What is CSI’s Drug Savings Initiative?
The Commissioner of Securities and Insurance, Office of the Montana State Auditor (CSI) began diving into the high costs of prescription drugs shortly after Rosendale took office. The Drug Savings Initiative encompasses all of the actions CSI is taking to address problems within the pharmaceutical industry to protect Montana consumers and lower costs. The Drug Savings Initiative includes legislation, legal actions, research, education, dedicating staff to the project, and working with stakeholders to create solutions.
Why are prescription drug costs so high?
The prescription drug industry is incredibly complex and not at all transparent. There are many reasons for high costs: research and development, regulations, distribution, middlemen, pricing schemes, contract provisions, and even gag clauses. Some of these costs are unavoidable and necessary for delivering needed medications to Montanans. Other costs stem from the complex web of transactions among the numerous companies involved between the manufacturing process and the end consumer use.
What can be done about it?
Commissioner Rosendale and the staff of CSI have taken the lead in Montana on addressing this difficult issue. CSI Chief Legal Counsel Kristin Hansen has directed her team to engage in litigation, administrative action, legislation, collaboration, and education. Here are some of the specific actions CSI has taken and continues to make progress on:
- Drafted legislation for the 2019 Montana legislative session (see bill HERE)
- Taken administrative actions against pharmacy benefit managers
- Secured favorable settlement concessions in District Court from PBMs
- Advocated for the Legislature to prioritize a study of the pharmaceutical industry
- Led the research during the Legislature’s interim study
- Given presentations to interested entities on the results of CSI’s research
- Collaborated with interested parties in both research and drafting legislation
- Educating other states and members of Congress
- Hired a special projects coordinator dedicated to addressing the prescription drug issue
- Billings Gazette: Montana lawmakers will consider bill to lower prescription drug costs
“Montanans are being harmed by price gouging, kickbacks and other schemes. It’s time to put an end to those unethical practices.”
- Bozeman Chronicle: Pharmacy industry ‘middlemen’ settle Montana case
“A company that influences drug prices has agreed to pay up to $375,000 for an independent examination of its records.”
- National Public Radio: A Tough Negotiator Proves Employers Can Bargain Down Health Care Prices
“[Bartlett] now works for the office of the Montana insurance commissioner, which is taking on pharmacy benefit managers in a bigger way.”
- Montana Television Network: Rosendale takes aim at drug-benefit managers
“The pharmacy-benefit managers have had control over this industry like a cartel, and they feel like they don’t have to answer to anybody.”
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Meet the Team
Matt Rosendale is Montana’s insurance commissioner, also known as State Auditor. He has made tackling the extremely high costs of prescription drugs a top priority for his administration in line with CSI’s mission of consumer protection and advocacy.
Kris Hansen is CSI’s Chief Legal Counsel and has built a team dedicated to taking on prescription drug costs. Before joining CSI, Kris was a state senator, served in the Montana Army National Guard, clerked for the Montana Supreme Court, and worked for the CIA.
Marilyn joined CSI following her work saving the state’s health plan millions of dollars per year. As Special Projects Coordinator, Marilyn uses her expertise as a CPA to dive into the details of the prescription drug industry’s pricing schemes.
As a CSI attorney, Derek has engaged in lawsuits with pharmacy benefit managers and collected data from PBMs to help CSI make informed policy decisions. He administered Montana’s 2017 special election at the Secretary of State’s office before joining CSI.
Mike Winsor is an insurance attorney with over 21 years of legal experience, including nine years as a private litigator and more than 12 years at CSI. He has expertise in contracts, insurance regulation, and complex transactions.