Health & Medicine

Proposed monthly cap on patient drug costs survives Assembly hearing

A major legislative effort to help rein in the staggering costs of new specialty drugs that can cost $1,000 a pill or more was put on hold Tuesday because it lacked the votes to pass the Assembly Health Committee, effectively ending the effort this year.

Another measure meant to help patients in the short term by capping their monthly out-of-pocket costs survived a vote by committee members.

The measure put on hold – Assembly Bill 463, by Assemblyman David Chiu, D-San Francisco – would require pharmaceutical firms to disclose the costs and profits of any drug or course of treatment that costs more than $10,000 annually.

An unusual coalition of health plans and patient advocates backed the bill, but it was strongly opposed by the pharmaceutical industry. Lacking the needed votes, Chiu opted to make his measure a two-year bill and take it up again in the next legislative session.

“This will take some real efforts to pull off practically and politically,” said Anthony Wright, executive director of Health Access California, a patient advocacy group. “The drug companies are big in California in many legislative districts. You can’t escape that.”

Another measure backed by Health Access California but opposed by health plans passed the committee by a vote of 11-5. AB 339, by Assemblyman Rich Gordon, D-Menlo Park, proposes putting a limit on how much patients pay each month for expensive treatments.

A 12-week regimen of a new hepatitis C drug called Harvoni can cost nearly $95,000. Patients take one pill per day, and each pill has a wholesale price of $1,125.

Patients can easily shell out thousands of dollars for their first bottle of pills before the state’s yearly cap on out-of-pocket expenditures kicks in. Gordon’s bill seeks to avoid having a huge bill come due in a prescription’s first month.

It also would prohibit health insurers from putting all treatments for diseases such as hepatitis C, HIV or AIDS in their highest price tiers.

The bill must still survive votes on the Assembly floor and in the Senate.

Call The Bee’s Hudson Sangree, (916) 321-1191. Follow him on Twitter @hudson_sangree.