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A closer look at N.H. pharmaceutical lobby



Monitor staff
Sunday, September 25, 2016

Data from the Associated Press shows New Hampshire ranked second highest in the nation in the number of Pain Care Forum lobbyists it had in proportion to the overall number of lobbyists in the state.

But that data doesn’t tell the full story. New Hampshire state law is broad when it comes to lobbying, requiring firms to register all their lobbyists, rather than a lead person to testify for a specific company.

“In some cases you may see X, Y, or Z corporation listed as a client of each lobbyist that may be in a lobbying firm,” said Assistant Secretary of State Dave Scanlan.

The Pain Care Forum is a group of organizations an AP and Center For Public Integrity investigation found actively lobbied state and federal politicians on legislation around opioids. Some of those organizations are pharmaceutical companies, while others were health care organizations including the American Cancer Society and the Arthritis Foundation.

New Hampshire has had an average of 20 registered lobbyists employed by members of the Pain Care Forum each year since 2006. In 2015, 22 lobbyists in New Hampshire represented members of the Pain Care Forum.

Lobbyists represent companies and organizations including PhRMA, Pfizer and Merck.

State law also requires that treatment and prevention advocacy groups like New Futures register as lobbyists.

With such a large New Hampshire Legislature, groups like New Futures play a key role in helping provide lawmakers information and research for bills focusing on treatment and recovery.

While the influence of pharmaceutical companies and allied care organizations is well-documented in other states, advocates and lobbyists in New Hampshire say most opposition to changes on opioids and treatment programs here has come from insurance companies and doctors.

The New Hampshire Board of Medicine was initially hesitant to begin the process of adopting new prescribing rules last year. Some feared it would put too many limits on a doctor’s ability to care for their patients.

And as the state’s heroin and opioid crisis worsened, many complained their insurance companies were not covering treatment the same way they would handle a medical claim.

State legislators put forth a bill mandating insurance carriers follow guidelines put forth by the American Society of Addiction Medicine when determining whether someone should be covered for substance abuse. The bill also dealt with patients wait time to get into treatment while insurance companies sort out what they will pay.

That’s not to say Pain Care Forum members didn’t try to sway New Hampshire legislators on other issues.

Back in February, as SB 523 – a bill requiring doctors to check the state’s prescription drug monitoring program each time they prescribe narcotics – was making its way through the legislature, state Sen. Russell Prescott received a letter from the American Academy of Pain Management.

Penned by the academy’s executive director, the letter asked New Hampshire lawmakers to consider the “significant negative consequences” the bill would have for the state’s patients and doctors, and opposed its passage.

“We believe that legislating this type of provision, rather than delegating to the appropriate licensing board, is dangerous and inappropriate,” the letter said.

The bill passed and will go into effect this year.

Advocates say they expect fewer opioid and drug treatment legislation at the start of the next legislative session in January.

Medicaid expansion and fully funding the state’s alcohol fund will be the two biggest priorities for advocacy organization New Futures.

But a lot of the work still to be done revolves around educating doctors and health providers of the new rules around prescribing, said New Futures Advocacy Director Kate Frey.

“I think that will really be the focus,” she said. “Most of it got done last year and now you have to allow the time for rules to be implemented and for providers to understand them.”

(Ella Nilsen can be reached at 369-3322, enilsen@cmonitor.com or on Twitter @ella_nilsen.)