Texas lawmakers consider reforms addressing prescription drug affordability


Boram Kim


The Texas House Select Committee on Health Care Reform heard testimony on several bills aimed at lowering prescription drug costs for Texans on Thursday.


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House Bill 25, also called the Wholesale Prescription Drug Importation Act (WPDIA), would authorize the Texas Health and Human Services Commission to develop a prescription drug importation plan to be approved by the Food and Drug Administration (FDA) that would allow certain low-priced drugs to be sourced from Canada. 

The program can be implemented under the Trump administration’s final rule, which declared Canadian drug importation poses no additional risk to the public’s health and safety.

The bill’s sponsor Rep. James Talarico (D-Round Rock) said the program would result in savings of 60-70% for consumers and millions of dollars for state agencies on prescription drug costs.

“Americans pay the highest prescription drug prices in the world—higher than any other industrialized nation,” Talarico said. “Forty-two percent of Texans stop taking their medication or choose to ration or skip doses, 125,000 Americans die every year from not taking their prescriptions, and that’s because Americans pay more than twice as much as Canadians for their prescription drugs, despite the fact that the US and Canada share equivalent regulatory systems for their medicines.

Meanwhile, the largest pharmaceutical companies can profit up to four times as much as other large companies, with some making profits of $95 billion.”

Representatives from the Pharmaceutical Research and Manufacturers of America (PhRMA), the Texas Pharmacy Association, and Texas Association of Manufacturers testified in opposition to the bill citing cost and safety concerns about bringing non-US-made drugs into Texas, which could harm the health of the local population and economy. 

Yet proponents said under federal provisions, the program would have to meet strict FDA standards for safety and monitoring of the supply chain, from manufacturing to consumption, before it could be approved. 

“We have a closed loop system that doesn’t allow competition and is controlled by an FDA that is largely controlled by pharma,” said committee member Rep. James Frank (R-Wichita Falls). “If you honestly look at the job—so if you work at [the] FDA, then you go work at pharma for a lot more money and therefore the rules are set up that way—they’re set up where you can’t import. They’re set up where you can change the formulation just slightly and all of a sudden you renew your patent and you make sure the prices stay high.

Other countries don’t allow that and it is a fault in the free market. A free market only works when government will at least require responsible behavior. And I think in this case, we don’t require any responsible behavior because there’s too close [of] a tie.”

Meanwhile, HBs 2180 and 999 would require health plans to apply rebates and copay assistance to reduce prescription drug cost-sharing for their beneficiaries. All three bills were left pending in the committee. 

HB 999 would allow third-party assistance payments to count toward a patient’s out-of-pocket expenses, while HB 2180 would require health plans to apply rebates on prescription drugs paid by manufacturers to pharmacy benefit managers directly to consumer costs at the point of sale. The return of rebates would impact an estimated eight million Texans, according to PhRMA. 

“Manufacturers pay over $236 billion in rebates and this [bill] allows a portion of the rebates to go directly to the patient, where they see immediate savings,” said Sharon Lamberton, deputy vice president of state policy and external outreach at PhRMA, testifying on behalf of the bill. “In fact, studies show $1,000 per year per patient could be saved and premiums only go up minimally 0.6%. This is consistent with the fiscal note that estimates that rates would only go up 1.5-2%.”