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New Drug Cards for Seniors
April 18, 2002 You'd think after reporting on the American health-care scene for 22 years nothing about it would surprise me. Still, it's hard to understand why our nation's elderly , the so-called greatest generation, has such a miserable time paying for the prescription drugs that keep so many folks alive and active into their later years. That question resurfaced again last week after a hastily assembled alliance of seven major pharmaceutical companies promised to reduce their prices 20% to 40% for certain low-income seniors by giving them a discount card to present at the pharmacist's counter. This unprecedented offer will certainly provide savings for couples with incomes less than $38,000 a year (or individuals with less than $28,000). But the new Together Rx card, as it is known, as well as several recent discount programs from other drug makers, amount to an absurdly inadequate solution for the millions of elderly Medicare recipients. Only about 30% of the 40 million seniors on Medicare qualify for the discount cards. And people who meet the income requirements but happen to live in states that already have a drug plan for the poor -- New Jersey and Pennsylvania, for instance -- aren't eligible for most of the cards either. To take full advantage of the new deals, seniors will have to lug a deck of different company cards to the drugstore. Even then, they will be frustrated and confused because the discounts vary widely from drug to drug. Bristol-Myers Squibb is discounting one drug 30% (Pravachol for cholesterol), one 46% (Glucovance for diabetes), and a third 50% (Glucophage, another diabetes drug). Worse, the price cuts aren't enough. A medicine costing $150 a month still will be unaffordable even if its price is slashed to $100. The drug companies' sudden attack of generosity is, in large part, a public-relations ploy. They've designed the cards to make themselves look good at a time when their image is about as bad as its ever been in all the years I've covered the field. Aventis Pharmaceuticals and AstraZeneca were in such a rush to get on board the Together Rx plan last week that they have yet even to figure out what discounts it will offer. The discount deals differ, industry execs say, because the companies fear they would violate antitrust law if they set up a single offering. Of all the cards out there, flat fee cards offered by Eli Lilly and Pfizer, seem to be the best and most comprehensive. They provide low-income seniors any Lilly drug for $12 a month and any Pfizer drug for $15 a month. "The Pfizer and Lilly plan are the simplest and offer the best savings," says Frank Segrave, head of pharmacy services at Wal-Mart Stores. (Let's just hope if you're a low-income senior, most of your prescriptions are for Lilly or Pfizer medicines.) Novartis's original card, released late last year, provided only a limited discount off the wholesale price, resulting in so little savings that by this spring only 10,000 people had signed up. We're in this mess because Medicare, the federal health plan for those over 65, pays only for medicines prescribed in a hospital. The rule goes back to Medicare's beginnings almost 40 years ago when there were few life-saving medicines to treat chronic ills like hypertension, arthritis, or diabetes. But now many older Americans are alive because they take a half-dozen and more medicines a day. The great irony of our health-care system is that those who can benefit most from the miracle of modern medicine often have the hardest time taking advantage of it. For now, savvy shopping, such as buying pills from drugstores in Canada -- where prices are much lower than the U.S. and the exchange rate is extremely favorable -- will still get more people better savings than the cards. Look at just one of the millions of cash-strapped elderly who don't qualify for the cards: My 75-year-old stepdad, Herb Kaspin. Despite heart disease and diabetes, Herb leads an active life; he recently drove from New Jersey to Florida and back. Herb has become a skillful consumer to afford the 10 medicines that keep him going, but still shells out a bundle. Herb pays $3,084 for a Medicare supplement plan that reimburses the first $450 of his yearly drug costs, leaving him and my mom a drug bill last year of $3,200. Herb figures he saves $500 more a year by wrangling drug samples from his docs. Herb also has a Canadian connection. A pharmacist up North fills five of his prescriptions through the mail at more than 50% off. One of Herb's buddies, a retired Air Force reservist, gets cut-rate drugs at a nearby U.S. air base; another pal gets a break filling his prescriptions at a Veterans Administration hospital, and still another buys his drugs at a casino run by a Native American tribe. All of this suggests, as many drug maker executives concede, the cards are a first-step solution only, and that by next year the landscape may change again. The National Association of Chain Drugstores has proposed that all the companies join it in offering a single card to simplify things. Many industry officials and some members of Congress believe such a single card may provide the platform for a federal plan. One idea floating about Washington is that Uncle Sam step in and provide a uniform benefit in which a senior's annual drug costs are capped. This may be a good time for retirees -- and their children -- to stop complaining and demand a solution that provides a real benefit for those who need it most. FAIR USE NOTICE: This page contains copyrighted material the use of which has not been specifically authorized by the copyright owner. Global Action on Aging distributes this material without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes. We believe this constitutes a fair use of any such copyrighted material as provided for in 17 U.S.C § 107. If you wish to use copyrighted material from this site for purposes of your own that go beyond fair use, you must obtain permission from the copyright owner.
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