Valeant's suggested co-pay help for government insurance patients more likely to be addressed in 2017/8, challenges expected - experts

17 Mar 2016

Valeant Pharmaceuticals' (TSE:VRX) interim CEO's recommendation that US law could be changed to allow drug companies to offer patient co-pay assistance to those on government programs is more likely to happen in 2017/18 than this year, Capitol Hill strategists said. Specifically, they noted any changes to Medicare, one of the government's largest healthcare programs, could possibly be addressed in potential healthcare reform legislation, but tension between Democrats and Republicans could derail efforts.

The concern over high drug prices and Valeant's poor reputation on Capitol Hill set a high bar on such efforts to change Medicare law, they added.

In prepared remarks for a recent House congressional hearing on drug pricing, interim Valeant CEO Howard Schiller urged Congress to consider amending laws that prevent co-pay coupons for patients in government-funded healthcare programs. Current regulation considers such assistance illegal kickbacks; drug assistance is limited to commercial insurance patients.

Valeant's point was in response to congressional inquiries into why the company was not doing more to financially assist patients, and patients on government programs brought up as examples, said a source familiar with the situation. In the commercial insurance market, Valeant probably spends as much as USD 1bn annually on patient-assistance programs (PAPs), he noted. The firm is not lobbying politicians to change the Medicare law but Congress may at some point consider it, he said.