Public Policy

Many legislative issues affect Baxter's business - reimbursement, tax, trade and a variety of regulatory concerns. Baxter's Government Affairs and Public Policy (GAPP) team works with lawmakers, governments and policymakers around the globe to support patient access to the company's life-saving therapies, increase understanding of the benefits of those therapies, address barriers to care and explore possible solutions. This work involves dealing directly with governments to improve the regulatory environment and reimbursement structure for Baxter's therapies, and collaborating with clinicians, non-governmental organizations and patient groups on coordinated efforts to increase access to care for millions of patients worldwide.

The Public Policy Committee of Baxter's Board of Directors oversees Baxter's government affairs activities. The committee reviews Baxter's political contributions, positions on pending legislation and political advocacy activities. For additional information on Baxter's government affairs activities, please refer to Baxter's 2010 Political Contributions Report. This report includes details about contributions made by Baxter and Baxter's Political Action Committee, BAXPAC, in 2010 as well as information about Baxter's membership in certain trade and industry groups.

Healthcare Reform

Healthcare reform efforts around the world seek to expand access to healthcare and reduce costs. In the United States, the Patient Protection and Affordable Care Act, signed into law in March 2010, contains several provisions that impact Baxter’s business. Most significant are increased rebates to state Medicaid programs for some of the company’s drugs and biologics, and expansion of the 340B Drug Pricing Program, which raises the potential number of healthcare providers that qualify for discounts on drugs provided to Medicaid patients. Baxter also will be required to pay a tax on the sale of its pharmaceutical products to the government beginning in 2011, and on certain medical devices beginning in 2013.

Baxter's U.S. GAPP organization was closely involved in the healthcare reform debate in Congress and its potential implications for Baxter. On parts of the legislation, the company worked with biotechnology and other industry groups to educate policymakers regarding potential impacts on manufacturers, their customers and their patients. Because of the unique nature of Baxter's products and how they are used and administered (largely infused or injected to treat rare, life-threatening chronic diseases) compared to traditional pharmaceutical products, it was particularly important for Baxter to attempt to mitigate any unintended negative consequences for its patients.

In 2010, Baxter supported efforts to expand access to health insurance for patients with high-cost chronic diseases, such as hemophilia, through high-risk pools. The Patient Protection and Affordable Care Act provides federal funding for such pools to cover patients with medical conditions who might otherwise be denied coverage by private insurers until 2014, when the law will prohibit insurers from refusing coverage to patients with pre-existing conditions. While risk pools will be available in every state, the mechanisms for coverage will vary and are still taking shape. Baxter is working to help ensure these pools will accommodate patients with rare chronic diseases without assessing unreasonably high co-pays or premiums.

To further assist patients and customers in implementing healthcare reform at the state level, Baxter created a 24/7 access Internet tool that has been added to the company’s patient and customer-focused websites below. These sites provide specific information for patients living with hemophilia and end-stage renal disease, as well as hospital customers:

• Hemophilia
• Acute and Ambulatory Centers
• End Stage Renal Disease

Canada Experience Helps Shape Taiwan Policy for Treating ESRD Patients

As a leading provider of products for peritoneal dialysis (PD), the predominant home-dialysis therapy for patients with end-stage renal disease (ESRD), or irreversible kidney failure, Baxter works with governments around the world to increase access to PD. This can provide cost and quality-of-life benefits compared to in-center dialysis.

In 2010, the Taiwan government was studying policy options to most effectively treat its ESRD patients. To support an evidence-based dialogue on this issue, Baxter’s GAPP organization in Taiwan convened a roundtable discussion for representatives of the Ministry of Health and the Bureau of National Health Insurance with Canadian nephrologist Paul Tam. Dr. Tam shared the experiences he had in Ontario, Canada, where in 2009 the provincial government announced a target to have at least 35% of all dialysis patients use PD. Baxter’s GAPP organization in Canada had worked with the government in Ontario to help shape its policies, which have produced positive patient outcomes. Drawing on the experience in Ontario, the Taiwanese Department of Health adopted a similar policy to increase the use of PD.

Increasing Access to Hemophilia Therapy

In China, most people with hemophilia do not receive adequate treatment. In fact, most are not even diagnosed. Baxter is lending its expertise in hemophilia therapy to the China Ministry of Health in support of a nationwide initiative to improve the country’s hemophilia diagnosis and treatment capabilities. The program includes the creation of a nationwide hemophilia patient registry, hemophilia management centers and the improvement of standards for hemophilia diagnosis and treatment. In 2010, China established its first hemophilia patient registry, with an initial 8,000 patients.

In Mexico, Baxter also played a supportive role in a government initiative to increase access to hemophilia care. The company worked with the Mexican Hemophilia Federation to advocate for greater hemophilia therapy coverage in the Catastrophic Disease category of Mexico’s Seguro Popular national insurance program. Starting in 2011, Seguro Popular began covering treatment for children under 10 years old with hemophilia A or von Willebrand disease. The program already covered children over 10 years old, who will continue to be covered for their hemophilia treatment.

Influencing Infection Control Guidelines in Australia

Healthcare-associated infections (HAIs), also known as nosocomial infections, are infections that patients get while in a hospital or other healthcare facility. HAIs lead to increased treatment costs and lengths of stay. HAIs can be prevented through various means, such as rigorous hand hygiene and aseptic techniques. Certain healthcare technologies and products also can play a role. Closed intravenous (IV) medication delivery systems and premixed products, for example, have a proven record of reducing bloodstream infections, a common type of HAI.

In 2010, Australia’s National Health and Medical Research Council, and the Australian Commission on Quality and Safety in Healthcare, jointly released the official Australian Guidelines for the Prevention and Control of Infection in Healthcare. Baxter’s GAPP organization in Australia provided evidence-based input into the draft guidelines. This included roundtable discussions with healthcare professionals and government representatives, visits by key stakeholders to Baxter’s manufacturing facility in Sydney where the company produces closed IV delivery systems for Australian hospitals, and publication of various white papers on reducing HAIs. The final guidelines were published in October, outlining standard precautions and steps, including standard practices for use of closed IV delivery systems to prevent and reduce infections.

Baxter and its employees also lend their voices to discussion of industry issues that affect Baxter and its customers through membership in many professional, industry and business organizations, covering a variety of geographic areas, diseases, markets and topics.