Congress to Debate Pharmaceutical Drug Benefit

Published in Pawtucket Times on June, 24, 2002

A looming November election is prodding Congress to get serious and tackle one of the hottest issues of interest to seniors – skyrocketing pharmaceutical costs that hit them hard in their pocketbooks.

At press time, two House Committees have now marked up the 255-page GOP prescription drug proposal. The final GOP bill is expected to be brought to the House floor for a vote later this week.

Congress is now poised to consider three prescription drug benefit proposals – two would expand Medicare and one would follow a private marketplace approach toward creating a meaningful prescription drug coverage for seniors.

Under the 10-year GOP proposal, which has a $ 350 billion price tag, drug coverage would be directly purchased by Medicare beneficiaries from insurance companies. Seniors would pay a $250 annual deductible along with a $ 34 monthly premium.

For low-income beneficiaries, Medicare would pick up the tab, paying for both premiums and deductibles. The GOP drug benefit would cover 80 percent of senior’s annual prescription drug costs up to $ 1,000; 50 percent up to $ 2,000 and none of the costs between $ 2,000 and $ 3,700, after which a catastrophic benefit would kick in.

In sharp contrast to the GOP plan, the Democratic House proposal costing about $ 800 billion includes a $ 25 per month premium with an annual deductible of $100.

Under a new Part D in Medicare, beneficiaries would pay 20 percent of the drug costs -up to $ 2,000, after which Medicare would pay 100 percent. Under a Senate Democratic proposal, costing up to $ 500 billion, seniors would pay a $ 25 premium but have no deductible. The Senate version would also set a limit of $ 4,000 in out-of-pocket expenses and require co-payments of $ 10 for generic drugs and $ 40 for preferred brand-name medications.

A vote on the Senate prescription drug package is expected to take place next month.

Democrats and Republicans are now cranking up their public relations machinery to take potshots at each other’s bills and tout their own proposals as “the real drug benefit.”

The bipartisan bickering surrounding the prescription drug-coverage issue is complex at best, especially for the senior voter ho must attempt to understand the minute details of the Democratic and Republican proposals.

Even wading through the pounds of press releases and background papers, generated by both parties’ spin machines and special interest groups, can become a challenge task at best.

Literature created by the House Republican Speaker’s Prescription Drug Action Team calls the Democratic prescription drug proposal an “election-year gimmick.”

The GOP plan stays within an already-agreed upon federal budget of $ 350 billion over 10 years to strengthen Medicare with prescription drug coverage, a flyer says, noting that the Democratic plans “simply spend billions more.”

Furthermore, the Republican generated literature announces that Health and Human Service Secretary Tommy Thompson has thrown the administration’s support firmly behind the GOP House proposal.

The HHS agency report finds competition among private insurers that offer the pharmaceutical benefit, concluding this approach would provide real financial relief for seniors.

According to HHS, analysis of the GOP proposal, seniors would save as much as 70 percent on their overall out-of-pocket costs for prescriptions. In addition, seniors would save 60 to 85 percent per prescription.

Meanwhile the Democrats have taken aim at the GOP proposal charging that it only serves the interest of the pharmaceutical industry.

U.S. Rep. Patrick Kennedy (D-R.I) gives his thumbs-up to the House Democrats plan, considering it to be the best legislative fix for protecting seniors against spiraling  costs. The Rhode Island congressman told All About Seniors the GOP proposal would pay, at most, 25 percent of the costs of medications. Moreover, Kennedy added seniors would face an enormous  gap in drug coverage, too. Seniors would be responsible for paying the tab if their medication costs fall between $ 2,000 and $ 3,700.

Washington, DC-based aging advocacy groups are also throwing their two cents into this complex congressional debate on prescription drug coverage.

In March 2002, the AARP, the nation’s largest advocacy group, released survey findings that indicate aging baby boomers and seniors see a public-sector response as the way to bringing meaningful pharmaceutical coverage to seniors.

According to the survey, eight in 10 Americans age 45 and over favor making prescription drug part of the Medicare system. Sixty-seven percent strongly favor this benefit.

Ron Pollack, executive director of Families USA, a national group that advocates for high quality, affordable health care, charged the “House Republican prescription drug plan is far designed to provide political protection for House incumbents than drug cost relief for America’s seniors.”

“The proposal provides precious little assistance and keeps prescription drugs unaffordable for millions of seniors,” Pollack said.

The closer you examine the provisions in the GOP prescription drug proposal, you will see major flaws, Pollack stated. “The proposal provides a very meager benefit and forces seniors to pay the lion’s share of drug costs,” he says, adding this will result in many seniors not being able to affordable medications they need.

Meanwhile, Pollack stated that using private insurance companies to provide prescription drug coverage is the wrong approach. He said there is no guarantee insurance companies will offer drug coverage in specific communities, and the GOP proposal allows insurance companies to define the coverage they offer in different locations.

