MassBio Testifies in Support of Patient Access Programs

November 10, 2009

John Heffernan, MassBio Vice President of Policy & Public Affairs, testified today in front of the Massachusetts Joint Committee on Public Health in support of Patient Assistance Programs:

"Good morning Senator Fargo, Representative Sanchez, and members of the committee and thank you for the opportunity to submit testimony on House Bill 2151, An Act Relative to Patient Assistance Programs, introduced by Representative Michael Rodrigues.

I am John Heffernan, Vice President of Policy and External Affairs at MassBio, which represents more than 600 biotechnology and associated industry members. I'm here on behalf of those members-- 370 of which are directly engaged in biotechnology research, development and manufacturing of innovative products that impact the economy and help patients in Massachusetts and around the globe-- in support of House Bill 2151.

We have seen the Biopharmaceutical industry both hailed as the key to our future success, as well as vilified as uncaring corporate entities hindering the progress of reform. Nothing could be further from reality. The reality is that we have approximately 45,000 people working in Massachusetts at MassBio member companies, academic institutions and teaching hospitals that are focused on finding ways to improve the lives of patients around the world.

Many biotechnology and pharmaceutical companies offer coupons, trial offers, and co-pay assistance in order to help patients defray costs for some medications. Patients in Massachusetts are currently prohibited from participating in these programs. Federal law prohibits coupons and discount programs from being used on federally funded healthcare programs such as Medicaid and Medicare Part D. Only Massachusetts has extended that prohibition to private health insurance. Passage of House Bill 2151 will allow patients an opportunity for significant savings on their prescribed medications. With so many people in Massachusetts feeling the crunch of this economic crisis, now is the time to provide them with much needed relief and vital access to their prescriptions.

While we have made great strides in Massachusetts on healthcare coverage, there are still uninsured or underinsured patients that fall though the cracks of an imperfect system. It is this population that is the neediest, due to issues such as financial hardship, multiple medical conditions and geographic challenges. In addition, insured patients still face high deductibles and co-pays for prescriptions. These programs are designed for them, but also to enable patients with private insurance to hold down their out of pocket costs for medicine prescribed by their physician.

Controlling costs continues to be the number one health care issue in Massachusetts. It therefore seems counterintuitive that Massachusetts remains the only state in which patients cannot take advantage of any discounts offered by pharmaceutical and biotechnology manufacturers to lower
the cost of prescription medications. Patient Assistance Programs are particularly helpful to patients that need biologics, for which there are no generic equivalent. For biologic products, many of which offer co-pay assistance for patients, this is the only medication available to treat the patient's disease.

There are also issues of adherence or compliance. Health care providers will tell you that one of the largest problems facing the health of their patients is whether or not they follow the directions of their doctor and pharmacist. According to a RAND Corp. study published on April 7, 2009, there is a strong correlation between increased copayments and delays in filling prescriptions for medications to treat their chronic illnesses. Untreated chronic illnesses can lead to greater illness to the patient and expense to the health care system. We want to increase the number of people adhering to therapeutic programs, and therefore leading healthier more productive lives. This would then lead to less strain on our healthcare system, and contain costs. Why create another barrier?

I would like to highlight several key points on House Bill 2151:

  • There will be no cost to the state - the consumer receives the benefit directly from the company.
  • Each Massachusetts health plan or health insurer maintains complete control over drug utilization.
  • There is no impact on insurer prior authorization, tiering or other cost control mechanisms. In fact, any Massachusetts health plan can still prohibit their enrollees from using of these discounts.
  • Many patients using co-payment assistance have already tried and failed a generic medication prior to being prescribed the product for which there is a discount.
  • These discounts and coupons often apply to both existing and new prescriptions. Even customers who have been taking a product for years can save under these programs.
  • Discounts would be available under the legislation to ALL, including people with private insurance, Prescription Advantage members, and others not enrolled in federally funded programs such as Medicaid and Medicare Part D.
  • The legislation would maintain prohibitions on unfair inducements to use one product over another, as well as prohibitions on these discounts for those enrolled in federal funded programs.

Joining me today is Dr. Richard Sagall who will discuss the merits of Patient Assistance Programs and other opportunities available for patients to receive and keep taking their medications and therapies. He will elaborate on the value of such programs and how important it is to educate patients and doctors of their benefits.

You will also hear from patients, living with diseases such as Multiple Sclerosis. They will explain how everyday life is while continually participating in her therapy, and how things drastically change while not complying with their programs, including taking prescriptions.

Thank you for your time today.


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