Bloomberg news published an article today (4/25/19) regarding charities established by industry to support drug pricing initiatives. You can read the full article here: https://www.bloomberg.com/news/articles/2019-04-25/pharma-s-charity-allies-help-its-fight-to-keep-drug-prices-high.
NOF was mentioned and quoted in the article due to our leadership of a coalition of nonprofits supporting Medicare Part D non-interference. Below is NOF’s position on this issue, which was not fully conveyed in the Bloomberg article:
The National Osteoporosis Foundation’s mission includes advocating for access to all available screenings, testing and treatments for patients who suffer from osteoporosis and low bone mass.
The current Medicare program allows for access to bone density testing for women over 65 and men over 70 with risk factors. Medicare Part D provides access to all available medications for osteoporosis patients. This is critical because it allows healthcare providers and informed patients to determine which medicine is most appropriate for the patient at each step in the patient journey, understanding those choices and options will change from initial diagnosis through disease progression.
The non-interference clause in Medicare Part D specifically says that the Secretary of Health & Human Services cannot interfere in the robust negotiations that take place between industry and payers in the Medicare system. This was a clause added by bipartisan legislators at the inception of the Medicare program to ensure that politics and budgeting didn’t interfere in providing the best options for patients in the Medicare system.
NOF has been actively supporting keeping the non-interference clause in Medicare Part D for several reasons:
- The Congressional Budget Office (CBO) has said that there is no greater savings to be had within the currently negotiated process without creating a formulary to determine which medications would be available to patients and which would not.
- The only current formulary in place is the Veterans Administration (VA) Formulary. We know that many Veterans buy into the Medicare Part D program with their own money because they often cannot get access to the drug they need on the VA formulary.
- NOF commissioned research to determine what would happen to osteoporosis patients’ access to medications on a formulary similar to the VA Formulary. It found that of the 8 generic medications currently available for osteoporosis, only 3 would be available on the formulary. Of the 5 that would not be available, 90% of osteoporosis patients use those drugs at some point during their treatment.
- In addition, no new medications available for osteoporosis treatment, which may be critical for patients at high risk of fracture, would be available on a formulary.
- None of the legislation currently being proposed addresses HOW it will reduce costs and preserve patients’ access to the medications they and their healthcare providers have determined is best for them.
We support the effort to lower drug prices so long as doing so does not adversely affect the ability of patients to access needed medications. However, NOF will continue to support the Medicare Part D non-interference clause to ensure our patients have access to all available treatments for osteoporosis and until there is a viable recommendation for lowering drug prices AND protecting patient access to their medications of choice.
If we lower drug prices, but the patient can no longer get the medication they need, that is unacceptable.
NOF will continue to advocate for our patients’ access to all treatments. NOF is a member of the National Health Council and follows its Standards of Excellence: http://www.nationalhealthcouncil.org/resources/standards-excellence-certification-program.
CEO and Chief Advocate