[Congressional Record Volume 145, Number 158 (Wednesday, November 10, 1999)]
[Extensions of Remarks]
[Page E2329]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 PATIENTS' FORMULARY RIGHTS ACT OF 1999

                                 ______
                                 

                         HON. LUIS V. GUTIERREZ

                              of illinois

                    in the house of representatives

                       Tuesday, November 9, 1999

  Mr. GUTIERREZ. Mr. Speaker, I am pleased to announce that today I 
introduced the ``Patients' Formulary Rights Act of 1999'', legislation 
aimed at protecting the health of millions of Americans.
  This bill, if enacted, would ensure that prescription medications are 
dispensed for one reason and one reason only: for the sake of 
maintaining a patient's health--not for the sake of adding to a 
company's profits.
  ``The Patients' Formulary Rights Act of 1999'' would help ensure that 
people enrolled in a variety of health insurance plans have access not 
merely to the drugs that they need, but also to something just as 
valuable to them and to the medical professionals who serve them: 
information.
  The field of medicine has changed dramatically in recent years, as 
managed care has become the dominant vehicle for the delivery of health 
care. While these changes have led to some positive developments, it 
also has led to many alarming problems.
  In far too many cases, ``managed'' care has meant that it is the 
information available to millions of Americans, and to their doctors 
and pharmacists, that is being ``managed.''
  The practice known as ``drug switching'' is a dangerous example of 
patients being kept in the dark about the choices being made by others 
that will determine their health.
  Sadly, when a patient finally becomes aware that the drug originally 
prescribed by a physician has been changed, it is often only due to the 
unfortunate consequences stemming from that switch. In far too many 
cases, the fact that one drug has been replaced by another is only 
detected after such an incident of ``therapeutic substitution'' 
manifests itself in the form of a serious health problem: an unforeseen 
reaction, a debilitating side-effect or even a life-threatening 
complication.
  In other cases, of course, a change in drugs will result in no change 
at all in a patient's condition. And that is just as unfortunate, as a 
patient may grow weaker and sicker after taking a drug that is of no 
help in combating the illness from which he or she suffers.
  To add insult to injury is the fact that such changes are often the 
result of pressure applied by accountants and CEOs, which too often 
trump the prescriptions supplied by doctors and the protocols preferred 
by pharmacists.
  I believe that my legislation offers a practical, yet substantive, 
solution to this growing problem.
  My bill would require officials of health plans to take new, yet 
reasonable, steps if they insist on maintaining a list of formularies.
  Most notably, a health plan will be required to notify all 
participants, beneficiaries, enrollees and health care professionals 
that such a formulary is used.
  A complete list of all prescription drugs included in the formulary 
will be provided in full.
  Such notifications will be required at the time of a patient's 
enrollment, and a full and accurate notification of any changes in the 
formulary will also be necessary. Such an alert will be issued at the 
time that any such changes occur, and will be repeated in an annual 
update to enrollees.
  In addition, health plans will provide enrollees with a reasonable 
and understandable explanation of the practice known as ``drug 
switching'' or ``therapeutic substitution.''
  As a member of Congress, I am accustomed to hearing Pentagon 
officials invoke the need for secrecy for the sake of protecting 
national security. From time to time, I can accept that. However, I 
cannot accept a similar argument from officials of the health care 
industry. To protect the health of their beneficiaries--that is, to 
protecting their security--such a veil of secrecy must be lifted.
  Finally, my bill would also instruct current enrollees on steps they 
can take to ensure that they will continue to have access to the drugs 
as prescribed by their doctor regardless of changes in their health 
plan's formulary policies or lists. This would establish the continuity 
of care and doctors, pharmacists and other health care professionals 
agree is so crucial to the well-being of their patients and customers.
  I am very gratified that this bill has already received the support 
of Citizens for the Right to Know, one of the nation's largest non-
profit organizations representing patients and health care providers 
and health care trade associations. Their endorsement of and advocacy 
for this legislation will, I am confident, encourage other members of 
the House to join in me in fighting for such changes. I greatly 
appreciate their work on this important issue.

                          ____________________