The Oregonian

Governor, lawmakers split over Hepatitis C drugs

SALEM -- Gov. Ted Kulongoski and the Oregon Legislature are battling over whether the state has the right to decide what types of drugs are prescribed to Oregon Health Plan patients with Hepatitis C.

An estimated 900 patients may be directly affected by House Bill 2480, which would prohibit the Department of Human Services from limiting the types of prescription drugs used to treat the infectious and potentially deadly disease. But if HB2480 became law, critics say, the pharmaceutical industry would be the biggest winner.

At issue is the state's ability to control prescription drug costs under the Oregon Health Plan.

"Drug companies are very powerful. They want to protect themselves," said Rep. Mitch Greenlick, a Portland Democrat who is also associate director of the Evidence-based Practice Center at Oregon Health & Science University.

Proponents of the bill -- ranging from grass roots organizations to two pharmaceutical companies -- say they understand the state's need to control prescription drug costs. But they argue that Hepatitis C is difficult to treat and physicians caring for Oregon Health Plan patients should have the full menu of drug choices.

"This is not a case where you can save a few dollars. People are dying of this disease," said Lorren Sandt, executive director of the Caring Ambassadors Hepatitis C Program, a national advocacy group based in Oregon City.

The 2001 Legislature created a law that included a list of lower cost drugs doctors must prescribe to Oregon Health Plan patients. The requirement did not apply to prescription drugs used to treat mental illness, HIV, AIDS and cancer. HB2480 would put Hepatitis C drugs in a similar category.

Hepatitis C is spread by blood contact and can be transmitted by IV drug use, sharing razor blades, body piercing or tainted blood transfusions. An estimated 61,585 Oregonians may be infected with the disease and the majority may not know it.

Untreated, Hepatitis C can lead to cirrhosis, liver failure and cancer. But treatment is expensive, costing between $20,000 to $36,000 for six to 12 months of drug therapy.

Though the governor's staff has voiced concerns, HB2480 has received broad bipartisan support.

Last month, the Republican-led House endorsed HB2480 on a 41-15 vote. The bill recently passed the Senate Rules Committee and is headed for a floor vote within the week. Observers say it has a good chance of passing the Senate and making it to the governor's desk.

On Wednesday, Kulongoski spokeswoman Anna Richter Taylor could not say whether the governor would veto the bill. But Taylor said he wants to protect the state's ability to provide the most cost-effective care through the Oregon Health Plan.

A recent evaluation found 27 percent of the Oregon Health Plan fee-for-services patients who started Hepatitis C drug therapy did not complete it. The wasted cost of ineffective treatment was estimated by the state to be as much as $22,000 per patient.

Barney Speight, a former administrator of Oregon's Office of Medical Assistance, said the state developed a protocol to ensure that the right people are matched with the right Hepatitis C drugs.

"The kinds of protocols and guidelines we've developed are not developed in a bureaucratic vacuum," Speight said. "But the pharmaceutical industry dislikes government-imposed approaches."

Hasina Squires, a lobbyist for Roche Pharmaceuticals, said HB2480 is not about government but about "allowing patients to access all types of treatment."

Sen. Alan Bates, D-Ashland, a family practice physician, comes down somewhere in between.

"The pharmaceutical industry will always be pushing their products," said Bates.

Still, Bates said he's willing to push for HB2480 -- and risk a governor's veto -- because doctors "not bureaucrats in Salem" should be making treatment decisions.

Michelle Cole: 503-294-5143; michellecole@news.oregonian.com