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Thursday, February 16, 2006

Guest View: State Misses Chance to Save Cash

By State Rep. John Heaton

    I cannot sit idly by and allow this session to lapse without shedding light on a gross oversight by our media and some legislators.
    Wearing the hats of pharmacist and lawmaker, this is the second year that I have tried to pass legislation that would save New Mexicans millions of dollars a year in medical costs. More specifically, this bill would save New Mexicans $50 million to $60 million per year in physician and pharmacy costs.
    Pharmacies and doctors are spending hours upon hours telephoning back and forth requesting and authorizing drug changes required by a patient's insurance company. And now, with Medicare Part D, which was written by the drug companies, the matter is further complicated by another 100 insurance plans added with very specific drug lists.
    My bill, HB34a Interchange of Therapeutic Alternate Drugs, was killed this year in the House Business and Industry Committee and pocket vetoed last year by the governor. The bill deals with the terms "therapeutic alternate" and "therapeutic interchange." While these terms may be new to New Mexicans, I can assure you that they are friendly terms.
    Generally, these words are associated with programs that would allow pharmacists to automatically substitute a drug that is required (on a preferred drug list) for a non-preferred drug, when a formal agreement exists between a physician and pharmacy as a prescription is filled. These programs are offered to help consumers save money on drug costs while providing safe, effective and less costly medicines.
    Therapeutic alternative drugs are drugs that can be substituted for other drugs— drugs that are often pushed by deep-pocketed pharmaceutical lobbyists. Many times therapeutic alternatives can be selected over the more popular and expensive name-brand medicines because they are as equally effective as the prescribed drug, but they cost less.
    For example, if a patient is prescribed an antihistamine such as Allegra, a pharmacist would be allowed to substitute it within the same therapeutic class of drugs, as required by the insurance company, with the full expectation that the substituted product will produce the same clinical effect. With a cost benefit to the patient, the pharmacist could substitute an equally therapeutic alternative like Loratadine. The cost for a 30-day supply of Allegra is approximately $62 and the cost for a 30-day supply of Loratadine is approximately $9.
    So why would certain legislators kill a bill that would save our citizens millions? And we wonder why our insurance costs are rising at double-digit rates and why we have the most expensive health-care system in the world. These alternatives are held to the same FDA standards as the originally prescribed drug. Could this be just another example of our government kowtowing to the desensitized, yet powerful pharmaceutical machine?
    Here is the contradiction: On Friday the House unanimously approved another bill to help New Mexicans buy prescription drugs at lower costs. The governor has not been shy about proclaiming his support for this bill. The measure would expand an existing program that allows people 65 and older to take advantage of discounted drug prices through a preferred drug list and would open the program to all New Mexicans regardless of age.
    So it seems that this Legislature does want to save New Mexicans money, but not to reduce the excessive profit of preferred drug companies. We can offer our citizens a discount on a preferred drug, but we somehow aren't able to remove the enormously expensive bureaucracy associated with using a required alternative at competitive prices.
    My job as a legislator is to watch out for the needs and interests, not only of the people in my district, but for all New Mexicans. While I don't mean to minimize the intent of the bill that would discount prescription drugs to all New Mexicans, I can't help but point out the other beneficiaries of that bill, as opposed to my proposed legislation. Citizens of New Mexico should be the focus of our legislation, not the bottom line of pharmaceutical companies.
    State Rep. John Heaton, D-Carlsbad, serves on the House Appropriations and Finance Committee and the Energy and Natural Resources Committee.