As a health care provider in Oregon, I recognize the need to address the cost of medications, which can be prohibitive for patients and undermine their ability to receive the care they need.
However, Senate Bill 844 and a new Prescription Drug Affordability Board is not the remedy to this problem. In fact, it will make it more difficult for Oregon patients to access care and receive their medications.
The flawed legislation will additionally pose an existential threat of insolvency to free standing infusion clinics, such as Evolve Health, which provide essential care to many Oregonians with chronic illnesses.
As part of the Evolve Health team, I help operate free-standing infusion centers that direct therapies for the management of chronic illness, including auto-immune and mental health disorders. We directly administer a multitude of infusion therapies for severe auto-immune disease, in addition to cutting edge treatment for severe depression and suicidal ideation. These treatments have been instrumental in allowing our patients to live healthier and more productive lives and have drastically improved the quality of life for hundreds of patients in our community.
SB 844 directly jeopardizes our ability to offer these treatments due to inequitable price controls that would be placed on some in the health care system such as doctors — while exempting other integral players in drug pricing, including insurers and pharmacy benefit managers. SB 844 prohibits physicians and other health care providers from billing above the upper payment limit determined by the proposed board. As a physician and small-business owner, I have no control over the cost of medications that are determined by the manufacturer and distributors.
Our medical practices do not have the leverage or purchasing power of large hospital systems or other facilities that may be able to acquire drugs at the mandated lower cost. Instead, we must pay the list price of these medications which will undoubtedly be higher than the cost ceiling mandated by the proposed legislation. This scenario would engender significant financial insolvency to free standing infusion centers, clinics, ambulatory surgery centers and physician offices. Physicians who are the only ones actually caring for patients on the front lines and their patients will be unfairly caught in the middle and punished by this legislation and the pharmaceutical wholesalers will continue to do business as usual.
Some may think SB 844 could help physicians by lowering medication list pricing. However, pharmaceutical manufacturers and distributors determine and set pricing on a national level, not on a state-by-state basis. They will not make a single state exception in their pricing construct to simply appease Oregon lawmakers. This would effectively punish Oregon medical practices and the patients they serve. SB 844, if carried out as it is legislated, will definitively force us to limit or end services we provide to our patients simply because we cannot afford to purchase these medications at the board's determined upper limit price.
When patients are unable to receive the care they need from our practice, they may be required to travel significant distances for treatment or cease their treatment entirely. Increasing the distance between a patient and their physician is not only a burden on the patient and their caregiver, but also jeopardizes continuity of care. It is irresponsible for the Oregon legislature to create increased barriers to care, making it more difficult for patients to receive the medications they need.
Physicians and their patients should not be collateral damage in this fight. As a healthcare provider in this state, I urge lawmakers to oppose SB 844 for the sake of patients who are their constituents.
Shawn M. DeRemer, M.D., is president and executive medical director of Anesthesia Associates Northwest and Evolve Health and Wellness.
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