Many Seniors Struggle with High Cost of Medications

Published in the Pawtucket Times on June 18, 2001

Many seniors are struggling to pay the spiraling cost of prescription drugs as a politically divided Congress seeks a solution by crafting a bipartisan prescription drug benefit tied to Medicare.

Until this issue is addressed, a tragedy occurs in many communities across the nation.

Often, the high cost of prescription drugs has forced seniors on fixed incomes into not taking their medications at all or using only partial doses.

Noncompliance in taking medication can lead to hospitalization, nursing home admission or premature death.

According to the Families USA study released in June 2001, costly prescriptions continue to hit seniors hard in their pocketbook.

The report found that 50 of the most heavily prescribed drugs for seniors on average rose more than twice the rate of inflation in the year ending January 2001.

On average, the researchers found that prices increased by 6.1 percent from January 2000 to January 2001, though the rate of inflation excluding energy in that time period was 2.7 percent.

Furthermore, the 18-page report stated that seniors are most affected by any prescription drug price  increase.

Although older persons represent just 13 percent of the total nation’s population, they account for 34 percent of all prescribed medications dispensed and 42 percent of all prescription drug spending.

Of the 50 drugs used more frequently by seniors, the average annual cost per prescription as of January 2001 was $ 956, the report noted.

Drug prices rose significantly over the one-year period of the study.

The report findings revealed that the cost of Synthroid, a synthetic thyroid agent, rose by 22.6 percent; 22.5 percent for Alphagan, commonly used to treat glaucoma; 15.5 percent for Glucophage, prescribed for treating diabetes; and 12.8 percent for Premarin, used estrogen replacement.

While rising drug costs are national, Rhode Island fiscal nets are in place to make prescription drugs more affordable to low-to-moderate income seniors, says Susan Sweet, consultant and advocate for a variety of nonprofit agencies and minority groups.

Many aging advocates and state legislators know Sweet as “the mother of the Rhode Island Pharmaceutical Assistance to the Elderly Program (RIPAE).”

“Rhode Island is one of a handful of states that has responded to senior’s concerns and anxieties about the high cost of prescription drugs,” Sweet says.

In 1985, the Rhode Island General Assembly moved to assist elders with rising prescription drug costs by enacting RIPAE.

Initially, the RIPAE program covered only medications purchased by low-income seniors to treat hypertension, cardiac conditions and diabetes.

In the past fifteen years, the General Assembly has expanded the program,” Sweet adds, to over the cost of prescription drugs to treat glaucoma, Parkinson’s disease, high cholesterol, cancer, circulatory insufficiency, asthma, chronic respiratory conditions, Alzheimer’s disease, depression, incontinence, infections, arthritic conditions and prescription vitamins and mineral supplements for renal patients.

Additionally, the RIPAE Plus Program, proposed by Lt. Governor  Charles Fogarty with House and Senate leadership, allowed moderate income seniors to purchase prescription drugs at a lower rate that is negotiated by the state.

The state also pays a portion of the remaining cost of the drug based on the senior’s income level.

“The innovations in RIPAE have made Rhode Island a leader in assisting seniors to stay healthy and independently,” Sweet says.

With the end approaching to this year’s session of the General Assembly, lawmakers are considering legislation to again expand the RIPAE Program, states Fogarty, who authored the legislation.

Fogarty’s RIPAE Next Step would cover all FDA-approved prescribed drugs, excluding cosmetic and experimental drugs, cap out-of-pocket expenses at $ 1,500 annually, and open up the program to people age 55 and over who are receiving Social Security Disability Insurance.

While no one really opposes the passage of RIPAE expansion this year, ultimate passage of the entire legislative proposal is really a question of competing budget needs and limited state dollars, Sweet comments.

House Finance Chair Tony Pires (D-Pawtucket) remembers a time in the mid-1990s when Governors Bruce Sundlun and Linc Almond attempted to roll back the RIPAE program by calling for an increase in the senior’s co-pay and limiting access to benefits.

“The General Assembly made it very clear that it did not want to reduce state support, but rather moved to increase benefits,” Rep. Pires said.

“This year we’ll be expanding the list of drugs to include prescription drugs used to treat osteoporosis,” Rep Pires tells The Times, adding that House leadership also supports an out-of-pocket prescription drug cap of $ 1,500 annually.

With the RIPAE Next Step’s price tag of $ 3.5 million dollars. “We can’t afford to pay for an open formulary program yet because of budgetary limitations,” Rep. Pires states.

In upcoming legislative sessions, coverage for gastrointestinal drugs will seriously be considered, he adds.

