April 03, 2007
Drug Discount Cards
On March 19, 2007 an article was published in The Seattle Times by Kyung Song, titled “Card Shaves Drug Costs.” It describes how Washington residents who are uninsured and used to pay retail price for their prescriptions are now eligible for a state-backed discount card. The Washington Prescription Drug Program discount card now adds Washington to the dozen or so states that negotiate discounts similar to what insurers demand for their uninsured residents. The discount card went into effect Feb 1, 2007 with about 1,100 people enrolled thus far. The program got started with the push of Gov. Christine Gregoire and eventually Washington paired up with Oregon’s drug-discount program, so that both states can negotiate with pharmacy-benefits companies together. About 400 of the 1,300 pharmacies in the state accept the discount cards.
The card allows customers without insurance to receive at least a 16 percent discount on brand name drugs and at least a 24 percent discount for brand names drugs purchased from a mail-order pharmacy. For generics, customers will save an average of 50 percent off or 67 percent off for prescriptions ordered through the mail. This card can also benefit those who already have coverage by providing discounts for those whose medications aren’t on their insurer’s preferred-drug list.
It appears that discount cards such as these would not only be beneficial for the patient, but it’s also good news for pharmaceutical companies. These programs provide a way to reduce the cost of prescription drugs for the uninsured and relieve some of the pressure currently on the federal government to get involved and exert some control over the prescription drug pricing, which is something that pharmaceutical companies don’t want happening. In addition, these cards may provide the drug industry with even more consumers because it may allow some patients to become users of certain drugs that they may have otherwise chose not to purchase because of the cost.
The Consumer's Responsibility
An article in the Los Angeles Times, titled “Soothing the pain of prescription drugs’ cost” by Genevieve Bookwalter, highlights how consumers can help lower their own drug costs by being more active and asking more questions. Consumers must speak up and let the physician and pharmacist know when the medicine bills are too high. As sited in the article, a study published in the American Journal of Managed Care in November “found that only a third of doctors discussed cost, insurance, supply, refills or money-saving generic drugs with patients when writing prescriptions [and] only 2% of patients asked those questions.” Patients are usually too embarrassed or afraid to talk about cost issues, however, by avoiding the topic patients appear to be losing out on easily available cost-saving measures, such as health plans, which offer mail-order prescription drugs, which at times charge the same amount for a three-moth supply of a drug as a retail pharmacy does for a one-month supply. Also, many patients may also by eligible for programs that can provide them with free drugs, such as Partnership for Prescription Assistance, in which “pharmaceutical companies and healthcare providers give free or low-cost drugs to the uninsured who make less than $41,300 for a family of four.” Since 2005 3.5 million people have signed up for this program, although over 29 million people may have qualified.
Patient advocacy groups, pharmaceutical, and insurance companies have come up with different strategies to help consumers cut the prescription drug costs. Top on the list is to talk with one’s physician about the cost of any new prescription and identify any possible alternatives that may cheaper. It was also recommended that one makes sure all of one’s prescriptions are really necessary and to consider generic drugs, which are usually significantly cheaper than brand drugs. In addition, it’s smart to comparison shop since prices can vary radically by store and by splitting pills a prescription for a double-dose pill may not cost much more than for a single dosage. Also, before buying a large supply of a new prescription make sure it works for you and look into mail-order pharmacies and special assistance programs or drug discount cards if you don’t have insurance.
This article brings to mind the same idea that many other articles do in discussing prescription drug prices. Pharmacists can be valuable tools in helping consumers reduce their drugs costs. They can advise patients in ways that may help them save money on their prescriptions and make them aware of their options, especially for those who are uninsured and therefore hit the hardest by the high cost of drugs. This extra effort by the pharmacist can help solidify a relationship with the patient and signal to the patient that the pharmacist is truly there to help and benefit the patient.
March 29, 2007
Generic Dispensing Driven up by Medicare Part D
In an article titled “Medicare Part D driving up generic dispensing” by Jim Frederick (Drug Store News. New York: Mar 5 2007. Vol. 29, Iss. 3; pg. 13) it explains how the use of generic drugs has “jumped from 48.4 percent to 52.6 percent of all prescriptions among patients covered by third party payers in 2006, according to the National Association of Chain Drug Stores and researchers at Wolters Kluwer Health.” The percentage of generic drug usage is even greater for seniors covered by Part D, as generics account for almost 60 percent of the drugs dispensed.
This increase in generic utilization comes as good news as it is helping to keep the growth of spending down even with an increase in the number of prescriptions dispensed. CMS, the Centers for Medicaid and Medicare Services, predicts that if such a trend continues prescription expenditures would continue to grow at a slower rate that total health expenditures. They also stated that promoting generic drug use is an important factor in keeping the Part D drug benefit affordable over the long term.
