Members of the Oregon Health Policy Board expressed frustration this week with the slow pace of efforts to hold down public spending on prescription drugs.
Across the state’s Medicaid-funded coordinated care organizations, prison populations, public health efforts, and public employee health plans, different agencies and groups are negotiating separately to buy medications – and therefore losing the clout and bulk-buying power they’d have if they worked together. But coming together requires navigating a warren of bureaucratic rules, and also agreeing on the best medical choices for diverse patient groups.
At least four separate Oregon groups are involved in efforts to tackle the problem – State Pharmacy & Therapeutics Committee, CCO Pharmacy Directors Group, Pharmacy Cost Colaborative, Health Evidence Review Committee. On Tuesday, Trevor Douglass, pharmacy purchasing and Oregon Prescription Drug Program director with the Oregon Health Authority’s Office of Clinical Services Improvement, summarized challenges these groups face.
Policy board member Felisa Hagins, political director at SEIU Local 49, responded with a call to quicker action.
“This is our third presentation on what is going on in the pharmacy space,” Hagins said.
“We keep talking about the same problem and rehashing the same solutions, and aren’t developing anything new and creative. It doesn’t seem to me after three presentations that we are moving forward,” she continued. “We keep taking about pharmacy as if it is just applied to public purchasers, when it is a whole state of Oregon problem.”
Hagins called on the state to look beyond easy, obvious and traditional solutions to drug pricing.
“We are in the leading edge on health care coverage and we are sitting on our hands when it comes to this problem,” she said. “We need to lead on this situation. We need to make a decision soon. Not three months from now, not six months from now.”
Policy board member Dr. John Santa, a longtime Oregon healthcare leader who now works for a Boston-based medical company, added his own call to action – urging for any new pharmaceutical plan to incorporate understanding of the opioid epidemic.
“That epidemic is caused by the model,” of how prescription drugs are funded and dispensed, he said. “The existing model needs to be held accountable for that epidemic.”
Policy board Chairman Zeke Smith, chief impact officer at United Way of the Columbia-Willamette, urged balance – asking whether incremental progress was due to a lack of courage, as opposed to the complexity of the challenge.
“Is the reality that some solutions would have negative results for consumers?” Smith asked. “I want to peel that back and understand.”
Dr. Carla McKelvey, policy board member and Coos Bay-based pediatrician, also called for clarity, asking Oregon Health Authority staff to explain why progress has been so slow.
“In all three of these presentations, there’s been this dancing around of what barriers exist, and nobody wants to say what they are,” McKelvey said.
Douglass, the staffer whose presentation preceded the policy board discussion, as well as Jeremy Vandehey, pleaded their newness in the jobs. Douglass took his position in April, and Vandehey has been serving as Governor Kate Brown’s health care policy advisor, and only this month began service as administrator of health policy and analytics for the Oregon Health Authority.
“This is the third presentation on the topic, but this is my first foray into this arena,” Douglass told the policy board. “I think that with the new leadership, and with my desire to really put things in place to organize the workgroups that make up our collaborative, we will begin to be a little clearer about what has happened.”
“Come back next month and give us a plan that isn’t a plan for a plan,” Brenda Johnson, policy board member and CEO of a southern Oregon migrant healthcare organization, urged Oregon Health Authority staff.
“Let us take a stab at that and come back next month,” Vandehey responded.
The next Oregon Health Policy Board meeting will take place from 8:30 a.m.-12:30 p.m. Oct. 3 at the OHSU Center for Health & Healing on the South Waterfront.
Reach Courtney Sherwood at [email protected].
