The Prescription Project has been invited to testify before the joint committee on health care financing tomorrow at the Massachusetts State House. The hearing is on a set of 17 health care reform measures called “An Act Controlling Health Care Costs and Improving Health Care Quality.” Health Care For All, a Massachusetts-based consumer advocacy organization that worked closely with legislators on the bill, has all you ever wanted to know about this bill and more on its website.

The RxP team is especially jazzed about five provisions in the bill to improve cost and quality in prescription drugs. They include:

  • creating drug formularies based on evidence-based drug effectiveness review information
  • providing for a statewide academic detailing program to educate physicians on cost-effective drug options like generics and to counter unscientific drug marketing
  • banning the sale of prescriber information to drug marketers
  • prohibiting gifts to prescribers from drug companies, and requiring disclosure of industry marketing payments
  • eliminating copays and coinsurance for chronic and preventive care
The last one—or sweet 16 in the bill—at first doesn’t seem to fit with the cluster of prescription-related actions. Eliminating copays and coinsurance for preventive and chronic care? What does that have to do with pushy salespeople?

But what we take and whether we take the recommended dosage or get our prescription refilled on time often depends heavily on how much we have to pay. This is especially true for chronic diseases that require long-term therapeutic regimens to maintain. Annual exams. Family Planning. Diabetes and cholesterol medication. Precisely the things this bill proposes to eliminate patient costs on. Think of sixteen as a smart public health move with an Rx twist.

And that’s why this bill is so on track. Its whole cloth reform agenda extends the length of the health care field in Massachusetts, not just to certain sectors. It acknowledges the thick and sometimes tangled web of stakeholders and interests in play, and how cost and quality pressures fundamentally affect how a person seeks and receives medical care.

And though its objectives are bold, the proposed act is not mere pie-in-the-skyness. This bill has to be wide-angle and comprehensive to address the super-wide-angle health reform that passed last year. That law—which requires every Massachusetts resident to obtain health insurance —allows for and demands that all players be at the table because when coverage is mandated, health care is everyone’s concern. This providence, which has made Massachusetts a leader on the national health care scene, demands a corresponding stewardship to ensure that the practice and delivery of that universal health care is safe, effective, and fiscally sound.

This bill—and tomorrow’s hearing—is that stewardship articulated: from making sure there are enough properly trained primary care physicians in the state, to requiring public accountability for all insurance rate increases, to ensuring the drugs a patient picks up at the pharmacy are the best ones he or she can get at the best cost. And as it stands on Beacon Hill, such stewardship comes in seventeen parts.