relief in their personal budgets. There was nothing to be gained by enacting legislation that will leave patient groups scratching their heads in wonder, thinking they were supporting a bill that would make real changes when, in fact, the chief feature of the legislation was voided. In the end, rebate reform in H.B. 22-1370 became a false bill of goods.
Evan Corazzari is an ulcerative colitis patient and past chairman and director of advocacy for The Rocky Mountain Chapter of The Crohn’s & Colitis Foundation.