ORLANDO -- Family physicians are frustrated with the rising cost of prescription drugs and they took that frustration to the the American Academy of Family Physicians Congress of Delegates today demanding action from the AAFP board.
The delegates made their case with a trio of resolutions debated before the AAFP's advocacy reference committee.
Those resolutions would allow Centers for Medicare and Medicaid Services (CMS) to negotiate discounts for drugs covered under Medicare Part D; back legislation allowing Medicare to manage the Part D formularies; and grant CMS permission to import drugs or re-import from Canada.
In general the delegates testifying supported the resolutions, but they often disagreed about what role and how much power formularies should have.
A universal formulary would simplify doctors' jobs, a Minnesota physician said.
"Formularies make it confusing for us and for patients" one physician countered, while another shuddered at the thought of a large, government-run formulary.
Another resolution targeted high prices for life-saving medications. In the wake of the recent public firestorm over EpiPen pricing, resolution author Robert Eidus, MD, called such drug companies' strategies a "debacle that we have with price gouging."
Eidus, of the New Jersey Academy of Family Physicians, added that the EpiPen "is just at the center of the issue." The resolution calls for AAFP to advocate Congress for alternatives for patient access to the Epipen, and to ask FDA to fast-track a generic alternative to EpiPen and other popular life-saving medications "that may currently be subject to monopoly power."
Another resolution attacked direct-to-consumer advertising of prescription drugs, an issue that has gained traction at recent American Medical Association meetings. Several delegates asked the AAFP to go on record supporting an AMA proposal to ban direct-to-consumer drug and medical device advertising. One physician called the practice "very deceptive," while another said that the drug commercials' tag-line -- "Ask your doctor about ..." -- yields little value to patients while pushing doctors into a corner.
AMA will consider reiterating its ban recommendation in November, an AMA representative told the delegates.
Not surprisingly the opioid epidemic was not far from delegates' minds -- and when a proposal to remove pain as the "fifth vital sign" came up for review, the dimly-lit, drab conference room which was overflowing with more than 300 physicians erupted into cheers. Monitoring pain has not improved pain control, physicians said, and should not be used to penalize physicians or determine patient care.
The AAFP delegates will convene tomorrow to begin voting on these and other resolutions in sessions that will continue through mid-day Wednesday.