CHAIN

Supporting Long Overdue Colorado Healthcare Consumer Rights

Supporting Long Overdue Colorado Healthcare Consumer Rights

The year 2022 promises exciting and substantive opportunities to bring better health care to Coloradans.  Maybe the most important of these is the discussion around a Colorado Consumer Health Bill of Rights.  Similar initiatives have sprung up in other states, indicative of the need to put consumers front and center in the health care debate.  It is long past time that consumer needs take precedence over the financial interests of health care corporations.  We expect more to come very soon on this critical effort. 

Kavita V. Nair

Kavita V. Nair

LET PATIENTS BENEFIT FROM PRESCRIPTION DRUG REFORM

“Coloradans continue to struggle to pay for their prescription medications. The largest yearly survey of Colorado households conducted by the Colorado Health Institute found that one in five Coloradans skipped health-care services due to cost concerns in 2021. Of the almost 10% of Coloradans who didn’t fill a prescription due to cost, 40% said their health declined.”

Read the full op-ed at: https://www.coloradopolitics.com/opinion/let-patients-benefit-from-prescription-drug-reform/article_36587002-c1e0-11ec-b2b8-579165e42efe.html

Rep Iman Jodeh

St. Rep. Iman Jodeh (D-Arapahoe)

LOWER OUT OF POCKET COSTS AND FIGHT BACK AGAINST COST SHIFTING

“Our bill is essentially a consumer protection bill, making common-sense reforms that will bring integrity and fairness to our health care system and save Coloradans taking expensive medications up to $1,000 a year. 

First, this bill will immediately reduce out-of-pocket prescription costs for Coloradans and prevent insurance companies from pocketing the billions of dollars in prescription drug rebates meant to help Colorado patients pay for their medicine”

https://sentinelcolorado.com/1gridoped/rep-iman-jodeh-our-plan-to-make-health-care-dependable-and-affordable

EMPOWER CONSUMERS AND LESSEN THE STRANGLEHOLD OF INSTITUTIONAL INTERESTS

Too little is being done in Colorado and across the country to put more power in the hands of consumers. Out of pocket costs and ‘skimpy coverage plans’ rob from consumers and oftentimes fail to deliver on the care people need.

The one positive piece of news from the challenges of the global pandemic is the transformative migration to digital health care. Practically overnight, consumers and providers discovered that many aspects of care can be delivered in totally different ways.

We need to take this disruption and convert it into a complete rethinking of how healthcare is provided that centers on the consumer, not the monied institutions that for too long have controlled healthcare policies.

LOWER OUT OF POCKET COSTS AND FIGHT BACK AGAINST COST SHIFTING

According to a new poll, Americans would like to see Congress focus more on reducing the overall costs of health care coverage such as premiums, deductibles, and copays (71%) over reducing the costs of prescription drugs (29%). This extends across party lines; 73% of Democrats and 64% of Republicans would like to see Congress focus on reducing overall costs of coverage.

And it’s no wonder. According to various sources, total out of pocket costs for families in 2018 exceeded $7,500 per year. We all have to be wondering what the point of insurance is if we have to pay upwards of $8,000 before any coverage kicks in.

There are scores of ideas available for Colorado lawmakers to consider that don’t involve draconian measures like setting prices or capping revenues. CHAIN will continue fighting for ways to directly lower out-of-pocket expenses and clamp down on the kneejerk response of shifting costs to consumers by providers whenever changes in the market occur.

Ensure Federal Drug Program Serves Patients, Not Profits

ENSURING FEDERAL DRUG PROGRAM SERVES PATIENTS, NOT PROFITS

Sprawling government health care programs can mean billions are wasted or misappopriated.  The 340-B program, a $29b effort to lower the cost of prescription drugs for those most in need, is a classic case.  The program has morphed into a source of profits for hospitals and other providers, taking billions in benefits away from low income and underserved families in need.  CHAIN is working toward restoring integrity to the 340-B program, and calling out similar government initiatives that have gone off course.  

Drugs

Prescription Drugs: Spending, Use, and Prices

In recent years, policymakers have expressed concerns about the high prices of prescription drugs. Those drugs offer wide-ranging benefits, such as reducing the need for services provided by physicians and hospitals, improving the quality of life, and extending life. However, high prices reduce consumers’ access to such medications. They also contribute to higher spending that strains budgets, including the federal budget.

https://www.cbo.gov/publication/57772

 

HOW INTENT MORPHS INTO ABUSE

The 340B program is a classic case of good government intent can morph into abuse, and why we should exercise extreme caution with further government intervention.

According to the Pacific Research Institute:

By attempting to help vulnerable patient populations in such an overly complicated manner, the 340B program creates inefficiencies throughout the broader healthcare system… These include vulnerable patients not receiving any of the price savings, the abuse of the 340B program by covered entities, increased incentives to prescribe more expensive medicines, a shifting of drug costs on to non 340B patients, and an unwarr-anted consolidation of medical practices. Due to these inefficiencies, the 340B program worsens the quality of the overall health care system.

