Posted on 07/23/2002 10:49:12 AM PDT by FourPeas
Elderly tell Stabenow about their struggle to cope with drug costs
Tuesday, July 23, 2002By Sarah Kellogg and Kyla King
The Grand Rapids Press
It wasn't too long ago that Willie Price didn't know from month to month how he would pay for the handful of medications that keep him feeling well.
Price, a 69-year-old retiree, paid prescription drug costs as high as $700 a month until a local agency helped him enroll in assistance programs.
And it still is a struggle for Grand Rapids resident Shirley Malone, who has to decide each month whether she will buy the groceries she needs or pay for her medication.
The 67-year-old is so fed up she is considering buying her pills from Canada, where costs are lower.
Both shared their experiences Monday with U.S. Sen. Debbie Stabenow, who was in Grand Rapids looking for personal tales to tell on the Senate floor today as the body debates prescription-drug price reform.
"It's one or the other," Malone told Stabenow. "Either I get my prescriptions, or I buy groceries."
After five years of debate, the Senate was to vote today on legislation to require Medicare to cover monthly prescription drug bills for seniors.
In Michigan, 1.3 million Medicare-eligible seniors and disabled residents would benefit from such a plan. The nearly 600,000 seniors covered by employer-paid plans would retain that coverage as well.
"We in the Senate have an opportunity to do something about (high drug costs) right now," said Stabenow, D-Lansing, Michigan's junior senator. "The governors are asking us to do that. Businesses are asking us, as are families, seniors and workers."
Malone, whose medications for a variety of ailments can cost up to $300 a month, told the senator her prescription tab runs so high she sometimes has to select which medications to sacrifice.
"I don't get all of them," she said. "The arthritis medication is outrageous, so that's always out."
Malone, who is on a fixed income of $763 a month, said she is considering searching the Internet for Web sites that allow seniors to buy prescription drugs from Canada.
"If I could get a discount on my medication, I'll do it," she said.
Willie Price said he was grateful when United Methodist Community House helped him get assistance. Until then, he struggled to pay for $700 in medication on a monthly income of $946.
"There was nothing I could do about it. I had no choice," he said.
Rebecca Thomas, senior services supervisor at United Methodist Community House, said Price's situation is common. Because Medicare does not cover prescriptions, Price said, the system is set up to make the people who can least afford it pay the most.
"The average senior spends between $250 and $375 a month," Thomas said. "It's ridiculous."
The Democratic plan being considered would cost $594 billion over 10 years.
The key provisions: There is no annual deductible and there is a $4,000-per-year limit on out-of-pocket expenditures. The monthly premium would be $25, and there would be a $10 co-payment for generic drugs and a $40 co-payment for brand-name drugs.
Republicans say the Democratic plan is unrealistic, given that the Congressional Budget Office estimates drug prices may increase by 20 percent annually in the next 10 years.
"No one has invented a prescription drug that gives you common sense," said Sen. Chuck Grassley, R-Iowa. "We need to make the dollars we have go as far as they can."
The GOP plan would cost
$370 billion.
It differs most substantially from the Democratic plan by relying on private insurance companies to administer the plan. The Democratic plan relies on the federal government.
Key provisions: The Republican plan would require seniors to pay a $24 monthly premium to private insurers and absorb a $250 annual deductible. The plan would pay for half of all drug costs up to $3,450 annually. It would provide no coverage for expenses between $3,451 and $3,700. The plan would pay 90 percent of all costs above $3,700.
Grassley said despite the gaps in coverage, the GOP plan assists the poorest to the wealthiest seniors.
But Democrats say the GOP plan does not do enough, and worse, it would require asset tests for low-income seniors. Medicare does not have such tests.
"Under the Republican plan, low-income senior citizens will be required to undergo a rigid assets test if they need additional assistance, and retirees will find the good prescription drug coverage they enjoy today at risk," said Democratic Sen. Carl Levin, Michigan's senior senator.
Last month, the House approved a $310 billion plan that, like the GOP's bill in the Senate, would turn to private insurers to deliver the government-subsidized prescription benefit.
National senior advocacy groups favor the Democratic plans.
"Unlike the House bill, (the Senate Democratic plan) has none of the gaps in coverage that would be costly for seniors and doesn't rely on for-profit companies to sell seniors coverage that many ... consider unworkable," said Barbara Kennelly, president of the National Committee to Preserve Social Security and Medicare.
Along with the 597,000 Michigan seniors eligible for drug coverage through employer plans, there are 76,000 Medicare beneficiaries who have their drug bills covered by health maintenance organizations.
For every senior being bankrupted by high drug costs, they could find eight that are not having a problem - yet they want to give ALL of them this benefit, even as families are struggling to make ends meet under an ever-increasing tax load. It's just plain sick.
"If FDA officials err on the side of under-caution in approving an unsafe drug, they are attacked by the media and patient groups, and investigated by Congress. Their victims, sick and dead people, are highly visible. If FDA officials err on the side of over-caution, keeping a safe and effective drug off the market, who's to know? The victims are invisible.
"For example, neither the Americans who get sick or die from meningitis C this year, nor their loved ones, will know that their illness or death could have been prevented had it not been for errors by FDA officials.
