Fixing rising pharmaceutical drug costs once and for all

Published in RI News Today on September 27, 2021

Just days ago, WBUR.org, Boston’s NPR News Station, featuring NPR News and Programs, aired a 45.37 minute program, “Steps to Fix America’s Broken Prescription Drug System,”  clearly illustrating the need to fix America’s ailing prescription drug program.  While Americans are traveling to Mexico in search of affordable prescription drugs, referred to as “Pharmaceutical Tourism,” the NPR program added a new twist. Now some state insurance companies are sending their beneficiaries to Mexico to purchase cheaper their pharmaceuticals manufactured in the United States at a lower price, on their tab.  

For instance, let’s take a look at Ann Lovell, of  Salt Lake City, Utah. The NPR Program, aired on Sept. 24, 2021, introduced us to the hearing-impaired former teacher who worked at an early-intervention program for deaf students that’s part of the Utah Schools for the Deaf and Blind, who traveled from Utah to Mexico five times to purchase Enbrel, to treat rheumatoid arthritis, with travel costs and a $500 cash incentive paid by her insurer, the Public Employees Health Program (PEHP). 

Lovell’s Utah physician writes her a prescription, and each tie she travels to Mexico she sees a physician at the Tijuana-based hospital as well.  She updates the physician on her medical condition, gets her prescription, and takes it to the pharmacist, who gives her the medication. 

NPR’s program noted that the Utah initiative was created under a 2018 state law, “Right to Buy,” by Republican Congressman Norm Thurston.  PEHP offers it only for people who use a drug on a list of about a dozen medications were the state can see significant savings.  Of the 150,000 state and local public employees covered by the insurer, fewer than 400 are eligible to participate.

Responding to a tweet promoting the offer, Levell quickly enrolled for as they say an offer she could not refuse.  She and a companion would travel on an all-expenses paid trip from Utah to Tijuana, Mexico to pick buy her pharmaceuticals at a steep discount paid for by the state of Utah’s public insurer to slash the high cost of prescription drugs. PEHP would only have to pay half of the cost of Embrel versus if Levell got it in the United States, saving tens of thousands of dollars. The annual U.S. list price for the drug, Enbrel, is over $62,000 per patient. 

It was one long, exhausting travel day.  At 5:00 a.m., Lovell and her friend flew from Salt Lake City to San Diego.  There, an escort picked them up and took them across the boarder to a Tijuana hospital, where she got a refill on her prescription.  After that, they were shuttled back to the airport and arrived back home by midnight. 

Lovell said she initially began paying $50 a month for her pharmaceutical, increasing to $450 in co-pays.  It would have increased up to $2,500 if she hadn’t started traveling to Mexico.  Without the program, she would not be able to afford the medicine she needed

With the COVID-19 pandemic closing the borders, PEHP’s “Pharmaceutical Tourism” initiative came to an end with the borders closing.   Lovell’s insurer came up with a new option of getting Enbrel at lower cost.  That’s when Lovell was told about the drug manufacturer’s coo-pay program where she would only have to pay five dollars a month.  

Calls for Medicare Negotiating the Cost of Pharmaceuticals 

Although traveling to Mexico or Canada to purchase more affordable pharmaceuticals is a temporary fix, the Washington, DC-based AARP calls for a permanent solution.  The national AARP advocacy group has launched a $4 million ad buy calling Medicare to step in to lowering the spiraling costs of pharmaceuticals.  

The Washington, DC-AARP noted that a recent AARP survey of voters found that 80% agreed or strongly agreed that drug prices could be lowered without harming innovation of new medicines. Strong majorities of voters, regardless of political affiliation, want Congress to act on the issue this year, with 70% saying it is very important. The survey also found that 87% of voters support allowing Medicare to negotiate prescription drug prices. 

