March 3, 2007

Few issues are more important to West Virginians than affordable health care. Every year, the Legislature considers and passes legislation with the aim of making health care less expensive, but it is an uphill battle.

This session, the House of Delegates adopted a bill intended to improve West Virginia's efforts to lower the cost of prescription medications. It is a complex, but very worthwhile effort.

Consider these statistics, which have been cited by a Boston University professor regarding West Virginia:

* In 2004, the average West Virginian spent $806 for prescription drugs, which is 41 percent above the national average.

* Although West Virginians earn less on average than those in many other states, they spent 3.1 percent of their personal income on prescription drugs, which is 81 percent above the national average.

And take into consideration that a very high percentage of our population is elderly - the second highest in the country. According to some recent estimates, 100 percent of the increase in health care costs in West Virginia last year came from prescription drugs.

In 2004, the Legislature adopted innovative and groundbreaking legislation intended to empower a new West Virginia Pharmaceutical Cost Management Council to negotiate lower prescription drug prices for state agencies, and ultimately for all West Virginians. But this is new territory. West Virginia is really leading the way and there have been a few sticking points that have prevented the Council from working effectively.

So this year, the House of Delegates has adopted the Pharmaceutical Availability and Affordability Act of 2007 (HB3164) to correct the situation. Gov. Manchin introduced the bill, and the House made some changes, with the support of 11 different consumer and labor groups that include the AARP, the West Virginia Council of Churches and the AFL-CIO.

As proposed by Gov. Manchin, the legislation takes the negotiating power from the Council and gives it to the Pharmaceutical Advocate. There currently is a Pharmaceutical Advocate, whose position was created by executive order, but this bill would make that a cabinet-level position set in code.

The Council would become merely advisory, but to give it a stronger voice, the House amended the legislation to remove the state agency officials and replace them with the following: a representative of low income citizens; someone with experience in the financing of a health insurance company; a representative of senior citizens; two licensed pharmacists; a representative of a pharmaceutical manufacturer with substantial interests in the state; one primary care physician; and one member of the general public.

The Pharmaceutical Advocate would have the power to negotiate agreements and purchase drugs. The original bill called for the Advocate and Council to gain the agreement of eight "jurisdictions," presumably states, before creating a pricing schedule from which to negotiate prices. But the House changed that provision to require the attainment of 5 million participants or entities, a more reasonable goal.

Once the schedule is created, a drug manufacture could seek a waiver on those prices if that entity can show that the cost of research, development and distribution are too high. But the cost of marketing and advertising would not be taken into account by the Council in considering such a waiver. This is to prevent companies from charging West Virginians for what they spend on marketing and advertising, including any gifts or other expenses provided to physicians and other health care professionals.

To simplify the process, the legislation also would remove any legislative rulemaking requirement regarding manufacturers' disclosure, and the requirements and the powers bestowed upon the Advocate would be clearly stated in statute.

I welcome and appreciate your input on these or any other legislative issues. Write to House Majority Leader Joe DeLong, Building 1, Room 228-M, 1900 Kanawha Blvd. E., Charleston, 25305, or joe@joedelong.com, or call 304-340-3220.