Instead of drug discounts flowing to those families most in need, the PRI report demonstrates how millions of dollars are likely flowing to the coffers of hospitals and other providers.

Comprehensive Regulatory Reform From The Bottom Up: The Case Of 340B

PUSH FOR GOVERNMENT AND INSTITUTIONAL ACCOUNTABILITY

A report by the non-partisan Government Accountability Office (GAO) layout out the path for greater accountability.  The GAO found major gaps in the administration of the program and lax accounting/reporting standards.  They conclude their work with six strong recommendations for reforming how the 340B program operates, including audits that verify the proceeds from discounted drugs are being used to lower the cost to consumers in need.

https://www.gao.gov/products/gao-20-108 

SUPPORT COMMUNITY MEMBERS WHO ARE TAKING ACTION

CHAIN fully supports Coloradans engaged in demanding greater accountability and transparency in the 340B program.  We urge everyone to look at 340B as the cautionary tale for why creating massive government programs to address health care inequities should be among the last strategies used.

Colorado’s Prescription Drug Importation Program Is Not a Solution

Colorado's prescription drug importation program is not a solution

Three years ago, Governor Polis and the state legislature touted passage of Colorado’s prescription drug importation bill.

Three years later, nothing.

    • No system for importing drugs from Canada and other nations.
    • Canada and other nations have said no to exporting drugs to Colorado.
    • Over $2 million in state tax dollars spent without achieving drug importation.

Drug importation – from Canada or any other country – is not a solution to the rising cost of prescription drugs in the U.S. 

Importing drugs into America from foreign sources adds up to a terrible practice.  

    • The federal government must issue a waiver for any state to implement importation, a process denied and stalled for decades and not likely to happen any time soon.
    • Four former Commissioners of the Food and Drug Administration (of both parties) vocally oppose importation because of safety and quality concerns.
    • Canadian authorities state repeatedly they will not allow the exporting of Canadian prescription drugs because of dire shortages in their own country.
    • Importing drugs from other countries could put millions of Americans at risk of serious harm or even death because of lax regulations and black-market operators.

We can and MUST do better.  CHAIN is busy educating law makers on why we need better solutions.  

Opinion: Drug makers charge hospitals less for some medicines. Consumers aren’t getting the savings

Opinion: Drug makers charge hospitals less for some medicines. Consumers aren’t getting the savings

Jennifer Churchfield

– Jennifer Churchfield –

For a real New Year’s Resolution, we are calling on Colorado’s U.S. Senators Michael Bennet and John Hickenlooper – to help us account for billions spent on a healthcare program that leaves struggling families holding the tab. The Federal 340B program is becoming the poster child for federal programs run amok, allowing billions designated for affordable prescriptions to be lost within the system and leaving underserved families without the discounts they need. Ultimately, the 340B program is failing to deliver on its promises of affordable prescription medicines.

A study recently released by a non-partisan healthcare think tank conducted a comprehensive evaluation of this Federal 340B program and further concluded it is failing patients. Known as the “340B Drug Pricing Program” (or 340B for short), the program calls for drug companies to provide hospitals and other providers deep discounts on certain prescription medicines. The savings from the discounts should benefit patients in the form of lower prices at the drug counter.

Yet instead, lower income, marginalized community members, and under-served patients are seeing little benefits, raising major questions as to where the nearly $30 billion in savings are going.

The national study, conducted by the Pacific Research Institute, found that 340B hospitals are more profitable than traditional hospitals while not providing more charitable care. Four Colorado hospitals largely mirrored the national study — from Pueblo to Denver to Steamboat to Glenwood Springs.

The report evaluated each hospital’s net income relative to net revenue. The profitability for 340B hospitals is 37 percent larger compared to the average of all hospitals. The report also showed 340B hospitals provided less charity care at 1.66 percent of net patient revenues, compared to 2.03 among hospitals in the Centers for Medicare and Medicaid Services (CMS) database.

The growth premium for profits was even starker, with profits at 340B hospitals growing 9.1 percent annually over this period compared to profitability growth of 2.5 percent annually at (non-340B) hospitals and nursing care facilities. 340B hospitals also maintained more contract pharmacies than the average hospital. This is concerning as the PRI report found a link between the number of contract pharmacies and the likelihood of 340B discounts not getting to the patient, and rather, being taken advantage of.

Discounted 340B purchases were at least $29.9 billion in 2019, Drug Channels notes. That figure is 23 percent higher than just a year earlier and demonstrates the explosive growth of the 340B program with no oversight to confirm the discounts actually make it to patients. Astonishingly, the 340B program is now almost as large as the Medicaid program’s outpatient drug sales.

However, 340B lacks Medicaid’s regulatory infrastructure and controls. Medicaid rebates directly and transparently lower drug costs for the government, while 340B discounts disappear into providers’ financial statements.

It appears all but certain that with America’s ballooning health care system, the millions of dollars that should be off-setting prescription costs for vulnerable patients — are actually getting lost within our massive healthcare system.

