Healthy Skepticism Library item: 1485

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Publication type: news

White E.
Group of House Rx Reimport Backers:Seek Stronger Provision in Medicare Bill
The Bureau of National Affairs, Inc 2003 Nov 18

Full text:

Forty-two House proponents of drug reimportation, including nine Republicans, sent a letter Nov. 17 to Rep. William M. Thomas (R-Calif.), chairman of the Medicare conference, urging that the Medicare conference report (H.R. 1) include “strong reimportation provisions” in accordance with commitments made to them by House leaders earlier in the legislative process.

“As you draft the conference report on legislation to extend prescription drug coverage for seniors, we respectfully urge you to include strong reimportation provisions in the final measure. As you know, 243 members of the House of Representatives are on record as strong supporters of reimportation with their votes on H.R. 2427,” the letter said.

Congressional staff said Nov. 17 that the Medicare bill emerging from conference is similar to the Senate-approved Medicare bill in the area of drug reimportation. They said the proposal includes language allowing drug reimportation, but only from Canada and subject to safety certification by the secretary of health and human services.

In July, the House approved H.R. 2427, which allows drug reimportation from some 25 industrialized countries. The reimport bill was bolstered by 87 House Republican votes for the measure. The bill, which is opposed by House GOP leaders, the Bush administration, and the pharmaceutical industry, is far broader than the Canada-only drug reimportation provision that lawmakers said they plan to include in the Medicare proposal. A Nov. 16 summary of the plan points out that the proposal will include “safety certifications.”

The drug reimportation backers’ letter also said it was “imperative” that the Medicare conference report include language preventing pharmaceutical companies from “drying up the availability of drugs for reimportation.”

It was unclear how many of those signing the letter might vote against the Medicare bill when it gets to the floor, if it does not incorporate their desired drug reimportation language. The nine Republicans signing the letter were Reps. Jo Ann Emerson (Mo.), Dan Burton (Ind.), Jack Kingston (Ga.), Wayne T. Gilchrest (Md.), Vernon J. Ehlers (Mich.), Peter Hoekstra (Mich.), William J. Janklow (S.D.), Gil Gutknecht (Minn.), and Donald A. Manzullo (Ill.).

Impact on House Vote?

Meanwhile, in a Nov. 17 statement, Gutknecht, the top sponsor of H.R. 2427, predicted that the omission of his bill from the emerging Medicare conference report would make the Medicare bill’s final passage more problematic in Congress.

“Members have been hearing from their constituents. The real issue with prescription drugs is affordability. This bill does little to deal with it,” Gutknecht said.

One House Republican aide, whose boss voted against H.R. 2427, described the emerging Medicare proposal’s drug importation provisions as “a flagrant, flagrant slap in the face of the reimporters.” The aide predicted Nov. 17 that House Republican leaders would lose some GOP votes for the conference report, based on its reimportation language.

A spokesman for Gutknecht told BNA early Nov. 17 that meetings were planned to discuss the drug reimportation language, but he could not be reached later in the day.

Emerson’s and Burton’s spokespersons could not be reached for comment Nov. 17.

During the summer, House Republican leaders who opposed Gutknecht’s bill brought it to the floor in exchange for a last-minute vote change by Emerson that enabled the House Medicare bill to pass by a one-vote margin. Emerson and House Speaker J. Dennis Hastert (R-Ill.) reached an agreement that GOP leaders would bring H.R. 2427 to the House floor. If it passed, then it would become the House’s negotiating position in the Medicare conference.

Emerson told reporters Nov. 7 that she had been approached separately by 11 House lawmakers within a five-minute span who told her that they would vote against the final Medicare bill if it did not include a “solid” drug reimportation provision.

Proposal Similar to Senate Language

Congressional aides who briefed reporters on the emerging Medicare proposal said that it includes language allowing drug reimportation, but only from Canada and subject to safety certification by the secretary of health and human services. In addition, a Republican committee aide said the proposal requires the Department of Health and Human Services to conduct a study on issues associated with drug reimportation within one year of the Medicare bill’s enactment into law.

According to a summary of the proposal, which is being drafted into legislative language, the HHS study would address major safety and trade issues regarding reimportation.

Seeking to Curb Drug Firms

In question Nov. 17 was whether the emerging Medicare proposal would include “antidiscrimination” language sought by the 42 signatories to the letter.

A House Ways and Means Committee aide to conference chairman, Rep. Thomas, could not comment directly on the drug reimportation provisions—which do not fall in the Ways and Means panel’s jurisdiction—but said that the overall proposal still was being drafted into legislative language.

Unlike the House-approved Medicare bill, which also provided for Canada-only drug reimportation subject to HHS certification, the Senate-approved Medicare bill included “antidiscrimination” language aimed at preventing pharmaceutical companies from choking off the supply of drugs to Canada in an effort to stop the reimportation of those medications at cheaper prices.

The letter from drug reimportation backers said that pharmaceutical companies were joining together to restrict the supply of drugs to Canada in an effort to block drug reimportation.

“As we begin the process of permitting reimportation, the intent of Congress is being overridden by corporate action in the form of limiting drug sales to countries like Canada,” the letter said.

The Senate-passed language would prohibit drug makers from entering into a contract for sale of a prescription drug that places a limit on supply or employs any other measure that provides pharmacists of wholesalers’ access to prescription drugs on terms less favorable than the terms provided to a foreign purchaser of the drug. Drug companies also would be barred from restricting the access of pharmacists or wholesalers to a prescription drug that is permitted to be imported into the United States under the drug reimportation legislation.

Generic Drug Issues

On another drug-cost related issue, the emerging Medicare proposal includes a number of provisions to close loopholes in the 1984 Hatch-Waxman Act, thereby speeding the market entry of cheaper generic drugs. Hatch-Waxman provisions in the Medicare agreement include language ensuring that branded drug companies can only obtain one 30-month stay to block the market entry of a competing generic drug when patent disputes occur.

As of Nov. 16, congressional aides were saying that questions remained outstanding over language providing generic drug companies the option to seek a “declaratory judgment” regarding the validity of a drug patent.

Sen. Charles E. Schumer (D-N.Y.), a staunch proponent of the declaratory judgment language that had been in jeopardy amid lobbying by the brand-name pharmaceutical industry, was pleased Nov. 17. He told reporters of the declaratory judgment language: “I heard they kept it in.” Schumer was referring to language from the Senate-approved Medicare bill, which lawmakers augmented to address potential constitutionality problems.