"It's a no-brainer to figure out which error FDA officials prefer to make. If you conclude they have a bias toward errors that create invisible victims, who don't know whom to blame for their illness or death, step to the head of the class. By the way, FDA conduct demonstrates that the admonition, "One can never be too safe," is something we should take with a grain of salt.
"Sometimes, drug companies produce a drug that's safe and effective, but the disease it treats is rare. There aren't enough patients available to go through the FDA's costly approval procedure to make the drug economically worthwhile. Those drugs are designated "orphan drugs.
"Prior to the Reagan administration's steps to correct this situation, thousands of people suffered or died needlessly. It's estimated that the 216 orphan drugs approved since 1983 are estimated to have prevented 108,000 deaths from rare diseases. Right now, there are scores of "orphan drugs" unavailable to physicians for treatment options.
"In addition to FDA policy that leads to the illness and deaths of untold numbers of Americans is the issue of drug costs. I'm disgusted whenever I hear politicians pontificating about high drug costs and the need for prescription-drug handouts. Congress, the FDA and the courts are largely responsible for the escalating costs of drugs."
The drug companies should just start making really big pills, something that'll fill ya up and stick to your ribs. Kill two birds with one stone.
But seriously, anybody under the age of 40 should just sign their paychecks over to anybody over the age of 65. They earned it.
My dad worked for a pharmaceutical company as part of their computerized drug approval process. In fact, he was instrumental in bringing great efficiencies to the FDA end of the process by creating a standardized electronic protocol for the transfer of data. Previously, all data was transferred in a paper format. The process IS still amazingly cumbersome, but I'm not certain that that is a bad thing. Yes, getting drugs to market in a timely fashion is important, but no less so than keeping dangerous ones off.
The process IS still amazingly cumbersome, but I'm not certain that that is a bad thing.
Your father did a commendable job. That is good. Does his honest and rational work reflect the culture within the FDA? No.
Yes, getting drugs to market in a timely fashion is important, but no less so than keeping dangerous ones off.
In one of his specials, John Stossel makes a powerful point.
There was a highly effective life-saving drug that the FDA held off the market despite it being successful used in several European countries. For a year FDA red tape kept the drug from being available in United States.
Stossel continues, "last year seven thousand peopled died from "XX". Doesn't that mean that the FDA killed seven thousand Americans last year?"
That one example is a snowball-size tip of the iceberg.
From the article you responded to.
"FDA officials can make two kinds of errors. They can approve a drug that has unanticipated, dangerous side effects that might cause illness and death. Or, they can err by either not approving or causing huge delays in the use of a safe and effective drug. Statistically, these are known as Type I and Type II errors. What are the FDA incentives?
"If FDA officials err on the side of under-caution in approving an unsafe drug, they are attacked by the media and patient groups, and investigated by Congress. Their victims, sick and dead people, are highly visible. If FDA officials err on the side of over-caution, keeping a safe and effective drug off the market, who's to know? The victims are invisible.
"For example, neither the Americans who get sick or die from meningitis C this year, nor their loved ones, will know that their illness or death could have been prevented had it not been for errors by FDA officials.
"It's a no-brainer to figure out which error FDA officials prefer to make. If you conclude they have a bias toward errors that create invisible victims, who don't know whom to blame for their illness or death, step to the head of the class."
I mentioned that as a reference for where I receive my information. I will also mention that my dad, although very skeptical about bureaucrats, never, ever criticized any of the people with whom he worked at the FDA because they wanted to slow down the process.
There was a highly effective life-saving drug that the FDA held off the market despite it being successful used in several European countries. For a year FDA red tape kept the drug from being available in United States.
Stossel continues, "last year seven thousand peopled died from "XX". Doesn't that mean that the FDA killed seven thousand Americans last year?"
First, no, unless the FDA is somehow responsible for those seven thousand people contracting "XX".
Second, the FDA's responsibility is to make sure our nation's food and drug supplies are safe (whether they accomplish this is up for debate). Simply because one, two or ten European countries legalized a drug does not mean that it is safe. What exactly does "successful used" really mean statistically? It's much to vague. I certainly would NOT our FDA to approve a drug simply "because France said so".
And, yes, I read your original post. No need to repost it. My response was an agreement that the FDA does indeed err on the side of safety and I believe that is their job.
My dad, a Bioresearch Statistician, was uniquely positioned to understand the drug approval process. It is incredibly cumbersome and complicated. That is takes years to approve, disapprove or request further research on a drug is not surprising. The number of factors that must be considered is mind boggling. The data that must be collected and the statistics that must be run are massive. In paper terms, the amount of paper necessary to consider one drug fill tractor trailers. Some things take time.
Of course orphan drugs exist. They exist, at least partly, because there is not enough ROI on them for the drug companies to pay for their approval or manufacture or marketing or research or all of the above. It's free market capitalism and as cold as that sounds, that's the way it is.
Overall, could the process be improved and or occur more quickly? Most probably so. Do I think the FDA as a whole is purposefully slowing the processes to keep life-saving drugs from the American public? No.
FP
"The Democratic plan being considered would cost $594 billion over 10 years. ...The GOP plan would cost $370 billion."
No, THAT'S frickin' ridiculous!!
SHEEEESH...MUD
Ten years ago my mother-in-law changed doctors. He immediately took her off six of her eight prescriptions. She has a very good prescription drug program, but he reasoned that she didn't need most of her medications. To this day, she's doing well without them. Something makes me think my MIL is not the only one.
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