Maryland’s Senate Finance Committee is considering bringing the “Expensive Drugs” bill (SB 437) to the floor for deliberation and a vote. This bill is misguided and seems to accomplish nothing to help the citizens of Maryland pay less for “expensive drugs” or in helping the medical technology companies in Maryland reduce the cost of development and manufacturing of life-changing therapies. Let’s take a closer look at the bill and why it should not make it out of committee.
The bill defines high cost drugs as those that are $2,500 per dose or annual course of therapy. I thought it was a misprint when I read it. In today’s health climate, $2,500, even for a monthly dose of a life-saving therapy, is not ominously onerous, especially when individuals’ out-of-pocket costs can be significantly less from medical or prescription benefits. Of course, some patients do get stuck with $2,500 bills and have difficulty with them, and there should be safety nets in place for them. Advanced therapies today can cost upwards of $25,000 for a single course of therapy (again with the same out-of-pocket picture). The Maryland legislators who decided on this figure gave their proposed committee much more work than it deserves simply because of the “high cost” definition.
More important than the defined amount is the intent of the bill. I can’t find it in the bill. If it is to have manufacturers report pricing, they already do, to multiple sources in various ways. If the intent is to lower drug costs for or improve the health of Maryland citizens, this bill does not lead to that. If the intent is to shame manufacturers into keeping prices below the “high cost” threshold, it’s misguided.
The bill adds administrative burden – and costs – to manufacturers and to the state. One example of this burden is regarding Patient Assistance Programs or foundations. Properly administered programs comply with guidelines from the US Department of Health and Human Services Office of the Inspector General. They are at arm’s length from the manufacturer, so the manufacturer would not know how many patients its contribution benefited, only an aggregate number based on all contributions. I struggle to see how this mandate help lower drug costs in the state, if that’s even the intent.
A final thought: if Maryland really wants to attract life sciences companies to the state, this is not the legislation that will be considered the sales pitch for bringing medical technology developers and commercial organizations to the state