This article helps make clear how important it is for community pharmacists to recommend the use of generic products over brand-name drugs whenever appropriate, since sometimes patients may not even be aware of the alternatives available and the amount of money they could potentially save. They should also help educate patients on the optimal use of their medications. Such suggestions by the community pharmacist can help lower drug costs for the consumers and optimize their care.
March 27, 2007
Employers Covering Workers' Prescription Drugs
“More employers picking up tabs for workers’ prescription drugs” is the title of an article by Milt Freudenheim, published on Feb 21, 2007 in Oregon’s The Register-Guard. The article describes how recently, many employers have stopped pushing their employees to pay more for health-care through higher premiums and out-of-pocket expenses. Instead some “major employers, such as Marriot International, Pitney-Bowes, the carpet maker, Mohawk Industries, and Maine’s state government have introduced free drug programs to avoid for paying for more expensive drug treatments down the road.” They are giving away drugs for many chronic conditions, like diabetes and asthma, in an attempt to decrease the greater medical expenses that may occur if these conditions are not treated.
The author also feels that another motive for employers to cover drug expenses is to help keep government involvement of health insurance at bay and drug makers, who would benefit from the employer drug programs are also in support. However, the main motive does appear to be keeping workers in good health since emergency room care and hospital stays can add up to a much higher expense for employers. This is conveyed by the fact that although most employers have increased co-payments for drugs in the past few years and employer drug spending has slowed, “total health care spending by employers has nonetheless continued to rise: 7.7 percent last year or more than double the general inflation rate, according to the Kaiser Family Foundation.”
As mentioned briefly by the article, such a shift by employers could be very beneficial for pharmaceutical companies. If more employers start paying for workers’ prescription drugs this could lead to more consumer use of prescription drugs, which would translate into more money for the drug makers. In addition, pharmaceutical companies do not want to see the government involved in health insurance or with controlling drug costs since this may lead to price controls for many drugs. Therefore, the employer drug programs will benefit the drug companies by keeping the consumers happy and using their drugs and the government less anxious to get involved.
March 18, 2007
On Feb 23, 2007, DrugNewswire.com (http://www.drugnewswire.com/13391/) released an article titled “Blue Cross and Blue Shield of Illinois Announces e-Prescribing Collaborative Program to Improve Patient Safety.” The article explained how the Blue Cross Blue Shield of Illinois was implementing e-prescribing state-wide as a way to improve the quality of care by increasing efficiency and prescription medication safety.
The Illinois e-prescribing Collaborative is an initiative to increase the use of e-prescribing throughout the state. Blue Cross and Blue Shield of Illinois will fund the first 500 physicians to implement the program; however additional physicians can participate by providing funding and technology support for e-prescribing. Since e-prescribing includes all those involved in the prescription process, such as insurers, physicians, pharmacists, and the patients, working together, the outcome will be much more cohesive and appropriate for an individual patient’s needs. In addition, this is believed to be an effective way to control health care costs as well, since it would reduce medication errors and therefore minimize the costs associated from these errors. The use of generics would also be increased, reducing patient drug expenditures, since the e-prescribing program would provide cues notifying the physician to lower-cost alternatives to brand name drugs.
The article described that the physician would have access to the e-prescribing software from a PDA or desktop computer and through this system he or she can check eligibility, co-pay and formulary information at the point of care. Physicians will also have the patient’s drug history available and can double check for possible allergies or interactions before prescribing the medication. Then once the final prescription is decided on, it would directly be sent to the patient’s pharmacy to be filled.
It appears that e-prescribing would also be beneficial for pharmacists in completing their tasks more efficiently and appropriately. E-prescribing can help pharmacists spend less time making callbacks to physicians for clarifications or changes to prescriptions. It can also help reduce the amount of time a pharmacist usually spends on the phone with a member’s pharmacy benefit plan trying to solve insurance problems that may arise from a prescription and instead the pharmacist can have more time to focus on personal patient care and counseling.
March 03, 2007
The Possibility of Generic Biotech Drugs
Recently, on Feb 15 2007, an article by Theresa Agovino (AP Business Writer) was published in the Associated Press with the headline “Study says Generic biotech drugs could save at least $71 billion over 10 years.” The article described how a study performed by the pharmacy benefit manager, Express Scripts Inc., claims that the cost of biotech medicines can be greatly controlled, saving patients and health insurance providers about $71 billion over 10 years, if generics of the biotech drugs could be marketed.