The Colorado Health Advocacy Information Network (“CHAIN”) supports common-sense and market-based solutions to improve America’s health care system. We are asking Colorado’s Congressional delegation, especially Senators Bennet and Hickenlooper, to lead the call for a 340B program audit by the Congressional Budget Office. There’s a reason the U.S. The Supreme Court is currently being asked to weigh in on this complex issue and decide if 340B reimbursements are being taken advantage of.

The 340B program started a simple and supportable intent — to help vulnerable patients with chronic conditions. In 2022 we ask Colorado’s Senators to resolve to fix 340B. It’s well past time to bring the program back to that original purpose.

-Jennifer Churchfield, CHAIN Chair

https://coloradosun.com/2022/01/18/colorado-drug-prices-rebates-340b-consumer-opinion/

Jennifer Churchfield joins the CHAIN Policy Advisory Committee

Jennifer Churchfield

JENNIFER CHURCHFIELD JOINS THE CHAIN POLICY ADVISORY COMMITTEE

Jennifer Churchfield

Jennifer Churchfield has partnered with public and private organizations for over 25 years. She is currently the co-chair of Front Range PharmaLogic. She served Arapahoe County as the Communications Director for Arapahoe Responsible Energy Advocates. Jennifer was elected for two-terms to the Cherry Creek School District Board of Education and was Board President from 2011-2013. She is a graduate of Miami University in Ohio.

Fight Policies That Endanger Access to Life Saving Medicines

FIGHTING POLICIES THAT ENDANGER ACCESS TO Life-Saving MEDICINES

Colorado doctors, patients, health care providers and experts are all expressing serious concerns about the impact a bill introduced in the state legislature this year will have on patients access to life-saving treatment. CO Senate Bill 175 threatens access to life-saving medicines by giving politicians control over what your doctor or hospital can pay for prescription drugs.  If the medicine costs more than what the state allows your doctor to pay, your doctor won’t buy the medicine, and you or your loved one won’t be able to get the treatment needed.

Those Most Vulnerable May Suffer the Most

Groups representing the disabled, LGBTQ, people of color, the underserved and Colorado’s seniors are speaking out in concern with SB175, especially the proposal that would let state politicians control prices and access to life-saving drugs.

Colorado small business owners and bioscience researchers are seriously worried about the impacts the bill will have on Colorado’s role as a leading medical research center.  And they are equally concerned about the gross interference in how life-saving medicines are priced and by extension how research happens.

Coloradans From All Walks of Life Speaking Out

This is just a partial list of the organizations speaking out against SB175’s provision to let state politicians control the cost and access to prescription drugs:

Colorado Society of Pharmacists
Colorado Retail Council
Colorado Gerontological Society
HIV+HEPC
Adams County Regional Economic Partnership
The Citizens Council for Health Freedom
Colorado Sickle Cell Association
Colorado Council of Black Nurses
Front Range Pharmalogic
West Slope Pharmalogic
Jefferson County Economic Development Corporation
Club 20
Westminster Chamber
Envision: You (an organization that supports, educates and empowers members of Colorado’s LGBTQ + (mental health and well-being for the lesbian, gay, bisexual, transgender, and queer/questioning community)

You can read the specific concerns of many of these groups here:

The impact of Coloradans speaking against compromising care and treatment is being felt across our state.

These are a sample of recently published articles in newspapers throughout Colorado of people voicing concerns about not being able to access today’s life-saving medicines or seeing tomorrow’s cures be stopped in their tracks.

The impacts of Senate Bill 175 on our care are real.  But so is the impact of us speaking out.  Together we can stop SB175 from becoming law and cutting off our access to hures.

Mark Spiecker, STAQ Pharma: A state prescription drug board will backfire

 

Emily Zadvorny, Colorado Pharmacists Society: A state Prescription Drug Affordability board puts pharmacies, access to medication at risk

Jennifer Churchfield, Front Range PharmaLogic: State drug price limits would not drive down prescription prices

Rep. David Soper: Colorado Should Reject European-style price-setting board

Joni Inman, Front Range PharmaLogic: A prescription-drug price-control bill is the wrong answer for Colorado

Additional Resources

Opposition Testimony: CO SB 21-175 to establish a Prescription Drug Affordability Review Board

Senate Health and Human Services Committee, March 17, 2021

SB 21-175: Provider Testimony, Senate Health and Human Services Committee

Dr. Miller Head of Rocky Mountain Oncology Society, Chief Medical Director of Oncology; Associate Chief Medical Director of Clinical Research, SCL Health Cancer Center of Colorado

Governor and Legislature Drug Pricing Bill Harms Patients

“Prescription Drug Affordability (Price Control) Board” Means More Bureaucracy – Not Cheaper or more Accessible Medications for Patients

 

Get Involved

The Missing Colorado Healthcare Link

Linking the right policy ideas with the right influential people is a great start to solving our healthcare challenges. But it’s just the beginning.  

Fixing healthcare is our shared responsibility. And Colorado citizens like you are the missing link. With your trust and support, we can create lasting change.

We can solve healthcare in Colorado. Ready to link up with CHAIN?