Cammie LaValle of Lakeville is a patient who relies on pain medication for her well-being. She has complex regional pain syndrome, which leaves her with “severe, unrelenting pain.”
After years of trying various medications, LaValle finally found one that works for her – prescription opioids. She says because of the many regulations put in place, her prescription tends to be unpredictable and often costly.
Her medication cost $200 more from one month to the next, despite being the same dosage, manufacturer, pharmacy and insurance plan, she said.
“I had no idea of that until I went to pick up the prescription. I’m also a disabled person, and we are a one-income family. You budget for things like this; you budget for your health care. When you have an additional $200 that you don’t anticipate, that does put families in a bad situation,” LaValle said.
A proposed portion of a Minnesota House omnibus bill adds to her worries. If passed, it would eliminate a part of a statute, known as the sunset provision, which allowed fees on opioid makers to be reduced once those companies reached above $250 million in settlements with the state.
The bill, HF2847, authored by Rep. Mohamud Noor, DFL-Minneapolis, additionally seeks to address high turnover rates of direct support professionals in the state and improve the workforce by providing good-paying jobs. But pain management advocates believe that a part of the bill will do great harm.
“Those pharmaceutical companies did horrible things, which killed my son. That’s what put me where I’m at here because my son died of an opioid overdose back in 2011 when things were just completely out of control. So I, of anybody in this whole body, should be the angriest, the most frustrated,” Baker said. “(Pharmaceutical companies) admitted screwing up; they’re paying billions of dollars to lawsuit settlements around the country. They’re paying a heavy price, and I just don’t think they have to continue to be hit on and beat on.”
Not agreed on from the start
In 2021, the Attorney General’s Office joined a $26 billion national settlement with pharmaceutical distributors McKesson, Cardinal Health, and AmerisourceBergen, and opioid manufacturer Johnson & Johnson. These settlements will bring more than $300 million into Minnesota over the next 18 years. In December 2022, the Attorney General’s Office joined five multistate settlements worth $20.4 billion, of which Minnesota’s share could be around $235 million. Minnesota cities and counties will use funds from these settlements for remediation programs and efforts to combat the opioid crisis.
On April 25, the omnibus bill, which includes the repeal of the sunset settlement, was heard on the House floor.
“The changes that are being proposed today are problematic, and they trouble me,” Baker said.
Olson and Noor did not return MinnPost’s messages seeking comment about the sunset provision.
Baker said Minnesota is going to get around $500 million from lawsuits with opioid manufacturers, and he estimated that the higher fees for manufacturers would end by 2031.
“We said if we hit $250 million in the state of Minnesota, we will blink this back off to the new and more reasonable licensing fees,” he said. “We’re gonna sunset this higher fee to a new level, a new normal level, which is much higher than it was, but it does bring down the really high fees right now that we’re collecting because of the ability from either lawsuits or licensing fees.”
What will change?
The application fees for licensure and registration of various professions, including drug wholesalers and manufacturers, have also increased in the legislation. Baker feels the inclusion of the sunset provision was a key element to why the original increases for application fees passed in 2019.
“Had there not been a sunset agreement back then, it would’ve never passed in the first place,” he said. “I want to leave that alone. That was our promise. We made a deal, and we have to stick to that deal.”
Dr. Todd Hess, a pain management specialist who previously ran a clinic in the Twin Cities, and who now speaks for fee on behalf of pharmaceutical companies, feels similarly. Hess, who retired a year ago, thinks this will increase costs and lower access for patients.
“The state of Minnesota could have $500 million, and most of that goes toward addiction, and yet then you’re gonna raise the fees on my patient’s legitimate opioids when you already have half a billion dollars?” Hess said.
The House passed the omnibus bill 70-60 and sent it back to the Senate, where Sen. John Hoffman, DFL-Champlin, is its sponsor. The Senate version does not include repealing the sunset provision. On May 2, some of the differences, including that one, will be discussed in the House-Senate conference committee.
Impact on pain patients?
The pain for LaValle’s syndrome is 42 out of 50 on the McGill Pain Index.
“This is higher than amputation, unprepared childbirth, and I wouldn’t believe it if I didn’t experience it myself. This is severe, unrelenting pain,” she said. “This has been a long battle for me, and so I am trying to protect not only access of the medications for myself and so I can have a better quality of life and have more functions but also all Minnesotans who are dealing with this.”
Hess believes that the extra costs for manufacturers and wholesalers would impact those who rely on these medications to function daily. LaValle said those medications allow her to continue physical therapy and strengthening.
“Because I have had access to pain medications, I’m able to do the physical therapy more. I’m able to do more exercises and more strength training. I’m able to do the dishes. I’m able to do laundry. Last summer, I even mowed part of my yard,” she said.
Hess said many pain management patients already have issues receiving their medications – and the proposed changes add to their fears.
“What got me concerned about this bill was that it’s just one more increased cost that will be passed on to my pain patients,” Hess said. “Many of my patients are already on disability or end of life, or have a severe chronic illness and don’t have the means that the rest of us do to pay for these medications.”
0 Commentaires