Working People are Tackling High Drug Costs Through State-Level Reforms

By Shaun O'Brien and Christine-Silvia De-Gennaro

Despite all of the talk in Washington, D.C., about health care, Congress and Donald Trump have done nothing to deal with the No. 1 health care problem facing working people. Surging health care prices—especially prescription drug prices—are putting ever-increasing pressure on family budgets, workers' health plans and public health programs.

Consider this: the average annual cost of a brand-name drug grew to $5,807 in 2015, more than three times what it was in 2006 ($1,788), according to AARP’s most recent analysis of widely used brand-name prescription drugs. There also have been instances of immense overnight increases in the price of some generic drugs. For example, drug manufacturer Rodelis raised the price of Seromycin, its off-patent tuberculosis drug, from $500 to $10,800 for a 30-day supply.

While federal policy makers ignore the problem with drug prices, working people are calling on their elected state representatives to take action. In two states—Nevada and California—working people have won important breakthroughs this year, establishing new rules requiring prescription drug corporations to be more transparent about their prices and the reasons for them, especially when drug prices go up by large amounts.

In Nevada, a coalition of unions spearheaded by the Culinary Workers Union and including the Nevada State AFL-CIO led the fight to win enactment of diabetes medication price transparency rules. Under this first-in-the-nation law, corporations that manufacture essential diabetes drugs must explain any price increases that are larger than the price increases for medical care overall. Between 2002–2013, the price of insulin jumped by nearly 200%. With 12.4% of adult Nevadans having diabetes, and 38.5% with pre-diabetes, such a large price increase hurt working people and their health plans and raised serious concerns about whether these increases were justified. The new law also requires prescription drug manufacturers to provide the state with a list of all of their sales representatives operating in Nevada, and those sales representatives must submit annual reports disclosing their activities. Further, a nonprofit group in Nevada that advocates for patients or funds medical research has to disclose any payments, donations or anything else of value it receives from a prescription drug manufacturer or certain other drug-related corporations or lobbying groups. The legislation was sponsored by Sen. Yvanna D. Cancela, who represents Nevada’s District 10 and is a member of Culinary Workers Union Local 226.

In California, a two-year fight led by the California Labor Federation resulted in enactment of a law that requires prescription drug manufacturers to provide health plans, public purchasers such as the state’s large public employee health plan (CalPERS) and pharmacy benefit managers 60-day advance notice of price increases greater than 16% over a two-year period. The manufacturers also are required to explain to state regulators the factors behind the price increase. Pharmacy benefit managers are required to notify workers' health plans of these large price increases so steps can be taken to deal with these increases, including negotiating better deals when possible. Drug manufacturers also are required to notify the state when they start selling new expensive drugs (costing $670 or more per month). The legislation was authored by Sen. Ed Hernandez, who represents California’s 22nd Senate District and is a doctor of optometry.

The United States is the only major economy without any government oversight or regulation of prescription drug prices. Federal law gives drug corporations unchecked monopoly rights for brand-name drugs over long periods, and there is little, if any, competition in the sale of some generic drugs. Companies are not even required to explain or justify their pricing decisions. While patients and their private health plans are "free" to negotiate with drug companies, in reality they face a take-it-or-leave-it proposition: pay the company’s price or go without a needed drug.

With the new Nevada and California state drug price transparency laws, working people are sending a powerful signal that they want and need real action on health care prices. Requiring prescription drug corporations to justify big price increases is an important reform that could cause drug manufacturers to reconsider excessive price hikes, give workers' health plans better tools to negotiate fairer prices, and lead to improved prescription drug policies from federal and state lawmakers. Hopefully, Congress and President Trump are paying attention and will start making even bigger changes to bring down prices, like authorizing Medicare to negotiate prescription drug prices for seniors and people with disabilities, and stopping corporate abuses of federal patent laws.

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Reposted from AFL-CIO

Posted In: Allied Approaches, From AFL-CIO

Union Matters

Get to Know AFL-CIO's Affiliates: National Association of Letter Carriers

From the AFL-CIO

Next up in our series that takes a deeper look at each of our affiliates is the National Association of Letter Carriers.

Name of Union: National Association of Letter Carriers (NALC)

Mission: To unite fraternally all city letter carriers employed by the U.S. Postal Service for their mutual benefit; to obtain and secure rights as employees of the USPS and to strive at all times to promote the safety and the welfare of every member; to strive for the constant improvement of the Postal Service; and for other purposes. NALC is a single-craft union and is the sole collective-bargaining agent for city letter carriers.

Current Leadership of Union: Fredric V. Rolando serves as president of NALC, after being sworn in as the union's 18th president in 2009. Rolando began his career as a letter carrier in 1978 in South Miami before moving to Sarasota in 1984. He was elected president of Branch 2148 in 1988 and served in that role until 1999. In the ensuing years, he worked in various roles for NALC before winning his election as a national officer in 2002, when he was elected director of city delivery. In 2006, he won election as executive vice president. Rolando was re-elected as NALC president in 2010, 2014 and 2018.

Brian Renfroe serves as executive vice president, Lew Drass as vice president, Nicole Rhine as secretary-treasurer, Paul Barner as assistant secretary-treasurer, Christopher Jackson as director of city delivery, Manuel L. Peralta Jr. as director of safety and health, Dan Toth as director of retired members, Stephanie Stewart as director of the Health Benefit Plan and James W. “Jim” Yates as director of life insurance.

Number of Members: 291,000 active and retired letter carriers.

Members Work As: City letter carriers.

Industries Represented: The United States Postal Service.

History: In 1794, the first letter carriers were appointed by Congress as the implementation of the new U.S. Constitution was being put into effect. By the time of the Civil War, free delivery of city mail was established and letter carriers successfully concluded a campaign for the eight-hour workday in 1888. The next year, letter carriers came together in Milwaukee and the National Association of Letter Carriers was formed.

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There is Dignity in All Work

There is Dignity in All Work