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Prescription drug costs in W.Va. keep rising

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Prescription drug costs in W.Va. keep rising

Picture of Alison Knezevich
The Charleston (W.Va.) Gazette
Saturday, January 29, 2011

CHARLESTON, W.Va. -- Prescription drug costs continue to climb for West Virginia, despite efforts to rein them in.

At the Public Employees Insurance Agency, the cost of generic prescription drugs, on average, is up 25 percent from last year, said director Ted Cheatham. Brand-name drug costs increased 10 percent.

PEIA, which spends about $260 million annually on prescriptions, has tried various ways to contain these costs, he said.

"But you don't see it because the trend is so high," Cheatham said. "The costs are still going up every year."

In 2004, West Virginia hoped to lead the nation in efforts to contain soaring prescription drug costs -- not just for public benefit programs, but for all consumers. The Legislature passed the landmark Pharmaceutical Availability and Affordability Act, signed by former Gov. Bob Wise in the last year of his administration.

The 2004 legislation created the Pharmaceutical Cost Management Council and an appointed state pharmaceutical advocate. Neither exists now.

A key component would have made drug makers disclose spending on marketing to doctors -- in the form of gifts, trips, speaking fees and other compensation -- and direct-to-consumer advertising.

The legislation's advocates wanted to use that spending data to help the state negotiate prices with drug makers.

Eventually, drug makers only had to report aggregate data, meaning individual doctors - and how many payments they received -- could not be identified in the disclosure figures.

Opposition from the pharmaceutical industry and a lack of political will hampered the efforts, say those involved in the original legislation. At the time, critics also questioned then-Gov. Joe Manchin's dedication to the initiative.

"It's really never been employed in the way that we envisioned," said House Health and Human Resources Chairman Don Perdue, D-Wayne.

The pharmaceutical industry "pushed back at every avenue," said Sen. Dan Foster, D-Kanawha, a leading advocate of the legislation.

"They're just very powerful. They have many lobbyists, and they're well paid and very well connected," Foster said. "And that's the way our system works, so as a consequence, it's been very slow going."

In 2009, the newly created Governor's Office of Health Enhancement and Lifestyle Planning took over the responsibility of collecting drug-advertising data.

But the legislation that created GOHELP eliminated certain spending-disclosure rules, like requirements to report amounts spent promoting specific drugs.

The most recent spending report is three paragraphs long.

Some provisions in the national health care package will accomplish what the state sought to do in its own legislation, said Perry Bryant, director of West Virginians for Affordable Health Care reform.

As part of the federal law, Congress passed the Physician Payments Sunshine Act. Eventually, it will make pharmaceutical companies and medical-device manufacturers publicly report gifts - such as food, entertainment and grant funding -- made to doctors and teaching hospitals.

Starting in 2013, people will be able to view these reports through an online database.

"I think that sunshine will change behavior," Bryant said. 

Karl Uhlendorf, a spokesman for Pharmaceutical Research and Manufacturers of America, said the industry supported the sunshine act.

"What's critical is that the appropriate context is delivered along with that transparency," he said.

He also pointed to industry-supported programs such as WVRx and the Partnership for Prescription Assistance, which provide free and discounted medications to uninsured people.

"We believe, and it's been widely shown, that medications can play an important role in helping control health- care spending by preventing hospitalization" and other expensive treatment, he said.

The federal health-care law also gives seniors in the Medicare "doughnut hole" a 50 percent discount on covered brand-name drugs. But Cheatham of PEIA worries that drug makers will raise their prices to make up for the rebates.

"They're not that generous, no offense," he said of the pharmaceutical industry.

"They're giving a 50 percent rebate, but ultimately, they're not giving any money away. They're raising the price of their drugs."

The federal government still can't negotiate drug prices for the Medicare Part D program, which subsidizes the cost of prescription medications.

Residents of West Virginia, with its aging population and high rate of chronic conditions like diabetes and obesity, take more prescription drugs than people in any other state, according to the Kaiser Family Foundation. West Virginians filled nearly 19 prescriptions per capita in 2009, compared to a national average of 12.

Reach Alison Knezevich at alis...@wvgazette.com or 304-348-1240.