SB 11, An Act Concerning Prescription Drug Access And Affordability

TESTIMONY OF THE CONNECTICUT HOSPITAL ASSOCIATION
SUBMITTED TO THE HUMAN SERVICES COMMITTEE

Tuesday, March 11, 2025

The Connecticut Hospital Association (CHA) appreciates this opportunity to submit testimony concerning SB 11, An Act Concerning Prescription Drug Access And Affordability. CHA appreciates the opportunity to comment on the bill and supports Sections 10-11, 13-15, and 37. In addition, CHA requests an amendment to Section 17 of the bill.

Connecticut hospitals and health systems care for patients, strengthen the state’s economy, and support vulnerable communities across the state. Every day, they work to improve healthcare access, affordability, and health equity. Even as they face ongoing challenges, hospitals provide world-class care to everyone who walks through their doors, regardless of their ability to pay. Hospitals also support an exemplary workforce as the largest collective employer in the state, contribute significantly to the state’s economy, and invest in their communities addressing social drivers of health.

Anesthesia Limits (Sections 10-11)

CHA supports Sections 10-11 of the bill, which prohibit a health insurance carrier from imposing arbitrary time limits for general anesthesia and denying, reducing, or terminating reimbursement based on predetermined time limits. We believe this provision is critical, and we further emphasize the importance of not restricting critical care to patients.

Obesity Treatment (Sections 13-15)

The prevalence of obesity in Connecticut continues to rise with a significant increase observed over a decade. In 2011, adult obesity prevalence in Connecticut was 24.5%. In 2022, prevalence rose to 30.6%. Connecticut hospitals and health systems work in partnership with their community partners to reduce obesity by promoting access to affordable healthy food, promoting physical activity, and improving community spaces to support healthy lifestyle choices. Obesity has associated health risks such as hypertension, diabetes, cancer, joint and bone problems, and mental health issues that can be prevented with effective weight loss.

Section 13 of SB 11 requires the state to pursue cost-effective alternatives to brand name drugs prescribed to HUSKY Health program members for obesity treatment, such as glucagon-like peptide (GLP-1) prescription drugs approved by the federal Food and Drug Administration (FDA). Additionally, passage of Section 14 of SB 11 would provide an opportunity to bring together experts who can study and recommend pathways for maximizing access and minimizing the cost of such drugs for the treatment of obesity in the Medicaid population.

GLP-1 medications are a proven means to reduce weight and the associated risks of other chronic diseases due to obesity. Some of the associated benefits besides effective weight loss are improved blood sugar control and reduced risk for heart disease. With the recent approval of generic alternatives by the FDA, we have an opportunity to ensure all patients with Medicaid coverage can access this important and effective treatment. Section 15 of SB 11 expands the definition of “weight loss drugs” to ensure adequate coverage of qualifying medications.

A healthy diet and increased activity, when combined with GLP-1 medications, can lead to sustained weight loss and improved overall health. CHA supports this bill for its potential to improve the health of patients with obesity and reduce avoidable healthcare utilization and associated costs.

340B Provisions (Sections 17-18)

CHA supports Section 18 of the legislation but asks that the definition of “covered entity” in Section 17 be amended to reflect the federal definition of “covered entity” in section 340B(a)(4) of the Public Health Service Act.

The 340B program was established more than 30 years ago to allow hospitals and other covered entities to stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services. Access to drug discounts provided through the program assists eligible hospitals in meeting the needs of patients in the communities they serve.

Under federal rules, 340B-covered entities, which include hospitals, are allowed to contract with “one or more” pharmacies to provide pharmacy services and 340B drugs to authorized patients. There are comprehensive federal guidelines and audit and registration requirements that govern a covered entity’s use of contracted pharmacies.

Pharmaceutical manufacturers have sought to undermine and impede covered entities’ use of contract pharmacies — in contravention of federal guidelines and advice. These actions have been to the detriment of hospital patients and the communities hospitals serve, lessening the benefit of the 340B program, which is used to support the unreimbursed care for low-income Medicaid beneficiaries, uncompensated care (charity care/bad debt), and the community investments hospitals provide each year.

Section 18 of SB 11 would prohibit the actions by pharmaceutical manufacturers that deny, restrict, prohibit, and discriminate against the acquisition of 340B drugs by a pharmacy that is under contract with a covered entity. This is an important protection that we support.

Unfortunately, hospitals and the patients and the communities they serve would not benefit from the protections in Section 18 because the definition in Section 17 of “covered entity” excludes hospitals except for UConn Health Center. In 2023, hospitals in Connecticut provided more than $270 million in uncompensated care to patients and were underpaid for care provided to Medicaid patients by $1.4 billion. Access to the 340B program is a core part of supporting care for the community and for continued community investments.

340B hospitals in Connecticut need the protection provided by Section 18 of SB 11, and we ask that the legislation adopt the federal definition of “covered entity” at Section 340B(a)(4) of the Public Health Services Act, which includes hospitals that meet certain qualifications.

Prescription Drug Shortages (Section 37)

CHA supports efforts to address prescription drug shortages. Section 37 would create a task force to study emergency preparedness and mitigation strategies for prescription drug shortages. The task force would be required to identify prescription drugs at risk of shortage and make recommendations on how to mitigate any shortage.

Managing prescription drug shortages is a daily task for pharmacy staff at hospitals throughout the state. Managing shortages requires significant time by staff and considerable resources by hospitals to ensure that patient care is uninterrupted. We support action to identify potential shortages and limit their impact.

Thank you for your consideration of our position. For additional information, contact CHA Government Relations at (203) 294-7301.