Biotech drugs are especially expensive because they are drugs that are derived from a living source, such as proteins, and generic drug manufactureres aren’t currently allowed to produce generic biotech medicines. As stated in the article, Express Scripts says that “the average biotech drug costs $71,600 a year, compared with the annual average for a traditional drug of $1,200” and that “Biotech treatments now account for 25 percent to 30 percent of a company's overall drug costs,” making controlling such costs a “top priority.” Therefore, a bill was recently introduced by lawmakers in Washington D.C. that would give the FDA the ability to approve copies or generics of biotech medicines.
The study performed by Express Scripts involved four categories of biotech drugs which would have generic competition if copies were allowed since their patents have expired: insulin for diabetes, erythropoietins for anemia, growth hormones and treatments for multiple sclerosis. The study then took a 25 percent discount off the price of these drugs, based on the discount of generic growth hormone in Europe, but Express Scripts claims that this is probably a conservative discount considering that most generics cost “60 percent less than its brand name counterpart.” However, many experts are not sure if generic biotech drugs would be much cheaper than their brand counterparts since its likely the FDA will require more testing for generic biotech drugs and they are also more expensive to produce. The article ended, stating that Kathleen Quinn, the FDA spokesman, said that the agency has not currently seen the legislation, but that with the way science has evolved, believes the agency may be able to eventually approve biotech drugs.
If the FDA gains the authority to approve these biotech drugs, it could mean huge savings for consumers. In addition, insurance companies may not place as much limitations on some of their plans if the prices of biotech drugs are reduced. Although, as the article pointed out, it depends on how much can be truly saved in using a generic since the cost of testing and production could still be extremely high. The passing of this legislation may also have a positive impact on the pharmaceutical industry, even though the manufacturers of the brand biotech drugs may lose some profits. By having other generic drug companies also produce these medicines it is possible to stumble upon safer or more effective versions of these treatments or even other valuable information that has still not been discovered.
On Jan 15, 2007 an article with the headline “Medicare reform bill carried in US House, veto or filibuster expected” was published by Pharma Marketletter. The article discussed HR 4, the Bill proposed by the Democratic Party, that would reform the Medicare Part D prescription drug plan by requiring that the Department of Health and Human Services to negotiate drug prices with drug companies.
The U.S. House of Representatives failed to meet the 290 votes or 2/3 majority vote, leaving the Bill at the option of being vetoed by President George W. Bush. Much of the opposition of the Bill arises from the fear that the government’s involvement in negotiating drug prices would lead to limitations in the availability of some drugs, which is an unnecessary risk to take since pharmacy benefit mangers appear to be successful so far in controlling drug costs. However, groups such as the American Association for Retired Persons (AARP) support the Bill, saying that it is a necessary measure “to ensure that Americans have the health and financial security they deserve” considering that fact that many firms are dropping health care insurance coverage and that the price of prescription drugs is continually increasing.
Those opposed to the bill believe that even if the Senate does not vote to end the debate, then the President will surely use his ability to veto the Bill. As stated in the article, the White House says that the President feels the government involvement conveyed by HR 4 “’impedes competition, limits access to life-saving drugs, reduces convenience for beneficiaries and ultimately increases costs to taxpayers, beneficiaries and all American citizens alike.’”
It seems as though the Bill, HR 4, will not be passed or ever go into effect. This is certainly good news for pharmaceutical drug companies who would most likely lose profits with government involvement in their pricing. Therefore, if the government were to get involved in drug pricing the industry may lose the motivation or desire to invest as much in research and the development of new treatments or therapies, which may end up hurting the consumer in the end. However, with the increasing price of drugs, it is hard to predict what exactly the consequences of government interference would be and whether they would outweigh its potential benefits.
February 28, 2007
In an article titled “Markets Keep Drug Prices Low” by the Washington Post, published on January 15, 2007, it states that the competition between private drug plans has been a major factor in the recent reduction in drug costs for Medicare beneficiaries enrolled in the prescription drug plan. “The average monthly premium has dropped by 42 percent, [and] there is a plan available for less than $20 a month in every state.” In addition, the author makes the argument that the government should not be involved in setting drug prices and negotiating with drug companies as way of reducing drug costs.
The article starts by pointing out that although the drug benefit appears to be successful in reducing the cost of drugs for many, some feel that the government has to have more control over the lowering the price of prescription drugs. Currently, there is legislation under consideration that would require the secretary of health and human services to negotiate and set the prices of drugs. However, the author indicates that it may lead to problems if a small group of government officials were to set the price of over “4,400 drugs” when this decision would be better if made by the millions of consumers. In addition, he feels that government price setting would limit drug choices because negotiating with manufacturers to lower prices usually leads to limited access to some drugs. The author also makes the argument that even though some may think that the government can use their great buying power as clout with the drug companies, the private-insurance sector plans and pharmacy benefit managers, who negotiate drug prices between drug companies and pharmacies, “cover about 241 million people, [while] Medicare could cover at most 43-million.” Therefore, the government does not have the amount of power one would think.
