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SB262: Asthma drug pricing transparency

...Democratic Sen. Yvanna Cancela...has introduced a bill that would apply the same standards toward drugs that treat asthma...SB262 largely copies provisions of Cancela’s 2017 legislation on diabetes drug transparency, which requires the drug manufacturer to submit information to the state related to the cost of the pricing of the drug, and explain to the state whether the drug has undergone a substantial price increase in the past two years...SB262

SB378: Drug pricing board

Proposed by Democratic Sen. Yvanna Cancela, this measure would establish a statewide Prescription Drug Affordability Board, charged with identifying certain prescription drugs with pricing that creates challenges for insurers and patients and that would recommend an upper price and payment limit on the drug...The bill lays out the structure, make-up and abilities of the board, funded by taxes on prescription drug manufacturers based on their market share and the required costs of the board. It also lays out a process for setting upper recommendations on prescription drug prices, including requiring the suggested limits become mandatory after 2024...SB378

AB303: Regulation of kratom products

Sponsored by Assembly Republican Leader Jim Wheeler, this bill would require the state pharmacy board to regulate and oversee the sale of kratom, a Southeast Asian tropical tree with leaves that contain psychotropic effects...The bill would also prohibit the sale of kratom products to children under the age of 18, or to sell any kratom products that have been altered to become “injurious” to a consumer. It sets a $1,000 fine and separate civil penalty up to $1,000 for violations...AB303

AB239: Opioid clarification bill

...this bill would make changes to the opioid prescribing law passed in the 2017 legislative session that prompted complaints by physicians in the interim. The legislation would, among other things:
- Codify certain definitions from pharmacy board regulations, including course of treatment and acute pain
- Allow providers to still prescribe a controlled substance after reviewing a patient utilization report if they determine the prescription is medically necessary
- Allow providers to prescribe a longer initial prescription for a controlled substance for the treatment of acute pain than normally allowed by law if medically necessary
- Remove a requirement that a provider make a good faith effort to attempt to review a patient’s medical records before issuing an initial prescription of a controlled substance for the treatment of pain unless the initial prescription is for more than 30 days or the medical records are relevant to the prescription
- Repeal requirements that providers consider certain factors — including whether there is reason to believe the patient is not using drugs as prescribed, the number of attempts by a patient to obtain an early refill of a prescription and the number of times a patient claims a prescription has been lost or stolen — before prescribing a controlled substance...AB239

Democratic Assemblywoman Ellen Spiegel presented two bills...that would allow patients to apply cash payments on drugs and the costs of out-of-network emergency bills to their insurance plan deductibles or annual out-of-pocket maximums...The two bills aim to reduce the financial burden of meeting high deductibles and annual out-of-pocket maximums, which have become increasingly common in recent years, by allowing patients to contribute payments made outside the scope of his or her insurance plan to them. But health insurers, at a hearing on the bills during a meeting of the Assembly Commerce and Labor Committee...expressed concerns that the requirements as written could be technically difficult to accomplish and overly burdensome...READ MORE

U.S. legislators have been introducing bills left and right proposing a variety of methods for bringing down drug prices. Now, Vermont's congressman is zeroing in on a specific class of diabetes medicines that he says have become far too expensive: insulin...Rep. Peter Welch introduced a bill on Wednesday that would make it legal for patients, wholesalers and pharmacists to import insulin from Canada, and eventually from other countries with acceptable safety standards...Welch clearly wants to make an end run around Lilly and its fellow insulin makers. If his bill were to become law, patients with valid prescriptions would be able to import low-cost insulin and have it covered by their insurance plans...

Surprise medical bills...patients receive after they’re transported by ambulance to a hospital — sometimes unconscious or in critical condition — that is out of their insurance company’s network. They’re also the bills patients receive when they land in an emergency room that contracts with their insurance company but are inadvertently treated by a doctor that doesn’t...Hospitals, physicians and insurance companies in Nevada have agreed that patients experiencing a true emergency shouldn’t have to worry about whether they’re receiving in-network care — or face bills totaling tens of thousands of dollars if they accidentally wind up out of network just because their provider and insurer don’t have a contract. Where there has historically been less agreement, though, is what to do about it...

