critics' ties questioned
One part of the proposal would restrict the drugs Medicaid patients could use based on performance and cost. If a cheaper drug worked as well as its more expensive counterpart, it would join a list of preferred drugs.
At least four Colorado nonprofit organizations that oppose the measure have taken drug-industry money and, of those, three have drug-company representatives on their boards of directors. Representatives of these organizations say they oppose the proposal not because of any ties to the industry but because they believe it to be unfair and a potential danger to patients.
The industry group Pharmaceutical Research and Manufacturers of America opposes the proposal 'because they limit drugs for the sickest and poorest of the population,' spokeswoman Wanda Moebius said.
The proposal, spearheaded by AARP, will be introduced this week by state Sen. Steve Johnson, R-Fort Collins. The group believes that money saved using the list would prevent other Medicaid services from being cut.
The plan also allows for some flexibility. For example, patients who didn't do well with cheaper drugs could be approved for alternatives. If for some reason the alternative is not approved, the state would not pay for the prescription.
But the measure would allow doctors to prescribe all AIDS/HIV drugs and some mental health drugs without seeking state approval, said Kelli Fritts, an AARP lobbyist working on the proposal.
The state nonprofit groups opposed to the proposal are the Colorado Gerontological Society, Mental Health Association of Colorado, Epilepsy Foundation of Colorado and Colorado Cross-Disability Coalition.
Consumer advocates question those groups' opposition to the proposal because of their ties to the drug industry.
Daniel Borochoff is president of the American Institute of Philanthropy, a nonprofit charity watchdog. He said the groups would have more credibility in the debate if they didn't have industry connections.
'It gets dicier when you a have board members that represent interests that may conflict with those of the nonprofit,' he said. 'It would be better to not have those people on the board. a It gives the appearance of a conflict of interest.'
Fritts said the drug industry's financial and institutional ties to the nonprofits could
She said she understands the difficulty nonprofits have raising money 'but it would be my hope that they could put that aside and look at what's best for their people and not what's best for the industry,' she said.
Oregon, Vermont, Florida, Louisiana, New Hampshire and Michigan have enacted similar policies, according to the AARP.
Julie Reiskin, executive director of the Colorado Cross-Disability Coalition, said her group takes money from the industry, but that's not why she opposes the measure.
The drugs on the list may not work for the severely disabled people she represents, Reiskin said.
Many suffer from complicated health problems and can experience harsh side effects to drugs. A woman Reiskin worked with was blinded by a medication.
The drug industry does not influence her policy-making, Reiskin said.
Reiskin said she solicited donations and got $10,000 from Pfizer Inc. as well as a few thousand more from AstraZenejca, GlaxoSmithKline and Johnson & Johnson for a total of $14,500 last year. That's 5.26 percent of her total budget of $275,668.
The group also has a registered lobbyist for Pharmaceutical Research and Manufacturers of America on its board.
Lorez Meinhold, executive director of Colorado Consumer Health Initiative, said her organization does not accept money or members who have a financial stake in the outcome of health-care policy.
'If we take a position on the bill, we want it to be clear that we took that position because that's what the consumers want,' she said.
Eileen Doherty, executive director of the Colorado Gerontological Society, said she opposes the preferred drug list because it limits access and creates 'a two-tiered health-care delivery system, in the sense that people who are on the preferred drug list don't have access to the same drugs that I have because I pay for my drugs through my health care.'
She said she has a pharmaceutical consultant and a Pfizer representative on her board. But neither the board members nor the industry money have anything to do with her opposition to the drug list, she said. And the Pfizer rep, she said, hasn't been active on the board.
The organization's board is made up of people representing HMOs, nursing homes and seniors, which helps the board understand the issues affecting seniors, Doherty said.
But Borochoff said that is akin to arguing to leave a few foxes in the henhouse 'because they can give us some security.'
Doherty refused to disclose to The Denver Post how much drug company money her organization has received.
Last year, the Epilepsy Foundation of Colorado got about $11,000 from four drug companies, foundation executive director Catherine Benavidez Clayton said. Three of the foundation's 15 board members are drug company representatives from Pfizer, Ortho-McNeil and Novartis Inc., she said.
Benavidez Clayton said the drug contributions were used mostly for education and amounted to a small part of her $350,000 budget.
She said she opposes the regulations because she worries that listed medications will have worse side effects and that fewer epileptics will take their drugs.
More seizures lead to higher ambulance and hospitalization costs, she said.
'We're isolating pharmaceutical costs and not looking at hospital costs,' Benavidez Clayton said.
The Mental Health Association of Colorado also opposes the proposal unless all mental health drugs are exempted, executive director Jeanne Rohner said.
'We believe that the psychiatric medications are not like other drugs within a class because even subtle differences a can have a huge impact on someone with a mental illness,' she said.
The association has no industry representatives on its board, but it took about $30,000 from the drug industry last year, Rohner said. That includes a legislative education day sponsored by drugmakers Eli Lilly and Wyeth-Ayerst and the Pharmaceutical Research and Manufacturers of America.
The money, she said, came with 'no strings attached' and was used to fund things such as speakers and health fairs. Her total budget, she said, was about $1.2 million.
"If we were
taking money from pharmaceutical companies and driving a pharmaceutical
agenda, a I think that would be a problem," Rohner said. "But
we're totally in charge of our program."