“In the upcoming years the state’s pharmaceutical assistance program will remain a top priority to the General Assembly, Rep. Pires says. “There will be an expansion of coverage to a full formulary when more state monies become available, he adds.

Currently, Lt. Governor Fogarty estimates that more than 170,000 Medicare beneficiaries in Rhode Island, who do not meet the state’s pharmaceutical assistance program’s income eligibility requirements, lack comprehensive prescription drug coverage.

With an aging population, Congress and state lawmakers must roll up their sleeves to find innovative ways of making prescription drugs affordable.

The Best of…Seniors to Become Computer Savvy

Published June  11, 2001, Pawtucket Times

           More than 50 years ago, Richard Walton received a Smith Corona portable typewriter from his parents for his 21st birthday.   Over the years the journalist and writer Walton, now age 73, touched typed eleven books on that bulky machine.  From his college days in the late forties until the early 1990s, he continued to use the antique typewriter.                 

         Today Walton has gone through three computers, his present system is a Compaq Presario, Model 7470.  “It pretty much has all the bells and whistles,” Walton says.  As a journalist he loves his computer because “you don’t have to retype entire pages.”  With his Smith Corona, any typos forced him to retype entire pages.   Now paragraphs can be moved around with ease, to view and change before the final draft.

         Walton gets other bennies from using new computer technology.  “I communicate with people everywhere using e-mail” he say,noting that when he needs to research topics for his articles its simple, just cruise the World Wide Web.

       Walton is one of growing number of seniors who are using the computer to keep in touch with family and friends, word processing documents, keeping the checkbook, making electronic purchases for a vast variety of items, from books, drugstore purchases to travel packages.  Seniors can also tap into this evolving technology to research and buy stocks and to do their banking and pay their bills. 

      Stacy Dieter, vice president of Business Development for SeniorNet, a nonprofit San Francisco-based company that teaches seniors to use computers and the internet, calls seniors “savvy” when it comes to operating computers.  “May be younger people are more use to maneuvering the mouse, but seniors can quickly pick up how the use the computer technology,” she says.

      Older adults are the fastest growing audience online, Dieter tells The Times.   According to Jupiter Communications, Dieter notes that by the year 2003, it is estimated that 27.3 million people over age 50 years old will be using the Internet regularly.”

       Adds Dieter, computer ownership is also slowly increasing too.   A SeniorNet and Charles Schwab & Company 1998 market research study found that 40 percent of all seniors now own a computer at home compared with 29 percent in 1995.  Meanwhile, seniors spend more time per month online (38 hours) than any other age group, with more than 83 percent making daily visits to the Internet, she says.

      Senior centers are also moving into the computer age by making computers more accessible to their older participants.   With assistance from the state’s Department of Elderly Affairs (DEA), a growing number of senior centers acrossRhode Islandare opening up computer labs. 

      With two Compaq computers provided by DEA, one donated by a Rhode Island  Dot.Com company, FindRI.Com, and one surplus City of Pawtucket computer, Joan Crawley, Director of Pawtucket’s Leon Mathius Senior Center, pieced together her equipment, bringing the computer age Pawtucket’s seniors.

        Beginning in June, a small multi-use room in the Senior Center, originally used for health promotion activities, was transformed into a computer lab.   The City of Pawtucket provided the expertise to install the computers with Internet access.

       “We’re in the organizational phase right now,”Crawley says, adding that her waiting list of seniors wanting to learn how to use computers and the Internet has grown to more than 30.

         Although Pawtucket’s Senior Center Director expects the computer lab to be up and running and courses taught by the fall, the computers are now available for use by those who are knowledgeable about their use.  Half and hour time slots will be made available to these individuals.

          Meanwhile, volunteer instructors are now being recruited to teach the basics (using computer’s key board and mouse) to learning computer software programs and how to surf the Internet.          “The perfect volunteer might be someone who has recently retired and wants to share their expertise,”Crawley says.  The more volunteers will allow the computer lab to have extended hours. .

          Why a computer lab?   “We want our seniors to use the Internet to look up information on health care, Social Security or even about Medicare. Crawley notes that a social worker will be available to assist the computer user in culling the needed information from the targeted web sites.

          Crawley adds, “Ultimately we would like to get an e-mail address so that seniors can talk to their love ones who live are far away.”  Additionally, she believes that savvy senior computer users can save money too, by not spending money for newspapers and magazine subscriptions.  They can just use the Internet to seek out information in hundreds of thousands of newspapers or magazines published around the world.

