Billions on the line for consumers and Medicaid with the coming pay-for-delay decision

  ·  Health Policy Hub

In the next two weeks, the Supreme Court will likely rule in the FTC v. Actavis case, and decide whether pay-for-delay – when drug companies pay their competitors to not introduce a competing generic product – can continue. The Boston Globe editorial board noted that “few cases before the Supreme Court this session could have more direct impact on consumers’ pocketbooks” than this one. Consumers have "billions of dollars on the line" with the Court's decision. (USA Today). This increasingly common practice of pay-for-delay affects generic versions of as many as 142 different brand-name  drugs, according to our analysis of FTC reports.

In an open letter to the Court released today, 31 state and national organizations urge the court to end these back-room pay-for-delay deals.  These groups – health plans, disability advocates, providers, and consumer advocates -- all know the most effective way to lower a drug's cost, and make it broadly affordable, is to make sure a generic becomes available as soon as possible.

We saw proof of this last year, when spending on brand-name drugs declined in the United States for the first time in more than a decade, largely due to the wave of new generic drugs that became available in late 2011 and during 2012. Drugs like Lipitor and Plavix, which cost more than $200 a month, became available as generics for less than $20 a month. Tens of millions of people switched to the generic prescriptions.

A good ruling by the Court on 'pay-for-delay' will help protect consumers from what the Washington Post calls “illegal collusion” by the drug companies. The Court’s impending ruling will impact the ongoing out-of-pocket costs for consumers.

And as millions of currently uninsured consumers are slated to join public and private health plans in a few short months under the Affordable Care Act, true competition between drugmakers is a critical component to keeping health care accessible and affordable.

In the prescription drug market, like many marketplaces, we all rely upon competition to drive down prices, and on regulation to prevent collusion and preserve healthy competition. For this reason, our nation’s anti-trust officials – State Attorneys-General and the FTC – are all asking the Supreme Court for the chance to enforce anti-trust laws. The Court should rule against pay-for-delay, and give regulators the chance to promote competition, and  help make drugs more affordable for millions of consumers.