An Interview with Drug Cost Control Advocate Richard Gottfried

New York State Assembly Health Committee Chair Richard N. Gottfried
New York State Assembly Health Committee Chair Richard N. Gottfried

At NASHP’s 30th State Health Policy Conference, state leaders from legislative and executive branches across the nation gathered to talk about what they are doing to manage escalating prescription drug costs in their states. Several states have recently passed or proposed legislation to force more transparency in drug pricing or to try to regulate drug costs.

Richard N. Gottfried, a long-time proponent of drug cost regulation and member of NASHP’s Pharmacy Costs Work Group, took time at the conference to answer questions about the growing number of state legislative initiatives to rein in drug costs. Gottfried of Manhattan was first elected to the NY State Assembly in 1970, and has chaired the Assembly’s Health Committee since 1987, working to expand publicly-funded health coverage and protect patient autonomy. He also serves on NASHP’s Health Care Access and Financing Committee.

How did you get involved in drug cost regulation?
If you’re involved in health policy as I am, you cannot do this work without confronting drug prices. For many years, my own thinking has been heavily shaped by what I’ve learned meeting with people from other states who were working to control drug costs. We need to learn from each other — none of us was born understanding the pharmacy industry.

Is controlling drug prices a liberal, blue state initiative?
It’s easy to be distracted by the fact that Vermont, Oregon, and California are in the lead on some of these issues, but on the other hand, Nevada recently passed drug cost control legislation and there are proposals to control drug prices in Utah and Oklahoma.

It’s really a question of whether you are fed up with the impact of drug prices on consumers and tax payers and employers and are determined to do something about it. There may be some degree of red or blue difference in how it’s done, but certainly there are people on both sides of the aisle working aggressively on this issue. The legislation we’ve been talking about in almost every case has passed with strong bipartisan majorities.

What’s the most significant thing that has happened this year?
There is a growing understanding that state governments are not powerless here, there are things individual states can do to protect their people. This is a long-standing principle of American government, whether it’s about abolition of slavery or women’s right to vote or child labor laws, some of the most important political developments in our government began at the state level.

What do you hope will occur in the next year in terms of drug cost legislation?
I think we’ll see a lot more states sharing ideas and developing new bills to regulate drug prices and getting them enacted. I often say we state lawmakers are in one of the few lines of work where plagiarism is encouraged, and a large part of NASHP’s job is to help states learn about what other approaches states are developing and spreading that information across the country.

Should drug companies be viewed and regulated like public utilities?
I’m not sure Americans are ready to go that far, but the problem is so severe and there’s so much bad behavior in the marketplace that people are fed up and want their elected government to do something for them.

What are the obstacles state lawmakers face in implementing drug regulation?
It’s the political power of drug companies, all the articles you read about how complicated drug pricing and marketing is, the fear raised by drug company propaganda that you will be depriving people from life-saving medication, and the feeling that this is too big for a state to tackle. All of those things are more mental obstacles than real ones. Unions and consumers and hospitals and doctors and employers who pay for most of our health coverage are also pretty powerful.

What would you tell state lawmakers who want to take some action to control drug prices?
It’s complicated, but that just means you have to pay attention and learn and stick to it