Even as prospects dim for a bill to charge pharmaceutical companies a fee for every opioid they sell in the state of Minnesota, supporters of the proposal remain defiant. There are signs that the issue of opioids may become a campaign issue this November.
The fee is opposed by some business groups and pharmaceutical companies. Bill authors estimate it would raise about $20 million a year for prevention, treatment and other programs to deal with the fallout of the opioid overdose epidemic, which now leads to about 40,000 deaths each year in the United States.
Gov. Mark Dayton sent Republican legislative leaders a letter Monday saying that removing the "penny-a-pill" provision was "letting pharmaceutical companies who have played a major role in creating this deadly epidemic off the hook."
"As public servants, we should be protecting Minnesota families whose lives are being devastated by addiction, instead of protecting the special interests of the major pharmaceutical companies, who continue to perpetuate the problem," Dayton wrote in the letter.
Tim Pawlenty also noted he would be "holding big drug companies accountable for their role in the opioid crisis that is destroying lives" in a video announcing he was running for governor. Pawlenty's campaign did not respond to requests for comment about his stance on the fee.
The bill's House author Rep. Dave Baker, R-Willmar, has removed the fee on pharmaceuticals from his version of the bill, which was referred to the Ways and Means Committee at a hearing on Monday night. Baker said during the hearing that he's still interested in a fee mechanism.
Sen. Julie Rosen, R-Vernon Center, said the fee on pharmaceutical companies is still alive in her bill, which she has tabled in the Senate committee she chairs to align it more with the House version. She still sees a path to including the fee in the legislation.
Rosen said it's unacceptable to fund the programs from the state's general fund, and that pharmaceutical companies that helped create the crisis need to step up to find a way to fund other financing if they don't like the fees.
"Where's the money going to come from? Is it going to come from children, K-12? Is it going to come from money that we set aside for mental health programs? Is it going to come from the money we set aside for roads and bridges," Rosen said. "I don't know, but it's got to come from somewhere."
Pharmaceutical Research and Manufacturers of America (PhRMA) director of public affairs Nick McGee said representatives of PhRMA at the Capitol have met with legislators about opioid programs throughout the session.
"We want to come to the table on comprehensive solutions," McGee said. "We just believe that taxing prescribed medications that meet legitimate medical needs is not an appropriate funding mechanism."
About 3.5 million opioid prescriptions were filled in 2016, according to the state's prescription monitoring program. Rosen estimates that the fee would add less than $5 to a 30-day prescription of oxycodone.
Rosen and House author Baker said they've so far been frustrated that pharmaceutical companies have objected to the fee but not proposed viable funding solutions.
"I have not seen any information from them except a color brochure that they've handed to me twice about what they're doing," Rosen said. "I keep asking them, 'What are you doing in these communities, who are you working with?'"
McGee said PhRMA has awarded grants to community groups in the last few weeks, including $25,000 to the Minnesota Farm Bureau and another $10,000 to the Lakeville Public Safety Foundation. He said PhRMA plans to announce other grants in the state soon, although there's not an exact dollar amount or timeline yet.
"We're continuing to make investments in community organizations that are on the front lines through grants and other supporting measures to make sure that communities have the resources they need," McGee said.
McGee suggested that the state can find money for the programs in the legislation elsewhere, including Medicaid reimbursement funds.
Rosen said that idea is a non-starter. She predicted that unless there's an agreed-upon funding mechanism for the programs in the bill, the fee will added as an amendment on the Senate floor by Democrats, and will likely pass.
Lexi Reed Holtum, executive director of the Steve Rummler Hope Network, which has pushed for the bill, said the time to wait for pharmaceutical companies to voluntarily contribute to solutions is over.
"The reality is that we are already as taxpayers paying, and what we're asking for is to have our legislators have enough courage to stand up to Big Pharma and have them be accountable," Reed Holtum said.
Similar legislation has been introduced in other states. New York recently became the first state to approve a similar fee on pharmaceuticals, which is expected to raise about $100 million each year.