AARP’s full-scale ad campaign blitz, including a $4 million ad buy, pushing back on false claims from the pharmaceutical industry that reforms would limit Americans’ access to medicines. AARP has called for fair drug prices for years and is urging Congress to pass legislation that would allow Medicare to negotiate drug prices, put a cap on out-of-pocket costs that older adults pay for their prescription drugs and impose penalties on drug companies that raise prices faster than the rate of inflation.

AARP’s new national ad campaign points out that Americans’ tax dollars subsidize new drug development even as Big Pharma charges Americans dramatically higher drug prices. The ad goes on to urge Congress to “stop the Big Pharma scam. Let Medicare negotiate drug prices.” Beginning tomorrow, it will air nationally on MSNBC and CNN; and in the DC metro area on the Sunday political shows and local radio stations, as well as on digital platforms including the New York Times, Washington Post, CNN, and Politico. In addition to paid advertising, AARP members began taking part in grassroots action beginning September 20. A social media campaign calling for older adults to #ShowYourReceipts has led thousands to share their monthly medication costs with AARP, with their monthly “bills” now running over $11 million.

“Americans are fed up with paying the highest prices in the world for prescription drugs,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer in a Sept. 17, 2021 statement announcing this advertising campaign. “Our 38 million members are watching and they are counting on their members of Congress to do what’s right and vote to let Medicare negotiate for lower drug prices.”

Now, Congress Must Act…

Congress is currently debating measures to rein in the cost of prescription drugs, and the House Ways & Means Committee advanced legislation this week that includes many of AARP’s priorities on fair drug prices.

Age Discrimination, Workplace Issues at House Hearing

Published in RINewsToday.com on March 22, 2021

Just days ago, Rep. Robert C. “Bobby” Scott (D-VA), chairperson of the House Committee on Education and Labor and Rep. Rodney Davis (R-IL) introduced, H.R. 2062, the bipartisan “Protection Older Workers Against Discrimination Act” (POWADA), a bill that would strengthen federal anti-discrimination protections for older workers. The legislation was introduced March 18, 2021, the same day of a joint House Education and Labor Subcommittee hearing, held to address a variety of workplace issues.  POWADA has been referred to the House Committee on Education and Labor for consideration.

The reintroduction of POWADA is timely.  As the COVID-19 pandemic continues, older workers are attempting to keep their jobs, working more and longer than they ever have. When seniors lose their jobs, they are far more likely than younger workers to join the ranks of the long-term unemployed. And unfortunately, discrimination appears to be a significant factor in older workers’ long-term unemployment.

A 2018 survey conducted by the Washington, DC-based AARP found that 3 in 5 workers age 45 and older had seen or experienced age discrimination in the workplace. The 2018 survey also found that three-quarters of older workers blame age discrimination for their lack of confidence in being able to find a new job.

Congress Gears Up to Again Fight Age Discrimination

Reps. Scott and Davis were joined by seven Republicans and 14 Democrats, including Civil Rights and Human Services Subcommittee Chair Suzanne Bonamici (D-OR) and Workforce Protections Subcommittee Chair Alma Adams (D-NC) to support H.R. 2062.

Rhode Island Rep. David Cicilline has also requested to be a co-sponsor of this legislation.

POWADA was first introduced in Congress after an adverse 2009 Supreme Court decision, Gross v. FBL Financial Services, made it much more difficult for older workers to prove claims of illegal bias based on age. Under Gross, plaintiffs seeking to prove age discrimination in employment are required to demonstrate that age was the sole motivating factor for the employer’s adverse action.  The Supreme Court ruling upends decades of precedent that had allowed individuals to prove discrimination by showing that a discriminatory motive was one of the factors on which an employer’s adverse action was based.

Scott’s reintroduced POWADA returns the legal standard for age discrimination claims to the pre-2009 evidentiary threshold, aligning the burden of proof with the same standards for proving discrimination based on race and national origin.

“Everyone– regardless of their age – should be able to go to work every day knowing that they are protected from discrimination. Unfortunately, age discrimination in the workplace is depriving older workers of opportunities and exposing them to long-term unemployment and severe financial hardship, says chairperson Scott, noting that the reintroduced bipartisan bill would finally restore the legal rights under the Age Discrimination in Employment Act, which covers workers age 40 and over.