One of the last statements the author makes against government involvement in setting standards is that such a move would lead to additional administrative costs since the Department of Health and Human Services would have to hire numerous new employees. In addition, this cost would end up being covered by taxpayers.
This opinion article, unlike many other articles, does not feel that government involvement is a beneficial way to help reduce drug costs. It is obvious that with the government staying out of this picture drug prices are continuing to rise although plans such as the Medicare drug benefit appear to be successful at the moment with reducing the costs of drugs for the elderly and the disabled. However, this article conveys that the government’s involvement may open a whole new box of problems that many may not even be able to foresee. What’s certain is that any move made by the government will have a great impact on the cost of drugs for the consumers of this country
February 12, 2007
An Opinion on How to Control Drug Costs
An article titled “A Prescription for Controlling Drug Costs,” by Arnold S. Relman and Marcia Angell, was published in Newsweek magazine on Dec 6, 2004 (Vol.144, Iss. 23; pg. 74). It addressed the public’s concern regarding the rapid rise of drugs prices in the United States, which as stated in the article was increasing at an annual rate of 10-12 percent, which is four times the rate of inflation.
The cost of health-care is a continual challenge, with drug prices becoming a growing contributor to the problem. The article states that one of the main reasons this is occurring is that unlike other countries, such as Canada and many European nations, the United States does not control the cost of drugs and the Pharmaceutical Industry is not interested in keeping the costs down. The Industry claims that it needs to charge such high prices for there drugs in order to recover from the amount of money that they invest for research and development. However, the article sites that the median profit margin for many American drug companies is well over those of other Fortune 500 companies. In addition, most of the new drugs being produced are not “life-saving miracle drugs.” but rather small variations on older drugs, or “me-too” drugs
The authors also feel that even though no one will be able to afford the increasing price of drugs in the future the current political climate will not be implementing any valuable reforms, since instead of trying to control U.S. drug prices, the Bush administration is simply advocating other countries to ease their regulations. Therefore, they claim that the first step necessary in controlling drug costs is up to the medical profession. The medical profession must stop depending on the pharmaceutical industry as to what drugs to prescribe and stop falling for various “sales pitches” the company may throw at them. Instead, they must rely on their own education and scientific studies, which would lead them to prescribe fewer and more cost-effective drugs.
The article appears to place the blame of rising drug costs on the government’s lack of control, the pharmaceutical industries greed, and the medical professions lack of responsibility for their own drug education. The authors insinuate that the pharmaceutical industry is more interested in profit margins than the patients they serve. Therefore, their drug prices must be controlled by the government and those in the medical profession must learn to ignore their advancements, which are geared at convincing them to prescribe more expensive, newer drugs. This article helps add fuel to the distrust much of the public has regarding the motives and procedures of the drug companies and awakens questions for those who may have never given the issue a second thought.
February 11, 2007
An article was recently published on Jan 12, 2007 in the Leader-Post, a Canadian newspaper, discussing the struggle the United States is having with keeping the price of prescription drugs down. Although the article, titled “Protect Drug Supply” is from Canada it concerns cross-border prescriptions between Canada and the U.S.
The article stated that in both the U.S. Senate and House of Representatives two identical bills have recently been presented to legalize bulk imports of cheaper prescription drugs into the United States. This is being done as an attempt to help keep the price of prescription drugs down. In other countries, American pharmaceutical companies sell drugs at a much lower price than what is available to the people of the U.S. Therefore, this bill would allow U.S. licensed pharmacies and wholesalers to import medications from Canada, Europe, Australia, New Zealand and Japan. However, experts believe it is unlikely this bill will become law since for that to ever happen it wouls have to be approved by George Bush and he has already declared that he doesn’t support the proposal. In addition, most Canadians do not want to see this become law since nations exporting their drugs, such as Canada, could then possibly run short on drugs for their own citizens.
If this bill were ever to be passed in the United States it would have a great effect on American pharmaceutical companies. Importing drugs from other countries would mean less profit for the companies, which is the last thing they would want to see. The drug companies are already irritated at the fact Canadian Internet pharmacies sell and “supply drugs to about three million Americans.” They probably feel this is already a cut to their profits and they are not going to stand for anymore. It would be of no surprise if the U.S. drug companies are lobbying hard to see that this bill never becomes law.