State legislators in Massachusetts are preparing to review a slew of bills aimed at state-level drug pricing, and the pharmaceutical industry is opening its checkbook to fight back...The state’s Joint Committee on Health Care Financing on April 11 will examine 21 bills targeting price transparency and affordability for patients. State Sen. Cindy Friedman...will take a hard look at measures to open up drugmakers' pricing secrets and lower sticker prices for patients...But pharmaceutical companies aren’t taking that challenge sitting down...the Pharmaceutical Research Manufacturers of America, told FiercePharma that the state’s push to cap prices would keep patients from getting the drugs they need...“We oppose government price-setting proposals in the states,” spokeswoman Priscilla VanderVeer said. “Government price controls limit access to medicines for patients and they stifle new innovation.”...READ MORE

Two bills introduced in a Senate health committee...in the Legislature would protect health care benefits in Nevada...Senate Bill 235 would extend pre-existing condition protections created by the federal Affordable Care Act to state law...If SB235 is approved, those with chronic conditions would continue to be protected from discrimination by insurers...A second bill, SB192, introduced in the committee...would require employers to offer comprehensive health coverage that covers all of the ACA’s 10 essential health benefits, including prescription and maternity coverage, if they pay employees at the lower end of a two-tiered minimum wage system...READ MORE

But in New Hampshire, Gov. Chris Sununu and some other state leaders are opposed. The problem, they say, is not just about pot. It’s about opioids — drugs that have ripped across this state, devastating thousands of residents and leaving New Hampshire in recent years with one of the highest per capita death rates from opioid-related overdoses. After so many deaths, so much misery and so much state money spent fighting opioids, the opponents say, how could anyone even think about easing access to some other drug?...Mr. Sununu called the debate over marijuana legalization “the next major battle” in the state’s response to the opioid crisis. He urged the commission, which includes medical and drug treatment experts, as well as the heads of various state departments, to take an official position opposing the legislation, which it did at its meeting last month...

Elite Medical Center...Since it opened...its business model has been based on providing emergency care to tourists...The federally-run Medicare program for the elderly and the state-run Medicaid program for low-income residents just isn’t lucrative and therefore isn’t part of its business model...The rest of Nevada’s hospitals use their privately insured patients to subsidize the cost of treating those covered under Medicare and Medicaid. Hospitals argue that the rates paid by government insurance programs don’t come close to the actual costs of providing care, so they must carefully balance the number of patients they take under each type of insurance in order to stay financially solvent....the other hospitals believe that Elite is siphoning off the well-insured patients at their expense and without shouldering any of the burden for treating those on Medicare or Medicaid. That’s why the state hospital association is pushing for lawmakers to pass AB232, which would require essentially all Nevada hospitals to accept Medicare and Medicaid...READ MORE

After taking on the pharmaceutical industry two years ago with an insulin pricing transparency bill, Democratic state Sen. Yvanna Cancela plans to continue...A suite of three bills, which Cancela plans to introduce next week, will establish a prescription drug review board, create additional pharmaceutical pricing transparency requirements and mandate that savings in the drug pricing process are passed along to patients. Like the legislation last session, the bills will address the roles that both pharmaceutical manufacturers and the middlemen in the drug pricing process, called pharmacy benefit managers, play in determining drug costs...The pharmaceutical industry has challenged a host of recent state legislation, including bills in California and Maryland, attempting to rein in drug costs by arguing that they violate the Commerce Clause, which restricts the power of states to regulate interstate commerce...READ MORE

Canadian pharmaceutical industry lobby groups, in an effort to head off a planned crackdown on prescription drug prices, offered to give up C$8.6 billion ($6.6 billion) in revenue over 10 years, freeze prices or reduce the cost of treating rare diseases...Those industry offers did not impress federal officials, coming last year as Canada prepared to expand the powers of a little-known federal watchdog called the Patented Medicine Prices Review Board to reduce the cost of prescription drugs...The government proposals would change the countries Canada compares its prices to, dropping the United States where they are highest, and set a formula to assess cost-effectiveness of medicines...the new rules were scheduled to come into effect last month but have been delayed as the government reviews feedback, which has some wondering if they will ever be implemented...Unlike other countries with universal healthcare, Canada’s government-funded healthcare system does not cover prescription drugs. Most Canadians rely on an expensive patchwork of public and private insurance plans for that. Among industrialized nations, only the United States and Switzerland spend more on prescriptions per capita...