Republican Rep. Rodney Davis puts aside political differences and has stepped up to the plate with a handful of GOP lawmakers to co-sponsor Scott’s POWADA legislation. “Every American, including older Americans, deserves to work in a workplace or jobsite that is free from discrimination. That’s why I’m proud to team up with chairperson Bobby Scott and a bipartisan group of lawmakers in introducing the Protecting Older Workers Against Discrimination Act. Our bipartisan bill provides workplace protections for older workers by removing barriers they have to filing discrimination claims, ensuring their workplace rights can be enforced, says Davis, pledging to work with colleagues on both sides of the aisle to finally get the bill passed,” he says.    

Oregon Rep. Bonamici, who chairs the Subcommittee on Civil Rights and Human Services, notes that her state has a rapidly aging population, and age discrimination in the workplace remains disturbingly pervasive.  She joins Scott in cosponsoring POWADA.

“I’ve heard from Oregonians who were denied or lost a job because of their age, but the bar for proving discrimination is very high and the outcomes are uncertain. The bipartisan Protecting Older Workers Against Discrimination Act makes it clear that unlawful discrimination in the workplace is unacceptable and holds employers accountable for discriminatory actions,” says Bonamici.

Adams, who chairs the Subcommittee on Workforce Protections, joins Bonamici in cosponsoring POWADA.  The North Carolina Congresswoman states: “Labor law must protect the dignity of all workers and it must recognize that discrimination against older Americans is discrimination all the same,” says Adams, who chairs the Subcommittee on Workforce Protections. The North Carolina Congresswoman notes that POWADA ensures that older workers will be fairly treated in the job market, returning the legal standard for proving discrimination back to its original intent. There is no place for disparate treatment based on age in the workforce.”

“Labor law must protect the dignity of all workers and it must recognize that discrimination against older Americans is discrimination all the same,” says Adams, who chairs the Subcommittee on Workforce. The North Carolina House Lawmaker says that POWADA ensures that older workers will be fairly treated in the job market, returning the legal standard for proving discrimination back to its original intent. There is no place for disparate treatment based on age in the workforce.

“The introduction of this bill is a crucial step to strengthening the law and restoring fairness for older workers who experience age discrimination,” said Nancy LeaMond, AARP Executive vice president and Chief Advocacy & Engagement Officer. “It sends a clear message that discrimination in the workplace – against older workers or others – is never acceptable.

“Age discrimination in the workplace, like any other kind of discrimination, is wrong.,” said AARP Rhode Island State Director Kathleen Connell. That’s why AARP is fighting all forms of age discrimination in the hiring process and on the job, including an unfair court decision that makes age discrimination more difficult to prove than race- or sex-based discrimination. “Rhode Islanders are living and working longer and experienced workers bring expertise, maturity, and perspective,” Connell added. “Yet negative stereotypes and mistaken assumptions mean that older people are often treated unfairly in the workplace. We need bipartisan Congressional action to address this stubborn and persistent problem.”

Tackling Workforce Issues

Over two-hours, four witnesses testified at a joint Zoom hearing, “Fighting for Fairness: Examining Legislation to Confront Workplace Discrimination,” held before the House Education and Labor Subcommittee on Civil Rights and Human Services and the Subcommittee on Workforce Protections. The morning hearing addressed an array of workforce issues including race and longstanding gender inequities and barriers and pregnancy discrimination at the workplace. A spotlight was also put on the rampant increase of age discrimination that older workers are now facing in the job market and the need to pass POWADA to reverse the detrimental impact of a 2009 Supreme Court decision.

Lauren McCann, senior attorney at AARP Foundation, pointed out to the attending House lawmakers that age discrimination in the workplace remains “stubbornly persistent” and urged a House Education and Labor hearing to “re-level the playing field” by passing strong anti-bias legislation.

