Daines visits senior citizens in MC

Mckenna Dosier Star Staff Writer
Monday, August 12, 2019
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STAR PHOTO/McKenna Dosier
Sen. Steve Daines met with Custer County citizens last week at the Drop-In Center to discuss the rising cost of prescription drugs.

The rising costs of prescription drugs weigh heavily on many Americans minds, especially seniors.  

Jan Pratt, coordinator of the Custer County Council on Aging, said she was tickled that Daines was making a stop in Miles City to discuss the issue.

U.S. Senator Steve Daines stopped by the Drop-In Center in Miles City last week to meet with seniors and other citizens interested in the topic. Daines is a member of U.S. Senate Committee on Finance, which has been one entity of government that’s been tackling the rising costs of prescription drugs.

The committee has responsibilities for all taxes, all trade and Medicare, Medicaid and social security. Daines said they have been working on a piece of legislation relating to Medicare part B, that would help lower out of pocket costs of prescription drugs.  

Many attendees agreed with the sentiments and were anxious to know why the costs were so high and rising.  

“I know in my own experience, I’ve been complaining to the druggist everytime I go to fill up here lately. The costs are going up from what they were a year or two years ago,” said Jim Barnes, president of the Drop-In Center.  

“It’s like the price of gas. You get reminded of that every two weeks when you’re filling up your tank, so you always keep in mind the price of gas,” said Daines. “Similarly, on prescriptions drugs, you’re often times having to get refills on a fairly frequent basis so you’re reminded of that out of pocket cost everytime you go to the pharmacy to get that prescription drug.”

Before the finance committee adjourned for the August work period, they passed a bill that would create $25 billion in savings for out of pocket costs for prescription drugs. One part of the bill was looking at the issue of catastrophic care, a situation with a catastrophic event that could lead to a large prescription cost. Daines said for those faced with that event, they could have to pay up to 5% of that total drug cost.  

“For a senior that can absolutely be financially devastating,” he said.  

This bill would shift costs from being percentage based to a $3100 flat cap.

Another provision of the bill placed a cap on list prices of prescription drugs so they cannot exceed inflation.  

“I’ve been digging into the price of prescription drugs,” said Daines. “It’s a very complicated pricing scheme.”

 Daines said he was in business for 28 years so he had a handle on pricing systems but prescription drugs is a very different system.  

“Pharmaceutical Benefits Managers negotiate with pharmaceutical companies on behalf of a group of companies or pool of people so they leverage the volume discount back in, to get a lower cost,” said Daines. “Well here’s one of the problems, these pharmaceutical benefits managers have been bought up by the insurance companies so you’ll have these insurance companies that buy the pharmaceutical benefit managers so now they’re one company. So when a pharmaceutical company wants to deliver a rebate or a discount that the PBM neogties, often times that discount will go back to the insurance company instead of going to the consumer.”

Daines said that’s part of what’s driving out of pocket costs up.  

Pratt asked if the middleman, the PBM, can be controlled, something Daines said got back to issues of transparency with pricing. One of the points of transparency is having a conversation with your care provider, before it gets to the pharmacy. Daines said the doctor and the patient should look at the choices together and decide what is best.  

“When was the last time you had that conversation? Not very often,” said Daines. “You’re having a conversation with the pharmacist, at that point the prescription is written and you don’t want to be going back up the street to talk with your physician.”

Daines said there have been many PBM and pharmaceutical company CEO’s in front of the Senate to testify and they are left still unsure why the discounts are going to companies and not to consumers.

Pratt said she’s been pleased that her physician and pharmacist typically ask if she would like brand name or generic prescriptions. She also asked about doctors receiving incentives for prescribing certain drugs and if that had any effects on costs.  

Daines said often times doctors will receive a cost plus type of payment, a set number then an added 6% of the drugs cost, which said he thinks is similar to a real estate commission. He said he’d like to see that moved to a flat rate.

“If it’s a higher priced drug, you’d be incentivized to prescribe a higher priced drug because you’re getting 6% on a higher number instead of a lower number so we want to make are we have the right incentives in place that incentivize doing the right thing for the patient,” said Daines.

Daines also said the finance committee is working to ensure pharmaceutical companies are providing samples of drugs to other companies in a timely manner, in accordance with intellectual property regulations, to allow generics or biosimilar drugs to be produced, which are often a lower cost.  

“I can tell you, President Trump is very supportive of these efforts. He’s heard loud and clear as we all have of concerns over the increase of out of pocket costs for healthcare and specifically prescription drugs, so the president is putting pressure on congress to act and that’s why I think with bipartisan support, and this bill that we passed out of the finance committee two weeks ago it was bipartisan, if you’re gonna get something done in D.C. right now, you’re gonna have to find bipartisan support,” said Daines. “So the president is putting a lot of pressure on Congress, and that’s a good thing, to find ways to lower the costs. As you know, the president is not real patient and that’s a good thing. He wants to see action taken.”

At the end of the meeting, district 19 state senator Kenneth Bogner, asked Daines how he felt about the recent gun violence and red flag laws.

Daines was part of a briefing with the director and deputy director of the FBI, about what is known about the mass shootings in El Paso and Dayton.  

On Aug. 3, a man opened fire at a Wal-Mart in El Paso, killing 22 people and injuring even more. Just one day later, a man opened fire in Dayton, Ohio, killing nine people and injuring many more. Daines said bother shooters created evil acts and had dark beliefs that the FBI is still investigating further.  

“I’m very concerned that there’s going to be a movement afoot in Congress to move towards more gun control which I dont think is the right answer. The Second Amendment is a constitutional right and additional gun control measures historically have shown us they don’t produce the outcomes we want to see,” said Daines. “The issue is that it’s not about the platform, the type of firearm, it’s about addressing the issue you have evil people.”

He also mentioned a stabbing in California on Aug. 8, that left four people dead and two injured. Daines said the malicious attack didn’t receive nearly as much press coverage as the recent shootings but proved that evil people will find ways to commit evil acts.  

“What I want to see is, let’s complete the investigation, let the FBI do its work and let’s look at what we could do to prevent this from happening but I am concerned about knee jerk reactions that may come out of Washington D.C. that will be focused on gun control, which I don’t believe solves the problem and violates the second amendment rights that thousands of Montanans every day legally exercise their second amendment rights and ultimately what happens is the people who obey the law are hurt by these laws and the people that are criminals continue to break the law,” he said.

(Contact McKenna Dosier at mckenna.dosier@gmail.com or 406-234-0450.)