“Seniors will have no certainty about the premiums they need to pay, the cost-sharing they will bear, the drugs that are covered and under what conditions they can obtain those drugs,” notes Pollack.

When both chambers pass their prescription drug proposals, U.S. Sen. Jack Reed (D-R.I.) said he believes the Senate and House can reach a compromise at the conference committee table.

However, he warned a compromise cannot come at the expense of a senior’s bank account.

I hope Congress listens to and hears a key message from AARP’s 2002 survey – that is eight in 10 of those participating consider providing a Medicare prescription drug benefit to be an extremely important priority for the President and Congress.

With pharmaceutical drug costs continuing to increase, millions of senior voters can no longer afford to wait for a solution blocked by political bickering.

At best, with a little more than four months until the November elections, Democratic and Republican lawmakers might just choose to put politics aside and strike a compromise that can achieve  widespread bipartisan support in both chambers for passage of a meaningful pharmaceutical benefit law.

It’s that time.

Lawsuits Filed to Put Brakes on Rising Pharmaceutical Costs

Published in Pawtucket Times on June, 2, 2002

In conjunction with seniors advocates lobbying Congress for Medicare prescription drug benefits and state legislatures for financial relief in paying for the spiraling costs of pharmaceuticals, the AARP and other aging groups, along with state attorney generals, are going to court to put the brakes on spiraling prescription drug costs.

Ron Pollack, executive director of Families USA, called for pharmaceutical companies to not delay generic drugs from coming quickly to market during an April forum on Capitol Hill, which was held to spotlight the anti-competitive practices of the prescription drug industry.

Delaying or preventing the widespread use of generic drugs endlessly increases costs for consumers, including Medicare beneficiaries as well as  third-party payers of health care, Pollack stated.

“It improperly extends drug monopolies that enables the drug companies to profit at the expense of everyone else,” he said.

The lawsuits bring litigated are intended to make the pharmaceutical marketplace work for everyone,” Pollack said, noting that it was ironic that the drug industry goes to great lengths to prevent the regulation of prices in the name of promoting a free market.

Legal initiatives are now a part of a broad AARP drive to reduce high drug costs that hit seniors hard in their pocketbooks. Washington’s largest aging advocacy group is ratcheting up its efforts to lower drug costs by joining three important cases against prescription drug manufacturers that have blocked the availability of lower-priced generic equivalents.

AARP CEO Bill Novelli has announced that his group’s attorneys will serve as co-counsel in three lawsuits that involve charges of patent abuse, suppression of generic competition and collusive agreements with generic manufacturers.

“Geriatric drugs approved by the Food and Drug Administration (FDA) at equivalents give consumers quality drug alternatives at reasonable prices,” Novelli said today. “Our aim is to help people get affordable access to the drugs they need.”

The lawsuits mark the first time that AARP attorneys will co-counsel in federal anti-trust litigation against drug manufacturers, he said.

AARP’s legal actions come against a backdrop of rising prescription drug costs. Spending for brand-name drugs has tripled in the last decade, rising from $ 40.3 billion in 1990 to $ 121.8 billion in 2000, and is expected to more than triple to $ 414 billion in this decade. Generic drugs typically cost 50 percent or less than brand-name drugs.

According to the AARP, millions of dollars are at stake annually for older Americans, who account for 42 percent of the U.S. prescription drug consumption, and other consumers who purchased prescription drugs.

The three ongoing class action cases – all in federal court – are In Re: Buspirone Antitrust litigation, In Re: K-Dur Antitrust and In Re: Tamoxifen. The AARP chose the cases because they involve important drugs that are widely used by Americans age 50 and over.

AARP attorneys are participating in these cases as co-counsel in order to ensure that a strong consumer voice is represented throughout the proceedings, including any settlement.

AARP attorneys will serve as co-counsel in the three above-mentioned cases with attorney’s associated with the Prescription Access Litigation Project (PAL), a coalition of consumer and health care organizations that was launched last year by Boston-based Catalyst.

With AARP name recognition, resources and clout, it is easy to see why Community Catalyst Executive Director Rob Restuccia is ecstatic about AARP’s decision to joint three of PAL’s class action lawsuits.

“The PAL coalition welcomes the firepower of the AARP, firepower that will strengthen our capacity to challenge the anti-competitive activities of some drug companies,” he said.

In the midst of AARP’s lawsuits here in Rhode Island, low-and moderate-income seniors and disabled will now see lower pharmaceutical costs with the passage of the three legislative proposals that would expand drug coverage of the state’s Rhode Island Pharmaceutical Assistance for the Elderly program.

A thumbs-up goes to the Rhode Island General Assembly for the wisdom of acting on these legislative proposals.

Meanwhile, at the federal level, Rhode Island U.S. Reps. Patrick J. Kennedy and James R. Langevin are gearing up for expected House debates in early June over legislation to create a drug benefit for the Medicare Program. Stay tuned for this one.