McCann told the committee that the ongoing COVID-19 pandemic has exacerbated the problems faced by older workers, who have left the labor force in the last year at twice the rate during the Great Recession.

McCann testified that passage of POWADA, sponsored by Scott, the Chair of the House Committee of Education and Labor, is crucial to reverse the 2009 Supreme Court decision in the Gross v. FBL Financial Services, Inc. case. McCann said that the high court’s 2009 decision abruptly changed the standard — from the longstanding requirement under the ADEA that a worker prove that age is just one motivating factor in adverse treatment on the job — to a much higher and tougher to prove standard: that age is the standard motive.

“Older workers now always bear the burden of persuasion in ADEA cases,” McCann emphasized.

According to McCann, House hearing comes at a time when older workers have been battered by the economic downturn caused by the pandemic. Unemployment for workers age 55 and older more than doubled between Feb. 2020, just before the pandemic began, and last month, based on AARP Public Policy Institute (PPI) analysis of federal data.

The number of age 55 and over unemployed has also doubled, up from one million in February 2020, to 2 million last month, according to PPI.

Turning to the Senate…

At press time, a senior Senate aide for Sen. Bob Casey (D-PA), who chairs the Senate Special Committee on Aging, says the Senator is posed to follow the House by throwing the Senate’s POWADA Senate companion measure into the legislative hopper Monday. 

The Pennsylvania Senator clearly understands why he again must push for the passage and enactment of POWADA.  “As more Americans are remaining in the workforce longer, we must recognize and address the challenges that aging workers face. We must make it clear to employers that age discrimination is unacceptable, and we must strengthen antidiscrimination protections that are being eroded,” says Sen. Casey. “POWADA would level the playing field for older workers and ensure they are able to fight back against age discrimination in the workplace.”

AARP: Vaccinate seniors now!Leaders respond. Add YOUR voice.

Published in RINewsToday.com on January 25, 2021

The debate heats up as to how Rhode Island should distribute its limited stock of COVID-19 vaccine. Days ago, AARP Rhode Island urged state officials and lawmakers to put seniors on the top of the list to protect their lives. Older Rhode Islanders should be a priority in getting vaccinated, says the state’s largest nonprofit. 

AARP Rhode Island, generally speaking, reserves sending public letters to public officials for the most critical of issues. Because of the pandemic, a critical issue, AARP is reaching out to its 132,000 Ocean State members and the public at large to demand immediate change.

“The message AARP wants sent to the Governor and State Leaders reads, in part, “Rhode Islanders 50 and older account for 98% of the state’s more than 2,000 COVID deaths. Yet only a quarter of vaccinations to date have been administered to older Rhode Islanders. You must revise the plan to vaccinate the most vulnerable among us. I am therefore calling on you to revise the state vaccination plan immediately to prioritize vaccinating our 50 and older population. There is no time to waste,” said AARP Rhode Island State Director Kathleen Connell.

A Call to Revising the State’s Vaccination Distribution Plan

Connell added, “Now that the state has responded to AARP Rhode Island’s call to make the state’s COVID vaccination plan and its execution more transparent, I am alarmed and dismayed to find data only now available reveals that just 25% of vaccinations to date have been administered to Rhode Islanders age 60 and older.”

“The current disparity — which flies in the face of federal health recommendations and causes great concern for many older Rhode Islanders and their families — is inexplicable, life threatening and unacceptable,” says Connell. 

AARP Rhode Island’s work is part of a nationwide effort, says Connell. “AARP is advocating hard to ensure every older American who wants to get the vaccine can get it,” said AARP Executive Vice President and Chief Advocacy & Engagement Officer Nancy A. LeaMond.

“It’s also vital that distribution plans for authorized vaccines are smoothly implemented,” LeaMond added. “There’s no time to waste: it’s time for full-scale mobilization, and any delays or early bottlenecks in distribution systems need to be addressed urgently. AARP remains committed to protecting the health and well-being of our nearly 38 million members and all Americans as we work together to defeat this virus,” she said.

