Minnesota legislative season opens: Saving health care insurance for poor, drug companies on the hot seat

Drug companies face bills that require disclosure of industry payments to doctors and funding for medication waste disposal.

ST. PAUL, Minnesota–With the Minnesota legislative session in full swing, here’s a look at bills of particular importance to the state’s health care community:

Saving GAMC– Lawmakers are racing to save General Assistance Medical Care, the state’s health insurance program for 36,000 poor residents. Due to Minnesota’s budget deficit, Gov. Tim Pawlenty has eliminated funding for GAMC, which runs out of money in April. The state plans to temporarily shift the enrollees to MinnesotaCare, a subsidized insurance program for workers can’t afford or denied coverage from private payers, for six months.

Not surprisingly, hospitals, doctors, and nurses have opposed Pawlenty’s decision. Eliminating GAMC will just push poor residents to seek treatment at pricier emergency care facilities, forcing hospitals to absorb the cost, said Janice Hennings, a spokeswoman for the Minnesota Hospital Association.

Yet the Minnesota Medical Association (MMA), which represents 10,000 doctors, is opposing a Democratic plan to extend GAMC for 16 months by cutting reimbursement rates to GAMC care by 50 percent. Instead the MMA proposes raising alcohol and tobacco taxes.

“We must ensure continued coverage for this population, but we cannot solve it by passing the cuts onto the clinics and hospitals that all of us rely on to keep us healthy and treat us when we are ill,” MMA Chair Dr. David Thorson testified Thursday a Senate hearing. “Although efforts to raise revenue can be politically unpopular, the MMA supports a balanced approach to solving our fiscal problems, including raising broad-based taxes if needed. Continuing to try to cut our way out of this problem will only cause greater problems down the road.”

Banning gifts– In recent months, a new group called the Minnesota Prescription Coalition (MPC) has attracted enormous media attention for it support of bills to ban gifts from pharmaceutical and medical device companies to doctors and prohibit drug companies for using advanced data mining techniques to market products to doctors.

Some of these ideas are not new but what makes MPC notable are its influential members: the Minnesota chapter of AARP, Medica, HealthPartners, Allina Hospitals and Clinics, Hennepin County Medical Center, and the AFL-CIO.

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“We encourage prescribing medications based on the best clinical evidence and reducing the conflict of interests that works against that,” said MPC spokesman Peter Wyckoff.

Influencing doctors through gifts and marketing leads to decisions that are not based on science, which results in reduced patient safety, inflated costs, and poor medical outcomes, he said.

While the drug industry predictably opposes the measure, LifeScience Alley, the state’s top medical device lobby, also rejects it. The proposals discourage doctors from working with industry to create innovative new therapies, said Frank Jaskulke, LifeScience Alley’s Members Services Manager.

The House bill, introduced Thursday and authored by Democratic Rep. Tina Liebling of Rochester, states: “it is unlawful for any pharmaceutical manufacturer, or, wholesale drug distributor, or medical device manufacturer, or any agent thereof, to offer or give any gift, or to request another person to gift to a practioner.”

The legislation also requires drug and medical device companies to report annual payments to the state.

In general, medical device makers have opposed state laws that govern product liability and conflict of interest, preferring clear national standards. The bill exempts “reasonable” payments to doctors for training and conference expenses, consulting agreements, royalties and intellectual property. But what’s reasonable in Minnesota might not be reasonable in Maryland, industry officials say.

Medicine disposal– Democratic Rep. Paul Gardner of Shoreview has introduced a bill requiring drug companies to fund and operate a “product stewardship program” that tracks, collects, and disposes unwanted medications. Prompted by research that shows traces of pharmaceuticals are appear in lakes and rivers, though not yet in Minnesota, Gardner says he wants a program similar to disposing old electronics.

But Jaskulke of LifeScience Alley says the bill overstates the amount of contamination (“the equivalent of two sugar cubes in a Olympic-sized swimming pool”) and imposes unnecessary costs on drug companies, which will ultimately drive up prices for consumers.

Angel Investment Tax Credit– A broad coalition of Minnesota’s technology community, including the University of Minnesota, LifeScience Alley, RainSource Capital, Twin Cities Angels, and the Minnesota High Tech Association support a bill authored by Sen. Kathy Saltzman that calls for a four year, $40 million tax credits for people and funds that invest in start-up companies like medical devices, pharmaceuticals, and nanotechnology.