The cost of prescription drugs and access continue to have a significant impact on national budgets and state decision-making. One strategy that has attracted attention is the idea of the massive, ”consolidated” or ”aggregated” purchase of drugs, which was designed to get a lower price for all those who are locked up. Since 1999, when Massachusetts approved an ambitious national ”mass Rx” plan, an increasing number of states, agencies and organizations have implemented, studied or encouraged mass procurement. This web report provides an overview and links to the laws, activities and analyses of this approach. Sometimes secondary wholesalers fill a void; they supply rural pharmacies or markets that do not reach national or regional wholesalers. But they choose stocks based on their customers` demand forecasts, price, margin and willingness to pay (Yadav, 2009). The cost of transactions required to deal with many suppliers and their generally poorer bargaining power encourage secondary wholesalers to store a variety of products or brands (Yadav, 2009). Established in 2002, the National Legislative Association on Prescription Drug Prices (NLARx) has described itself as follows: ”The National Legislative Association on Prescription Drug Prices is a bipartisan organization of legislators across the country who advocate for reducing the cost of prescription drugs and access to affordable drugs. Members of the District of Columbia and New England, as well as Pennsylvania, New York, West Virginia, Oklahoma, Texas, Alaska, Arizona and Hawaii are members of NLARx. For more information: NLARx website: www.reducedrugprices.org/ [1/2013] The Early History: Northeast Legislative Association on Prescription Pricing (NELA) In 1999, MPs from six states in New England, New York and Pennsylvania established the Northeast Legislative Association on Prescription Drugs to discuss the state`s regional and pharmaceutical activities. A core group first met in Vermont in December 1999.
The Association was officially established at a meeting of deputies in Maine in June 2000, with follow-up meetings in Rhode Island, New Hampshire, Connecticut and Massachusetts. In July 2001, participating legislators voted in favour of a coalition for fair prices for prescription drugs (PDFPC). The proposal states in part that ”the eight countries of the association could form a joint purchasing coalition to aggregate purchasing power with manufacturers and jointly award contracts on best pharmaceutical practices and benefit management services. The role of the association is to develop the concept of PDFPC and to propose a structure for the participation of each state. The member countries of the associations have about 43 million inhabitants, or more than 11% of the total population of the United States. At a meeting in October 2001, participants also voted in favour of extending the organization to 22 states. Although the organization has bipartisan membership and two cameras, it has members with very different views. For example, a dissenting member of the board of directors, Rep. Mazur from Vermont said: ”It seems that the NLA is all talkative and not an action. Hitting drugs seems counterproductive, because their intensive research, after more recent and better treatment, costs billions. NELA was redefined in August 2002, with a new name, NLARx, which replaced NELA and the statutes were amended to allow for expanded national membership.