The potential impacts of handing decisions about access to prescription drugs to a new unelected state commission are big. A similar proposal was recently rejected in Virginia and has been rejected four times by the Wisconsin Legislature, including again last month. Before Michigan follows in Colorado’s footsteps, people should ask lawmakers five important questions:
1. Why are advocates for rare disease patients, who are often the most affected by drug pricing decisions, excluded from representation on the Commission? The proposal mandates a patient advocate, yet the patient group that faces the most devastating diseases and has the fewest treatment options is denied a voice.
2. Why doesn’t Michigan’s bill ban the use of “quality-adjusted life years,” a controversial metric that devalues the lives of the elderly, the physically and mentally disabled, and the chronically ill? This metric is already banned in the federal Medicare program and should not be allowed here. In creating this commission, Michigan lawmakers must ensure they do not hard-code discriminatory treatment of our most vulnerable patients.
3. Who will benefit from the “savings” the Commission will create? There is no guarantee or provision that the savings realized through price caps or restrictions will be passed on to consumers. The result may be reduced treatment options and no financial relief at all for patients.
4. What relief will vulnerable patients who are subject to the Board’s decisions receive? Colorado is subjecting a popular arthritis medication to potential price controls and restrictions. Michigan health data shows that the state has a higher prevalence of arthritis than the national average. Furthermore, the disease burden of arthritis can affect work ability, disproportionately affecting manual laborers and older adults. The impacts of ceding power over important health care decisions to an unelected, unaccountable board will be far-reaching.
5. Will Michigan lawmakers themselves be subject to regulation by this commission? Michigan lawmakers can participate in state-sponsored plans that are regulated by federal law. As proposed, these health insurance plans would be exempt from the formulary commission’s decisions. Michigan lawmakers should be willing to play by the same set of rules and consequences they impose on their constituents before delegating authority over important health care decisions.
While the interest in lowering drug prices is laudable, moving forward without protecting patient access to care and without public accountability is a dangerous prescription. Programs cannot be measured by intent; outcomes matter, even more so when patient health is at stake. Michigan lawmakers should learn from the mistakes and dangerous examples of others, not repeat them.
