Eli Lilly Amendment Exits Oregon Legislature as it Entered: Quietly

House Bill 4110 passes the House, requiring insurance companies to maintain coverage for people in police custody awaiting trial, putting taxpayers off the hook for those medical expenses.

The amendment that would restrict pharmacists from dispensing generic insulin slipped out of the Capitol in the same way it appeared -- quietly, in an irregular committee at an odd hour.

The Joint Capital Construction budget subcommittee voted to delete the amendment from House Bill 4110 at its 7:45 p.m. meeting on Wednesday. The full Ways & Means Committee approved HB 4110 without the amendment at its 8 p.m. meeting on Thursday.

House Majority Leader Val Hoyle, D-Eugene, had used her influence as chair of the House Rules Committee to insert an amendment into an unrelated bill for the benefit of a political donor, Eli Lilly. That amendment would have protected the pharmaceutical giant against competition from generic insulin which may receive approval from the U.S. Food & Drug Administration as early as next year.

But an article from The Lund Report cast daylight on the deal, derailing the measure.

The underlying bill survived and advanced to the House floor on Friday, which may help counties save millions by requiring health insurers to pay the medical bills for jail inmates who have paid their insurance premiums. The requirement is limited to those in local police custody who have not been convicted, and does not force insurers to pay for injuries endured during the act of an alleged crime.

“We as taxpayers eat this expense for medical care even though he’s paid premiums on those medical expenses,” said Rep. Mitch Greenlick, D-Portland.

Greenlick said it would simply require insurance companies to pay claims for policies they sold, regardless if the insured person was able to make bail.

The Capital Construction Committee further amended HB 4110 to cut some slack for insurance companies, capping payment for in-jail medical services to 115 percent of Medicare and giving insurance companies the ability to direct police to send jail inmates to their in-network providers when practical.

The Eli Lilly amendment produced little chatter at the subcommittee hearing and none in the full budget committee. Within the Capitol, discussion of the bill had been obscured and couched in arcane terms like biosimilar -- medical jargon for generic biological medicine.

By using such language, the actual ramifications of the bill -- overriding Food & Drug Administration policies on generic medication -- had little discussion.

The change in law would have added products like generic insulin into a law from 2013 that prevents pharmacists from substituting complex brand-name biological drugs with biosimilar, or generic equivalents. The law was hypothetical -- no generics for complex biological drugs used to treat cancer, AIDS and Hepatitis C have even received approval from the FDA. Since SB 460 expires in 2016, the law would likely disappear before any biosimilar drugs had reached the market.

But that was not true of insulin. The drug company Sanofi-Aventis will lose its patent for Lantus next year, opening a window for generic competition from Merck. Although Eli Lilly is developing its own generic, a lawsuit from Sanofi has embargoed that drug until July 2016.

Bill Cross, the lobbyist for the Oregon State Pharmacy Association, told The Lund Report that the amendment in HB 4110 could have driven up the cost of medicine by capturing many more drugs than just insulin. Patents have run out or are nearly expired for two drugs for rheumatoid arthritis -- Humira and Enbrel -- both of which cost insurers $33,000 per member per year.

Another drug, Copaxone, used to treat multiple sclerosis, has a patent that will expire in several months. That drug, which costs $59,000 per member per year, brings Teva Pharmaceuticals a reported $4 billion a year in revenues.

Editor's Note: An earlier version of this article incorrectly put drug costs per month rather than per year.

Christopher David Gray can be reached at [email protected].

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