Three years ago, Peter Shumlin created the National Association on Prescription Drug Prices (NLA), a paper organization with no authority. He hired Cheryl Rivers as its executive director. Her job was to set up a clearinghouse for ideas for states to reduce drug prices and increase access for constituents. As one of three Vermont House members on that commission I attended NLA’s quarterly meeting in Concord, New Hampshire in June.

Funding of NLA has always been contentious in Vermont. Maine, Washington, DC and Vermont participate in the organization but Vermont pays 50% of the costs. New York and Connecticut anticipate paying as they did last year but failed to send a check. Rhode Island, New Hampshire, Massachusetts, Pennsylvania and Hawaii, who are also members, contribute nothing.

Some view NLA as a Democratic political action committee taking advantage of an emotional issue to capture headlines. Many of NLA’s directors who are Democrats use drug prices as an issue for political visibility by waging a multi-front war on the pharmaceutical industry, claiming they are motivated only by profit.

NLA directors have used the cheap drug topic to run for higher office as evident in the 2002 election in New England. The executive director’s major function is sending newsclippings from around the country to fuel this war by bashing pharmaceutical companies claiming they exploit consumers.

In FY05 Vermont’s funding will be cut and it’s doubtful NLA will survive unless it can generate added income. Peter Shumlin is focused on setting up a non-profit pharmacy benefit manager function (PBM) to seek contracts with states to combine their purchasing power and leverage lower prescription drug prices for consumers.

At the NLA quarterly meeting we heard two proposals from Pharmacy Benefit Companies (PBM’s) who could facilitate this effort. One proposal included a best practice approach in the acquisition, utilization and dispensing of prescription drugs. The other created a hierarchy that NLA would control. Both proposals had some good points but Vermont is already managing drug price escalation for its Medicaid program with its own PBM contractor and multi-state purchasing initiative with Michigan and South Carolina.

NLA is aggressively pursuing its PBM mission using a $100K grant from the Heinz Foundation for that effort. The head of the foundation is the wife of US Senator John Kerry, who’s also a Democratic Presidential candidate. Total budget for this effort is $1.2 Million and unless that’s raised, NLA’s survival is doubtful.

Representatives of the Douglas Administration gave an excellent presentation on the Vermont/Michigan multi-state pool. They cautioned members that managing prescription price growth is dynamic and will require constant attention and new approaches to keep the growth down to responsible limits.

Peter Shumlin also reported that he’s on a national board called the North America PCA. Its purpose is to accredit all pharmacies in the US, ensuring they’re following best practices. He indicated the new Federal prescription drug bill supports this certification process though current bill summaries fail to identify that provision. It appears as if this accreditation would usurp states’ rights in overseeing pharmacists’ licensing. He also added that if a single location of a national chain were to “fail” then the accreditation would be lost for the entire chain; a practice not normally used in other industries.

Rep. Kathy Lavoie, (R. Swanton) and I introduced a resolution urging states to consider and take full advantage of various prescription drug cost control programs, like pharmaceutical patient assistance programs, discount cards, PBM’s , preferred drug lists and multi-state purchasing agreements. It passed and is a good first step toward NLA recognizing some of the work done by pharmaceuticals and other states to lower costs to consumers.

What was not discussed at the NLA meetings I attended was that prescription drugs have proven to help reduce other health care costs by keeping people healthy and out of hospitals and nursing homes. Because more people are taking more medicine some drug costs are high. However, that doesn’t preclude states and consumers from to shopping smartly to get the best price.

It appears that NLA is all talk and little action. Slamming pharmaceuticals seems counterproductive because their intense research for newer and better treatment costs billions. Duplicating what other states are doing with taxpayers money also isn’t productive and is a disservice to our constituents.

Thank you for your calls and notes. I can be reached at 658-3975 (home), 1-800-322-5616 or 228-2228 (State House) and via e-mail.

Rep. Frank Mazur
South Burlington