Much lobbying has shifted from the federal level to the state level, especially when it comes to laws that make it harder for pharmacists to substitute cheaper generic drugs for high-cost ones, Liz Essley Whyte and Ben Wieder report for the Center for Public Integrity. "The laws in many cases require the pharmacist to take extra steps
before dispensing the cheaper drugs, including notifying the doctor,
retaining extra records or, in some cases, getting patient consent."
The center's analysis of five years of lobbyist registrations, compiled by the National Institute on Money in State Politics, found that "since 2010, the number of entities with either in-house lobbyists or part-time hired guns working in the states has grown more than 10 percent," Whyte and Wieder write. "That means, on average, every state lawmaker was outnumbered by six companies, trade associations, unions or other groups angling for their attention from 2010 to 2014."
A 1997 study by the University of Iowa found that "not a single entity had lobbyists registered in all 50 states," Whyte and Wieder write. But in 2013, "at least nine companies and interest groups lobbied in every state: AARP, the American Heart Association, AstraZeneca, AT&T, Express Scripts Holding Co., the National Federation of Independent Business, the National Rifle Association of America, Pfizer and PhRMA." (Center for Public Integrity graphic: Growth of state lobbying)
"In general, drugmakers favor laws that allow them to sell drugs widely
at the price they set, often asking lawmakers to force insurers or
government to pick up the tab," Whyte and Wieder write. "Drug companies ask state lawmakers to make sure Medicaid or other health plans cover their products. They ask for drugs to be distributed widely, such as Mylan Inc. asking states to allow schools to stow EpiPens for any child who has a severe allergic reaction—even without a prescription. Painkiller makers such as Purdue Pharma LP resist efforts to restrict prescriptions, as the opioid epidemic claims lives."
Opponents say these laws make it less likely a pharmacist will substitute a biosimilar—less costly drugs that function in much the same way as more expensive ones—"and more likely to instill doubt in patients about the alternate drugs," Whyte and Wieder write. "That could mean fewer patients get access to cheaper versions of specialty drugs that treat a range of diseases, including cancer, hepatitis C and Crohn’s."(Read more)
The center's analysis of five years of lobbyist registrations, compiled by the National Institute on Money in State Politics, found that "since 2010, the number of entities with either in-house lobbyists or part-time hired guns working in the states has grown more than 10 percent," Whyte and Wieder write. "That means, on average, every state lawmaker was outnumbered by six companies, trade associations, unions or other groups angling for their attention from 2010 to 2014."
A 1997 study by the University of Iowa found that "not a single entity had lobbyists registered in all 50 states," Whyte and Wieder write. But in 2013, "at least nine companies and interest groups lobbied in every state: AARP, the American Heart Association, AstraZeneca, AT&T, Express Scripts Holding Co., the National Federation of Independent Business, the National Rifle Association of America, Pfizer and PhRMA." (Center for Public Integrity graphic: Growth of state lobbying)
Opponents say these laws make it less likely a pharmacist will substitute a biosimilar—less costly drugs that function in much the same way as more expensive ones—"and more likely to instill doubt in patients about the alternate drugs," Whyte and Wieder write. "That could mean fewer patients get access to cheaper versions of specialty drugs that treat a range of diseases, including cancer, hepatitis C and Crohn’s."(Read more)
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