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CT Healthcare Cabinet issues final recommendations on containing drug costs

BY John Stearns

2/21/2018
Connecticut's Healthcare Cabinet has issued its final recommendations for containing prescription drug prices, culminating a yearlong effort examining factors driving up drugs costs and the impact of those increases.

The 53-page report contains recommendations that require legislation and those that can be implemented using existing administrative authority. Many of the recommendations mirror draft recommendations issued last month by the group comprising government and industry representatives. The cabinet's recommendations will be sent to lawmakers and Gov. Dannel P. Malloy.

The cabinet said it received 37 public comments on the draft report issued Jan. 2 and considered all public comments in formulating its final report, according to the report's executive summary.

"Prescription drugs are a significant part of overall healthcare costs," said Lt. Gov. Nancy Wyman, who chairs the cabinet. "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."

Wyman said the 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."

Legislative recommendations include:

–Establish a Drug Review Board

Identify potential abuse in the pricing of 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

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

Require 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 health care

Ensure 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.

Administrative recommendations include:

Track the impact of prescription drug price increases

Beginning in 2019, require 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

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

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 health care.

–Improve provider technology

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.