If you have osteoporosis, your doctor may prescribe a drug called teriparatide, which drug maker Eli Lilly sells under the brand name Forteo.
In the pharmaceutical industry, Forteo, which helps rebuild bone, is what’s known as the flagship product – a huge, trusted seller bringing billions of dollars to its maker. However, when you walk into the pharmacy to get your prescription, you may be in shock. After their price rises Third more Among the best-selling branded drugs between 2012 and 2017, Forteo now costs an average of $ 3,906.62 in Colorado for a one-month supply, according to A report released this month By the Ministry of State for Health Care Policy and Financing.
Crossing the border into Canada, however, Forteo is a relative bargain – $ 880.58, according to the same report.
This difference of $ 3,026.04 explains why Colorado health officials, after two years of ups and downs, continued to press ahead with a plan to import prescription drugs from Canada, even as they began to realize that the savings might not actually affect the state’s Medicaid spending. Much. Instead, the state believes the import program will primarily benefit the commercial sector – private insurers and self-financed employers who provide health coverage to nearly half of all Colorado residents.
On Monday, the country issued a “Call to Negotiate”, to search for potential vendors who would help put the import program together. The state is looking for a company to help run the program, as well as a wholesaler in Canada that exports medicines and an importer in the United States to ensure the drugs meet safety and distribution standards.
Interested companies have until April 26 to apply. If all goes according to plan, the state will present the program for federal approval in the fall, and work will begin in 2023.
“Everything we do will color within the lines and follow the protocols established by (the Food and Drug Administration) and the federation,” said Kim Bemstiver, CEO of HCPF. “… the quality will match the same protocols, but the prices will be significantly different.”
Savings for private insurers – but not Medicaid
The 117-page report released this month by HCPF examined the prices of 50 prescriptions in Colorado and Canada. The differences were most pronounced with more expensive drugs, such as Forteo. The report found that they are present along the price range. Epi Pens $ 250 in Colorado are $ 88 in Canada. An inexpensive thyroid drug called Synthroid that costs $ 1.20 in Colorado is the least expensive in Canada – only 8 cents.
Altogether, the HCPF report found that importing those 50 drugs from Canada could result in an average savings of 63%.
But the report contained a surprise: The import program won’t actually save much money for the state’s Medicaid program – which, in the case of a pandemic, now covers nearly a quarter of all Coloradans. The reason has something to do Federal rule Asking drug companies to sell drugs to Medicaid at their best price. Medicaid also benefits from the discounts required for rapid growth when drug prices increase faster than inflation.
Bimestefer said HCPF analysts discovered the post-discount pricing that Medicaid countries now for prescription drugs are already comparable to those of other countries’ prices.
“This is an amazing discovery,” she said.
Medicaid discounts in Colorado tripled between 2014 and 2019. The bottom line is that Colorado’s Medicaid program actually paid less overall for prescription drugs in 2019 than it did in 2014.
So Bimestefer said the import program will mostly help those with private insurance.
“We can build it the way the proposals come in.”
Exactly what the Colorado program would look like is still up in the air. By issuing a call to negotiate – as opposed to a more standard request for proposal – state officials hope to keep discussions with potential partners open. The determination of exactly which drugs to import and how to operate the program will not be finalized until after Colorado has selected its vendors.
“There is no evidence for this,” said Bemstiver. “The industry is creative, innovative, and expert. So it gives us the most flexibility. … We can build it the way the proposals come in.”
Colorado also hopes to benefit from a greater certainty about the entire import concept, now federal authorities It was finished The Rules Allowing countries to set up their own programs. The combination of federal rules and the flexible approach of the state made Bimestefer confident that Colorado would avoid the fate of Florida – which launched its import program only for Zero companies bid on the contract.
Kelly Schwartzendruber, HCPF pharmacist who works on the import program, said the state has received initial attention from some Canadian wholesalers. Bimestefer said HCPF is talking with Canadian authorities to ensure the Colorado program is not hurting Canada’s supply of medicines, something Canadian officials have previously raised concerns about.
“We do not intend in any way to impede Canadian supplies,” Bemstever said. “We are doing everything we can to be a good partner for our friends in the North.”