(Trenton) – Every year, prescription drug prices rise and increase the difficulty for residents to get their necessary, daily medicine. According to the ADA, the average fee for Insulin increased by 64% from 2014 to 2019. Insulin is not the only drug that continues to rise in price as many other prescriptions follow a similar pattern. From 2013 to 2018, the average payment for one inhaler of Advair, a leading medication for Asthma, amplified from $316 in 2013 to $496 in 2018.
While prices have climbed throughout the years, there has been inadequate data reporting which has made it difficult for the Division of Consumer Affairs to monitor emerging trends in prescription drug pricing at each stage of the supply chain. Additionally, there has been limited transparency from pharmacy benefits managers (PBMs), which has set an uneven playing field between pharmacies and patients.
To ensure prescription drug prices are affordable and patients are not taken advantage of, Assemblyman John McKeon sponsors a bill package that would place a flat cap on payments for individuals prescribed certain drugs and greatly improve transparency between pharmacies and patients. The package was approved by the Assembly Financial Institutions and Insurance Committee on Monday.
“Prices continue to rise and residents with covered insurance suffer from having to pay unreasonable amounts,” said Assemblyman McKeon. “For instance, there are nearly 900,000 New Jerseyans who currently take a form of insulin. If these rates continue to escalate, many people will not be capable of affording their essential medications. It is clear, the current structure must change. Establishing a flat cap would make certain the residents in our state are guaranteed their medicine.”
The legislative package includes:
- (A-2839) (McKeon/Karabinchak/Quijano) – Requires health insurance carriers to provide coverage for epinephrine auto-injector devices and asthma inhalers; limits cost-sharing for health insurance coverage of insulin.
- (A-2840) (McKeon/McKnight/Moen) – Establishes certain data reporting requirements for prescription drug supply chain; requires Division of Consumer Affairs to issue annual report on emerging trends in prescription drug pricing; appropriates $900,000.
- (S-1616/A-2841) (McKeon/Freiman/Mosquera) – Establishes new transparency standards for pharmacy benefits manager business practices.
“Transparency shines a light on drug pricing and holds manufacturers accountable for increases or high prices for new prescriptions. Pharmacy benefits managers were created as middlemen to reduce costs but a lack of transparency has allowed them to operate virtually unchecked,” said McKeon. “In order to reduce patient costs, we must enhance transparency in various capacities which would allow our state agencies and the public to become more aware of unfair fee surges.”
The measures now head to the Speaker for further consideration.