ORLANDO -- The American Academy of Family Physicians voted to support legislation allowing CMS to negotiate drug prices for Medicare, during its Congress of Delegates meeting Tuesday, leaving at least one delegate pleased.
"This is very important," Marianne LaBarbera, MD, of New York, told 鶹ý. "To allow direct negotiation (would) improve access and would make a significant impact in costs."
The AAFP's reference committee on advocacy stipulated that AAFP's resolution cover Medicare broadly. "Medicare drug price negotiation should not be limited to Part D alone," the committee wrote in its report, issued late Monday.
LaBarbera said AAFP's decision should benefit seniors. "Cost is a huge factor in compliance," she said, noting that many seniors live on fixed incomes.
The decision followed debate on three Medicare drug price resolutions Monday. The committee then referred to the Board of Directors a measure calling for AAFP to back legislation allowing Medicare to manage Part D formularies and restore drug rebates for low-income beneficiaries, and granting CMS permission to import or re-import drugs from Canada. "The reference committee recognized the complexity of addressing formularies and drug importation," according to its report.
Also this week, delegates settled key measures regarding drug pricing and pain:
The Congress resolved to strive for eliminating pain's classification as "the fifth vital sign" regarding patient care evaluation. Monitoring pain has not improved pain control, physicians said during an AAFP hearing Monday, and should not be used to penalize physicians or determine patient care.
The Congress also adopted two measures aimed at helping patients procure life-saving medications and devices when a pharmaceuticals company has cornered the market. One calls for AAFP to publicly espouse and advocate for patients to have such access, while the other urges FDA and the U.S. Congress to prioritize and fast-track competitive alternatives to monopolized medications or devices such as the controversial EpiPen.
The latter resolution was added by delegates at the last minute, after the advocacy committee had shot down a similar resolution calling for AAFP to urge FDA and Congress to act.
The committee "discussed the broad impact of drug pricing, noting that drug pricing is an issue that could apply to other drugs beyond EpiPens in the future," according to its report, so the committee suggested the publicity-advocacy campaign "to address the broader impact of patient access to monopolized pharmaceuticals ..."
The committee also "encourages AAFP advocacy efforts to address drug pricing issues more broadly," its report said.
Still not everybody was pleased with a final result that overruled the committee to include pushing the FDA and the U.S. Congress: "I would like to challenge the board to do more," said one delegate who had supported the original measure.
The AAFP Congress also passed a resolution calling for establishing a national database per a national prescription drug monitoring program. The database would allow providers to review information about patients prescribed medications shown to lead to abuse, such as opioids. Delegates from Missouri, the only state without such a program (Washington, D.C,. has one too), co-sponsored the resolution and said they were embarrassed by their state's lack of action.
Finally, one day after the AAFP failed to take action on the single payer healthcare system, LaBarbera, a sponsoring delegate promised Wednesday that the measure would be back at next year's Congress of Delegates. LaBarbera echoed another sponsoring delegate's pledge during a committee hearing Monday.