July 16, 1999

The Joint Committee on Health Care recently held a state house hearing on a bill that essentially would raise prescription prices for many patients by discouraging them from obtaining less expensive generic medications. Because of the testimony of two MGH employees and others in opposition to the bill, any action on the proposed law now is significantly delayed.

Harold DeMonaco, director of Drug Therapy Management for the MGH and the Massachusetts General Physicians Organization, and Roger Snow, MD, MPH, of Internal Medicine Associates, testified against House Bill (HB) 1935. This bill would amend an existing law that created the Drug Formulary Commission (DFC) and empowered it to develop a list of interchangeable drug products. The commission produces a list of generic drugs that are "therapeutically equivalent" to brand name drugs and are approved by the US Food and Drug Administration (FDA).

Under this law, which was passed in 1976, a pharmacist is required to dispense a generic version of a drug, which can be between 20 and 60 percent less expensive than a brand name drug, unless a physician mandates the brand name drug be used. The DFC also has the ability to recommend the removal of a drug from the list if scientific data shows that the generic is clinically unacceptable as a replacement for the brand name drug.

HB 1935 would require that certain brand name drugs be added to the formulary list, which means that the less expensive generic drugs could not be substituted unless consent was given by the patient and the doctor.

According to DeMonaco, HB 1935 implies that the existing FDA regulations governing therapeutic equivalence of generic drugs are flawed. "There is no compelling scientific data to support the idea that the current system of approving generic drugs is not effective," he says. "This legislation would needlessly add to the already high costs of drugs and would have a direct impact on such vulnerable patient populations as senior citizens."

DeMonaco says that this bill also would add to the public's misconception that generic drugs are of lower quality than brand name drugs. "Generic drugs that are deemed therapeutically equivalent can be substituted for the name brands," he says. "There is no scientific data to support the claim that generic drugs are inferior."

After the testimony of DeMonaco, Snow and several other opponents to the bill, HB 1935 was sent to committee for study, which, according to Jeff Lockwood of Partners Government Relations, basically stops the bill's progress until the next legislative session.