          By adding a computer lab to the Senior Center’s programming, “We’re very excited about bringing Pawtucket’s senior population into the 21st century,Crawley says gleefully.

          SeniorNet is the world’s largest trainer of adults over 50 on computer technology and the Internet with 220+ SeniorNet Learning Centers in 38 states as well as the best on-line community for older
adults at http://www.seniornet.org.

           Herbert P. Weiss is a Pawtucket Rhode Island-based writer covering aging, health and medical care  This article appeared in June 11, 2001 in the Pawtucket Times. He can be reached at hweissri@aol.com.

Study Seeks Seniors Wanting Healthier Lifestyle

Published in Pawtucket Times on June 4, 2001

A University of Rhode Island research study that is currently under way is seeking seniors looking for a healthier lifestyle. The unique East Providence-based health promotion program plans to expand into nearby Pawtucket, Seekonk, Barrington, and the East Side of Providence and seeks 300 additional senior volunteers to participate.

At the SENIOR Project, URI researchers are investigating whether physical activity and nutrition are being elixirs to better health.

According to Director Phillip Clark, Sc.D., at URI’s Program in Gerontology, the National Institute on Aging-funded study takes a look at the effectiveness of a health promotion program geared at reaching people are at different stages of readiness to change their health-related behavior. “One size fit all” describes most health promotion programs, Clark tells The Times, but the SENIOR’s Project’s 12-month health promotion approach is “highly individualized.”

Currently, more than 1,000 enrollees age 65 and over have randomly been assigned to four health promotion interventions. All enrollees received material with large-print type for ease in reading.

The first intervention group receives a 20-page manual that explains the process of changing behaviors and the importance of physical exercise.  The second group is provided with a similar manual that also explains the change process but focuses on the nutritional benefits of eating fruits and vegetables.  A third group receives both sets of informational health promotion materials while the fourth group receives a manual on fall prevention.

Based on the results of quarterly questionnaire, an individualized report is generated and provided to each enrollee about their specific attitudes and behaviors, providing them with suggestions as to what they can do to make positive health and nutritional changes.

There are 16,000 possible variations of the computer-generated reports based on how the individualized questionnaires are filled out notes, Geoffrey Greene, Ph.D. RD, LDN, a URI professor in the Department of Nutrition and Food Sciences who also staffs the URI research team.

Greene adds that quarterly telephone counseling is offered too, by trained counselors. Using individualized reports, the counselor effectively coaches each older enrollee. “The counselors might focus on either the person’s attitudes or behaviors, depending on the person’s readiness to change,” he stated.

In between the quarterly reports. Greene notes that each enrollee will receive eight newsletters. Depending on the intervention group, the senior will be mailed a newsletter focusing on either nutrition, physical exercise, or both. Those seniors receiving the manuals about fall prevention will receive no newsletter. The URI nutritionist states that one of 40 variations of newsletters could be mailed to enrollees, linked to their level of readiness to change.


What specific nutritional lessons do people learn? Seniors receiving nutritional information on fruit and vegetables learn the importance of eating at least five servings of fruits and vegetables, Greene says. “It can help to reduce your high blood pressure, prevent certain types of cancers, reduce the risks of heart disease. Those who eat even more servings seem to have lower risks of diabetes, too,” Greene adds.

Greene states that seniors receiving nutritional intervention who already eat a lot of fruits and vegetables are told by the trained counselors to increase their variety. “A person is steered toward specific types of vegetables and fruits that are richer in nutrients and protective against certain types of diseases,” he adds.

As to physical fitness, Clark says that exercise is properly the most important health behavior for older adults. “It benefits body, mind and spirit,” he adds, noting that people of any age can benefit from a regular exercise program. Before beginning any exercise program, one needs to check with a physician, warns Clark.

Clark believes that “It’s never too late to begin to increase your physical activity.”

Estelle Tetreault, 78, a former public health nurse who had cardiac surgery last March, is a believer in the SENIOR Project and is pleased with her positive lifestyle changes. “The program really gets us off our butts,” she quipped, noting that her interest in health promotion influenced her to enroll.

For a while, Tetreault admits, she was a couch potato. “Exercise and nutrition have become a regular and more important part of my life,” the former Pawtucket and now East Providence resident says. “The upshot is I joined the SENIOR Project to support them but the project has become a source of support for me.

Tetreault’s longtime friend, Fran Robertson, also an East Providence resident and participant in the research study sees the tangible benefits, too. “Everyday Fran reminds herself to eat five fruits and vegetables,” Tetreault says, noting that her friend now regularly reminds herself to exercise daily.

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