Pharmacy & Therapeutics - October 2008 - (Page 609)

COMMENTARY The Next President’s Prescription for Action on Drugs Obama and McCain Positions Similar—with One Major Difference Stephen Barlas Regardless of whether Senator John McCain or Senator and the profits of the pharmaceutical industry to trump good Barack Obama is sitting in the Oval Office on January 20, policy and the will of the American people,” Obama said on the 2009, the door there will be swinging outward as a series of floor of the Senate. health care proposals—all with prescription drug and pharJohn McCain did not vote that day, but in November 2003, macy implications—fly up Pennsylvania Avenue to Congress. as the House and Senate were adopting a conference agreeBoth presidential candidates have talked up differently strucment establishing the Part D program, he complained that protured proposals aimed at providing health insurance for the 43 viding an outpatient drug benefit to senior citizens without first to 47 million Americans who are without coverage, but the two getting drug costs under control was like “rearranging the men almost resemble conjoined twins on some key drug matdeck chairs on the Titanic.” He expressly bemoaned the abters. sence of a negotiation provision. He said: That Oval Office door will be swinging inward, “Taxpayers should be able to expect Medicare, too, as Democrats on Capitol Hill start salvaging as a large purchaser of prescription drugs, to be pharmaceutical-oriented legislation—some of able to derive some discount from its new market which sank during the 2007–2008 session because share. Instead, taxpayers will provide an estimated of a veto threat by President George W. Bush—and $13 billion a year in increased profits to the pharsend those resurrected bills to the new president. maceutical industry.” Either man will probably be waiting with the faNeither candidate has directly addressed formous presidential pen in hand. mularies, much less P&T committees, either in Both candidates, for example, are likely to sign the context of Part D reform or in their plans for bills that would make major changes in the providing health insurance to the currently unStephen Barlas Medicare Part D outpatient drug program, includinsured. McCain’s health insurance access proing allowing the federal government to negotiate prices with posal centers on eliminating the tax subsidies for employers drug companies, a proposal that the House passed early in 2007 to provide health insurance, instead giving individuals and but that floundered in the Senate because of that threatened families tax credits of $2,500 and $5,000 with which to purchase veto and a lack of Republican support in the upper house. insurance in the private market. Mr. Obama would create a The problem with federal negotiation, according to Bill Hernational insurance program, run by the federal government, melin, Director of Government Affairs and General Counsel of that the uninsured could buy into if they preferred. the Academy of Managed Care Pharmacy (AMCP), is that it Of course, every sector in the pharmaceutical industry— constrains formularies. He says it is “almost a no-brainer” that from manufacturers to wholesalers to pharmacy benefit manCongress will pass a Medicare Part D reform bill as one of its agement companies (PBMs) to retail and hospital pharmafirst orders of business. He explains that the “800-pound cies—supports the concept of universal health insurance. An gorilla” in the room is the question of whether any legislation expansion of access to health insurance would lift all boats in provides for eliminating the ability of prescription drug plans the pharmaceutical distribution chain, even though it might (PDPs), authorized under Part D, to negotiate prices with create some waves, too. drug companies and giving that negotiation authority to the Kevin J. Colgan, MA, RPh, FASHP, President of the Amerifederal government. can Society of Health-System Pharmacists and Senior Vice The House passed a “direct federal negotiations” bill right President of Health Economics and Outcomes Research at off the bat, in January 2007, which passed by a largely partiEPIQ, Inc., says: san vote of 255 to 170. The Senate Finance Committee then “I don’t have a preference for the Obama plan over the passed a similar bill in April 2007, but the full Senate never McCain plan. My preference is that we go about getting that passed that bill. When the bill came before the Senate on April taken care of.” 18, 2007, it captured 55 votes, five short of what was needed Despite their frequent reference on the campaign trail to to shut off debate. Senator Obama voted for it. expanding access to health insurance, neither candidate would “Once again, a minority of the Senate has allowed the power expect quick action on that priority upon election to the White House. But discussions between the new President and Congress are sure to get off the ground quickly. Charles Cote, Stephen Barlas is a freelance writer based in Washington, DC, who Director of Public Affairs of the Pharmaceutical Care Managecovers issues inside the Beltway. ment Association, has stated: “There is much more demand to get things done [for] the uninsured than 10 to 15 years ago.” Accepted for publication September 12, 2008. Vol. 33 No. 10 • October 2008 • P&T® 609

Table of Contents Feed for the Digital Edition of Pharmacy & Therapeutics - October 2008

Pharmacy & Therapeutics - October 2008 Contents Editorial Medication Errors Prescription: Washington New Drugs/Drug News/ New Medical Devices Drug Forecast Medical Management of Parkinson’s Disease Why Is Health Care Regulation So Complex? The Next President’s Prescription for Action on Drugs Trends in Managing Multiple Sclerosis Product Profiler: Sancuso®

Pharmacy & Therapeutics - October 2008

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