WASHINGTON, D.C. – Congressman Doug Collins reintroduced key legislation last week aimed at lowering the cost of prescription medication and increasing transparency in the drug pricing process. Introduction of this legislation comes after President Trump called on Congress to directly address the rising cost of prescription drugs during his State of the Union address.
H.R. 1035, the Prescription Drug Price Transparency Act, requires greater transparency and accountability from Pharmacy Benefit Managers (PBMs).
H.R. 1034, the Phair Pricing Act, lowers the cost of prescription medication for patients in the Medicare Part D program.
“For too long, we have turned a blind eye as pharmacy middlemen have manipulated drug prices to maximize their profit margin. The Prescription Drug Price Transparency Act will protect patients and pharmacies by increasing transparency over the drug pricing process, providing greater oversight to protect taxpayer dollars, and ensuring patients are able to choose their pharmacy,” said Rep. Collins.
“By requiring price concessions between pharmacies and middlemen be included at the point of sale, the Phair Pricing Act will guarantee patients at the pharmacy counter directly benefit from lower costs allegedly negotiated on their behalf.”
As middlemen in the pharmacy industry, PBMs determine which drugs are covered under federal programs including Medicare Part D, Medicare Advantage Part-D, and FEHBP. They maintain Maximum Allowable Cost (MAC) lists, which set the maximum reimbursement rate given to community pharmacies for drugs covered by federal programs. PBMs often take advantage of their role as middlemen by delaying price updates to maximize their profit margin while pharmacies are forced to sell prescriptions at a loss.
H.R. 1035 increases drug pricing transparency and accountability by accomplishing the following:
Ensures MAC pricing lists are updated every seven days for Medicare Part D, Medicare Advantage Part-D, and FEHBP;
Preserves pharmacy access for patients by protecting their ability to choose a pharmacy;
Requires PBMs disclose sources used in MAC price determinations;
Provides greater oversight to prevent waste, fraud, and abuse of taxpayer funds in Medicare Part D, Medicare Advantage Part-D, and FEHBP.
There is a clear gap between reality and the claims that pharmacy benefit managers (PBMs) and prescription drug plan (PDP) sponsors negotiate with pharmacies on behalf of patients. According to the Centers for Medicare and Medicaid Services (CMS), PBMs and PDP sponsors often use these pharmacy rebates and price concessions to pad their profits instead of lowering the price patients pay for medications, which is the stated purpose of the rebates and price concessions.
H.R. 1034 protects patients and provides greater oversight by accomplishing the following:
Requires all price concessions between a pharmacy and PBM be included at the point of sale to decrease patient’s costs.
Realigns market incentives to ensure patients have access to and receive the best possible care.
Directs the Secretary of Health and Human Services to establish a working group of stakeholders to create quality measures based on a pharmacy’s practice.
Ensures PBMs disclose all fees, price concessions, and programs to CMS.
Background: Rep. Collins introduced both the Prescription Drug Price Transparency Act and the Phair Pricing Act in the 115th Congress.
Fetch Your News is a hyper local news outlet that covers Dawson, Lumpkin, White, Fannin, Gilmer, Pickens, Union, Towns and Murray counties as well as Cherokee County in N.C. FYN attracts 300,000+ page views per month, 3.5 million impressions per month and approximately 15,000 viewers per week on FYNTV.com and up to 60,000 Facebook page reach. If you would like to follow up-to-date local events in any of those counties, please visit us at FetchYourNews.com
According to the latest numbers from the US Centers for Disease Control (CDC) and Prevention’s National Center for Health Statistics, Fentanyl is now the most commonly used drug involved in overdoses.
The new report says that the rate of drug overdoses involving the synthetic opioid increased by about 113% each year from 2013 through 2016.
What is fentanyl?
Pharmaceutical fentanyl is a synthetic opioid pain reliever, approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine.
It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States.
However, most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl. It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product–with or without the user’s knowledge–to increase its euphoric effects.
Illicitly-made fentanyl use is on the rise
The rate of overdose deaths involving synthetic opioids other than methadone, which includes fentanyl, doubled from 2015 to 2016. Roughly 19,400 people died from overdoses involving synthetic opioids other than methadone in 2016.
