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Some
Retirees Look Abroad for Prescription Drugs
By RANDI HUTTER EPSTEIN
NY Times, September 24, 2002
Gary
Truman for The New York Times
Stuart Lauterbach, 72, of Boynton Beach, Fla., has 1 of 7 drugs covered.
After months of
intense debate, proposals aimed at helping the elderly pay for
prescription drugs did not make it out of the Senate this summer. Neither
the Republican plan, which involved government subsidies to private
insurers, nor the Democratic plan, which would have expanded Medicare
benefits, garnered the 60 votes needed.
The stalemate
has left many elderly to devise their own strategies for saving money on
prescription drugs. Some buy drugs abroad: for instance, several drugs
that require a prescription in the United States are sold over the counter
in Mexico, where they are much cheaper. Other people simply skip their
pills now and then.
There are other
techniques. "I prescribe some people double the dose they need so
they can split the pill, because sometimes buying the higher dose is
cheaper than buying twice the lower dose," said Dr. Erik Steele, a
family practitioner in Bangor, Me.
No one tracks
how much is spent on drugs abroad. American doctors can apply for licenses
that permit them to write prescriptions that can be filled in Canada. The
demand for Canadian drugs has spawned middlemen who order drugs for
residents who want to avoid traveling to Canada.
The Food and
Drug Administration does not condone buying drugs in Canada or Mexico or
on the Internet. Dr. Tom McGinnis, director of pharmacy affairs at the
agency, said that when consumers bought drugs online, they did not know
where the drugs were coming from.
"It's
buyer beware," he warned. "We have heard about recycled
medications, counterfeit drugs and medicine past its expiration
date."
Many Medicare
recipients enroll in health maintenance organizations, paid for by
Medicare. Medicare recently reduced its payments to H.M.O.'s, prompting
many of them to drop Medicare patients, increase premiums or cut drug
benefits. A recent report by the Henry J. Kaiser Family Foundation said
that 40 percent of people in Medicare's managed care programs had complete
drug coverage, down from 80 percent in 1999.
Four people
agreed to share their stories about how they obtained their prescription
drugs. Two have private insurance that does not cover prescription drugs;
two are enrolled in H.M.O.'s, paid for by Medicare.
Stuart
Lauterbach, 72
Mr. Lauterbach, of Boynton Beach, Fla., retired as chief executive of
Flemington Supply Company in New Jersey. Mr. Lauterbach can get his
medications from the Department of Veterans Affairs, but the agency offers
only one of the seven drugs his doctor prescribes. His insurance does not
pay for prescription drugs.
I go the
Veterans Administration and pay $7 for a three-month supply of one of my
pills. But I take six other drugs. The V.A. does not have most of the
drugs that my doctor prescribes.
So what do I
do? I go online and get all of my drugs and my wife's drugs from Canada,
and I save a lot of money. I was paying $600 a month, but now I'm paying
$800 for three months.
My drugs come
from Manitoba. When you call, it takes three to five weeks because they
are so busy filling prescriptions. If I run out of pills and I get them in
the United States, it costs me a fortune.
The price of
drugs is uncalled for if they can have the same drugs, in the same sealed
bottles, in Canada for two-thirds of the price. I have a pacemaker and a
fibrillation so I have to be on all of these drugs.
Fred Sanchez, 59
Bryce
Harper for The New York Times
Fred and Yolanda Sanchez are enrolled in an H.M.O. paid for by Medicare.
A retired steel company welder and
foreman, Mr. Sanchez, of San Antonio, is enrolled in an H.M.O., paid for
by Medicare. He pays $10 to $30 a month for each prescription. He is
taking four drugs and his wife, Yolanda, is taking seven.
It's hard, it's
real hard. My wife is on medicine for her thyroid, and she also takes
medicines for her diabetes, high blood pressure, and asthma. It's tight,
especially when you think we also have to pay for groceries and utilities.
I am on medicine for back and shoulder pain and medicine to lower my
cholesterol.
Sometimes we
just don't buy the drugs because they are too expensive. We try not to go
longer than a week off medicine. At one point her sugar got really high.
What we do is we wait and get free samples from the doctor.
But we worry
when she goes off her medicine because sometimes she can't even walk from
the bedroom to the kitchen because she can't breathe well.
Things keep
getting tougher. We used to get the bottle of oxygen without paying, but
now we have to pay for it. The H.M.O. pays for the breathing medicine, but
not all of the diabetes medicine.
I have had four
surgeries for my back, and I'm still in pain. I tried to stay off the pain
medicine. It got too expensive. It just seems to be getting out of hand.
Della
Leyva, 56
Mrs. Leyva, of Los Angeles, is a retired beautician. Her H.M.O., which
Medicare pays for, covers some of her drugs, but Mrs. Leyva said the
out-of-pocket cost had been increasing. She now pays $15 for a month's
supply of one pill, up from $9. Her husband takes eight pills a day, and
she takes four.
In 1980, my
husband had a heart attack and was put on three drugs, and they weren't
that expensive. We just had to pay about $3 or $5. But in the past few
years, the prices for medication have gone sky high.
My husband is
now 69, and he is taking a diuretic and steroids and drugs for his ulcer.
It's really cutting into our money. He is also on inhalers and oxygen. But
what was happening was that I was running out of his inhalers before the
end of the month. If I needed to start on the next month's supply, I could
not get the reimbursement so I had to pay the full price, $95. If I could
wait two days, I would be able to get the same medicine for $25.
Then we found
out that a friend could get the same inhalers for $10 in Tijuana, Mexico,
about a three-hour drive from here. He gets me two or three, to keep us
ahead of the game. We didn't tell our doctor at first, and when we did, he
was concerned, but he can't do anything about it. I need the backup. I
need more than two inhalers a month.
I haven't
looked into other medicines in Tijuana, but I will. I won't go because I
can't leave my husband alone, and he can't go there. So, I will find
friends to get the drugs for us. I hate to complain but a lot of our money
we have been saving is going to pay for medicine.
Clifford B. Turner, 69
Herb
Swanson for the New York Times
Clifford B. Turner, 69, of Bangor, Me., has insurance that doesn't cover
drugs.
Mr.
Turner of Bangor, Me., is a retired foreman for Sikorsky Aircraft in
Stratford, Conn. Mr. Turner's former employer provides insurance, but it
does not cover prescription drugs.
My wife and I
get insurance until I am 70, but that does not pay for the drugs. That is
why I go to Canada. We are not poor, but like a lot of folk our cash is
rather limited. I am on a diuretic and inhalers and medicine for Type 2
diabetes.
Now, if I
didn't go ahead and somehow stagger my prescriptions, I could easily blow
$500 in one shot at the pharmacy. But my doctor has a Canadian license, so
I go to Canada and pay about a third the price.
We live 79
miles from the border, so now we go over and visit with friends and family
and then get the drugs. I don't mind the trip, but it's kind of ludicrous
that we've got to go there. I know they've got chartered buses, and they
fill them up right away with senior citizens.
There are a lot of people who are just borderline, who
are earning just enough to put them on the high side of the income
requirements, and that little bit of difference in income can make the
difference of having a piece of meat for dinner or just beans.
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