Rhode Island leaders respond to AARP’s call

Speaker of the House of Representatives Shekarchi:

“We all want the most at-risk people, including our seniors, to have access to the vaccine absolutely as soon as possible. My father is 94, and it will be a tremendous relief to me and my family when he is protected,” said House Speaker Joseph Shekarchi (D-Dist. 23 Warwick). “President Biden’s timeline includes prioritizing access to the vaccine for those 65 and older, and it’s important that we comply with it,” he says.  

“I understand we need greater supply. Our House COVID-19 Vaccine Task Force will vigilantly monitor the distribution to ensure our state is doing everything we can to get the vaccine to those most at risk, particularly those 65 and older, as soon as possible, in cooperation with the federal government,” adds Shekarchi.

Dr. Chan, RI Dept. of Health:

In a Jan. 22 email vaccine update, Dr. Phillip A. Chan, MD, MS, the Rhode Island Department of Health’s (RIDOH) Consultant Medical Director, reported that 66,070 doses of vaccine had been administered in Rhode Island (52,925 first doses, and 13,145 second doses). “We are working hard to distribute vaccine, but supply remains very limited. Right now, we’re receiving enough first doses each week for about 1.5 percent of our population. While other states are in the same position, Rhode Island ranks among the top states nationally in terms of the rate of second doses administered,” he said.

As to the vaccination distribution timetable, Chan noted that nursing home residents and staff began to get vaccinated in December. “This week, we started to vaccinate in assisted living facilities and other congregate living settings.  By middle of February, we expect the vaccine will be available for adults 75 and older,” he says. 

According to Chan, there are 187,000 Rhode Islanders age 65 or older. “Since we are only getting 14,000 first doses of vaccine a week, we are taking a stepwise approach to this group as well,” he noted in RIDOH’s vaccine update.  “Please note that there is no action older adults need to take at this time to get a vaccine. When we are ready to start vaccinating this population, we will communicate with the public, healthcare providers, and community organizations to provide instructions.”

Incoming Governor, Lt. Gov. McKee:

Meeting outside Lt. Gov. Dan McKee’s Cumberland home, WPRI reporters, Eli Sherman and Brittany Schaefer, got insight into McKee’s thoughts about the state’s COVID-19 vaccine rollout strategy and issues surrounding this distribution. They report the details in a Jan. 23 WPRI blog article, “McKee: Teachers should get vaccine before others in Rhode Island.” McKee will move into the governor’s seat once Gov. Gina Raimondo is confirmed as U.S. Commerce Secretary.  

Here are some points from McKee’s interview in the Sherman and Schaefer’s blog article: 

“We need to really move up on the list teachers and the support staff in schools,” McKee said. “We’re not going to open the economy until we do that, and teachers are not going to feel comfortable by and large until we get them vaccinated.” (Teachers are not in the Rhode Island Department of Health’s phase one vaccination rollout)

“Prioritizing educators would inevitably delay vaccinations for all non-educators, and McKee did not name any other group Saturday that he thought should be prioritized. When asked specifically about adults 65 years and older, McKee said he expected they would also be prioritized, but underscored the state is only receiving a limited amount of supply of the vaccine from the federal government,” says the WPRI blog.

President Joe Biden encourages states to make it a priority to vaccinate people age 65 and over, along with grocery store workers and teachers. No specifics have been released yet by his administration. 

“I think it’s a supply issue, but that age group is a priority,” McKee said. “We’re going to follow the lead of the Biden administration”.  

Stay tuned as the debate continues on how Rhode Island should disseminate its limited COVID-19 stockpile – and what it can move to when the flow of vaccine becomes more generous.

Give Governor Gina Raimondo your thoughts as to AARP Rhode Island’s call for vaccinating people age 50 and over “immediately”.  Here’s the governor’s contact details:  Governor Gina Raimondo, 82 Smith Street, Providence, RI 02903; email: governor@governor.ri.gov; phone: (401) 222-8096.