Reports from law enforcement indicate that much of the synthetic opioid overdose increase may be due to illegally or illicitly made fentanyl. According to data from the National Forensic Laboratory Information System, confiscations, or seizures, of fentanyl increased by nearly 7 fold from 2012 to 2014. There were 4,585 fentanyl confiscations in 2014. This suggests that the sharp rise in fentanyl-related deaths may be due to increased availability of illegally made, non-pharmaceutical fentanyl, and not prescribed fentanyl.
The number of states reporting 20 or more fentanyl confiscations every six months is increasing. From July to December 2014, 18 states reported 20 or more fentanyl drug confiscations. By comparison, six states reported 20 or more fentanyl drug confiscations from July to December 2013.
What can be done?
CDC suggests the following actions in response to increases in fentanyl-related overdose deaths:
Improve detection of fentanyl outbreaks
- Public health departments:
Explore methods for more rapidly detecting drug overdose outbreaks, including fentanyl.
- Medical examiners and coroners:
Screen for fentanyl in suspected opioid overdose cases in regions reporting increases in fentanyl confiscations, fentanyl-related overdose fatalities or unusually high spikes in heroin or unspecified drug overdose fatalities. Not all jurisdictions routinely test for fentanyl.
- Law enforcement:
Law enforcement can play an important role identifying and responding to increases in the distribution and use of illegally-made fentanyl.
Expand Use of Naloxone
Naloxone is a safe and effective antidote to opioid-related overdoses, including heroin and fentanyl, and is a critical tool in preventing fatal opioid overdoses. Depending on state and local laws, this medication can be administered by EMS, law enforcement, other drug users, or family and friend bystanders who have obtained the medication.9
- Health Care Providers:
Multiple doses of naloxone may need to be administered per overdose event because of fentanyl’s high potency relative to other opioids.10
- Harm reduction organizations:
Conduct trainings on naloxone use to persons at risk for opioid-related overdose and their friends and family members.
Decatur, GA – Within the past week, the GBI Crime Lab’s drug identification unit received three cases from separate seizures of the synthetic opioid carfentanil. Carfentanil is a fentanyl analog used as a tranquilizer on large animals such as elephants.
It is purported to be 100 times stronger than fentanyl and suspected of playing a role in hundreds of overdoses in the Midwest part of the country this past month. It can be inhaled or absorbed through the skin and very toxic in small quantities. The cases that came in the lab were from the metro Atlanta area and were all suspected to be heroin. As a result of this drug coming into the GBI Crime Lab, lab scientists have enhanced their safety protocols to protect them from the potential dangers.
Some of the changes include wearing a face mask as well as testing any case suspected to contain heroin under a ventilated hood. Officer safety is of grave concern and all officers are strongly encouraged to take extreme caution when handling any suspected opioid.
Carfentanil is not intended for human use and the opioid overdose reversal drug Narcan may be effective but only after multiple doses. The public is urged to be aware of the extreme dangers of handling and consuming carfentanil.
Murphy, NC— Sheriff Derrick Palmer announced the Union County Georgia Sheriff’s Office arrest of James Lanier Heaton, George David Gowder III, John Michael Gowder, Virginia Lou Harkins, Gail Gowder, and Jamie Harkins all who provided Blairsville Georgia addresses, for charges stemming from a joint investigation into prescription fraud.
FYN spoke with officials and the hospital confirms John Michael Gowder is the CEO of Union General.
The joint operation involved members of the Drug Enforcement Administration, Tactical Diversion Squad, the Union County Georgia Sheriff’s Office and the Cherokee County North Carolina Sheriff’s Office. Although the investigation is ongoing to date information has been discovered that would indicate that the ring was operating in Cherokee County North Carolina and may be facing charges here as well.
Sheriff Palmer stated “We enjoyed the opportunity to work with the agencies involved. Sheriff Mack Mason and his Office have been a tremendous ally as we are sending the message No longer can you deal drugs across county and state lines – We will hunt you down and prosecute you.”
Sheriff Palmer encourages any one that has information on this crime or any other to report it. To report crime in Cherokee County you can call the anonymous tip line at 828-837-1344 or email a tip at firstname.lastname@example.org or call 911 if you observe a crime in progress.