At the 2020 Legislature, a frightening possibility on prescription drugs

There are plenty of bad ideas floating around the State Capitol, but this one deserves special attention: Some Minnesota policymakers want us to follow in the footsteps of a few states that have embraced a radical drug rationing policy that purports to lower the costs of prescription drugs. They seek to create a drug council that will decide what prescription drugs can and cannot be sold in Minnesota and at what price. It's a far-reaching and very scary policy idea that must not become law.

Lower prices at the pharmacy counter is a laudable goal and one that all legislators should be dedicated toward achieving. But to do so will require all of those involved in the health care supply chain — from drug manufacturers to insurance companies as well as hospitals and pharmacy benefit managers (to name just a few) — to come to the table. As is often the case in making laws, there's show help: creating an unelected, unaccountable body to make complicated drug pricing decisions, and then there's real help: working to develop market-based solutions that will help patients better afford their medicines. The so-called "Prescription Drug Affordability Act" is just another version of show help, which will do very little to help those suffering with chronic or life-threatening diseases who currently have difficulty affording their medicines and seek to have the widest array possible of treatment options.

The bill calls for the creation of a Prescription Drug Affordability Commission and Advisory Council that is modeled after several other state commissions. Many of those state commissions were designed to resemble an American organization called the Institute of Clinical and Economic Review, or ICER. ICER uses a methodology that is formally described as a "quality-adjusted life year" (QUAY) to establish a "dollar value to each remaining year of a sick patient's life."

Here's the ghoulish part: ICER attempts to figure out how much extending a patient's life is worth — they literally use the QUAY to make life-or-death decisions. And in Minnesota's case, those decisions would be made by an appointed body — kind of like a Metropolitan Council for prescription drugs.

The Minnesota legislation would empower the commission to review the costs of various prescription drugs and "set maximum reimbursement levels for drugs whose cost creates an affordability challenge to the state health care system or patients." That's a fancy way of saying that prescription drugs in Minnesota would have "price caps" leveled on various prescription drugs. And some breakthrough drugs might not even be sold in Minnesota under this proposal. Attorney General Keith Ellison would be empowered to enforce the various provisions of the law and to prosecute drug manufacturers with "appropriate criminal charges" for those who don't comply with the significant price controls and other mandates contained in the legislation, some of which require the annual release of proprietary information from drug manufacturers to state bureaucrats.

Several states have tried price controls and complicated drug reporting rules like those outlined in this proposal. Those regulations haven't lowered prescription drug prices for sick patients — they're tied up in court. But most important, new and innovative treatments could be kept out of reach of desperate Minnesotans who are chronically ill and desperate to try the newest treatment for their disease, all because of an unelected commission.

It all boils down to this: When you are diagnosed with a life-threatening disease, how much is an extra year of your life worth to an unelected, unaccountable, government bureaucrat vs. how much is it worth to you and your family? Will the bureaucrat in St. Paul know or care that your daughter is getting married next September or that your first grandson is due to arrive in early June? I doubt it.

Those life-or-death decisions are best left to a patient and their physician. These quality-of-life decisions cannot and should not be made by a government bureaucrat using a cost-benefit analysis of what a year of your life is worth.

Too many of our friends and neighbors struggle to pay health insurance premiums that cover very little. Let's work together to find reasonable solutions that will truly lower health care costs across the board for all of us rather than hastily adopting a shortsighted proposal that should literally scare us all to death.

Annette Meeks is CEO of the Freedom Foundation of Minnesota.