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Are You Ageing "Normally"?

What Trump's Proposed Drug Plan Does for Elders (and Others)

EDITORIAL NOTE: This is long-ish and gets a bit wonky in places but it is important to know this stuff.

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We have all known or have read about elders who don't fill medication prescriptions or cut them in half because the cost forces them to make the choice between life-saving drugs and food.

Just recently, I had a personal encounter with such an issue. A newly prescribed drug I inject twice a day costs me hundreds of out-of-pocket dollars a month which is way beyond my means and at first I told the doctors it was out of the question; find something else to help me that I can afford.

Then someone in the meeting realized they had neglected to note that I need the drug for only three months. I don't like dipping into my emergency fund for that much money, but I suppose that's why I call it an emergency fund. And I can handle three months.

I'm lucky to have that fund. Millions of American adults who can't afford their prescriptions with or without insurance converage just don't fill them, endangering their health and their lives.

Why, do you suppose, are prescription drugs so expensive in the United States, higher than in other countries. Here is an explanation from CNN:

What reporter Christine Romans overlooks in this video is that pharmaceutical companies do not bear the entire of burden of new drug development. A great deal of money and help comes from the U.S. National Institutes of Health (NIH).

In the White House Rose Garden on Friday, President Donald Trump unveiled a proposal he says will lower the prices of prescription drugs for consumers. It tells us something that minutes later, the stock market price of pharmaceutical companies soared:

”The stock prices of Pfizer, Merck, Gilead Sciences, and Amgen all spiked after Trump’s speech,” reported STATnews. “Wall Street analysts said the speech posed few threats to the drug industry on the whole.”

Do you think that outcome could that have anything to do with input from the man accompanying Trump at the podium Friday, the one who will be in charge of implementing Trump's proposed drug plan, Health and Human Services (HHS) secretary Alex Azar?

TrumpAzarScreenGrab

Until last year, Azar spent a decade employed at pharmaceutical giant, Eli Lilly and Company first as the firm's top lobbyist and later as president of Lilly USA LLC.

So what does Trump's proposal, disingenuously titled American Patients First, include? NBC News reports:

”The plan, presented as a thinly described set of executive actions...focuses on four elements, according to the Health and Human Services Department:

Increasing competition
Better negotiation
Creating incentives to lower list prices
Reducing patient out-of-pocket spending."

That is a far cry from Trump's campaign promise to

”...allow Medicare to negotiate directly with drug manufacturers... The industry is now having the last laugh,” reports The Atlantic. “In a speech Friday on drug pricing, President Trump completed his 180-degree turn on Candidate Trump’s promises.

“The White House’s new plan, as outlined, does seek to address high prescription-drug costs. 'We will not rest until this job of unfair pricing is a total victory,' Trump said. But it doesn’t directly challenge the pharmaceutical industry and the direct role it plays in setting prices.

“Indeed, the new policy largely meets the goals of big pharma, signaling an ever-tightening bond between Trump and drug manufacturers.”

Trump didn't say much about how his proposals will lower prices and what is conspicuously missing, despite the second item on that list, is any plan to allow Medicare to directly negotiate drug prices with pharmaceutical companies.

Big Pharma won that one when Medicare's prescription drug plan, Part D, was introduced in 2003; the legislation specifically disallows price negotiations between Medicare and the pharmaceutical companies. Trump's proposal does not change that.

During the Rose Garden speech, Trump attacked what he called “global freeloading” by countries where citizens often pay much less than Americans for the same brand-name drugs:

“He directed his trade representative to make fixing this injustice a top priority in negotiations with every trading partner,” reports Robert Pear in The New York Times...

“It is not clear,” continues Pear, “why higher profits in other countries would be passed on to American consumers in the form of lower prices, and officials in those countries pushed back hard.”

The Times also reported on another of the proposal's items:

”Alex M. Azar II, the secretary of health and human services, said the Food and Drug Administration would explore requiring drug companies to disclose list prices in their television advertisements.”

It is equally unclear how that would reduce the cost of advertised drugs. It is worth quoting Robert Reich, Professor of Public Policy at UC Berkeley who served as President Bill Clinton's secretary of labor, at some length on this:

While it’s true that Americans spend far more on medications per person than do citizens in any other rich country – even though Americans are no healthier – that’s not because other nations freeload on American drug companies’ research,” writes Reich in Eurasia Review.

“Big Pharma in America spends more on advertising and marketing than it does on research – often tens of millions to promote a single drug.

“The U.S. government supplies much of the research Big Pharma relies on through the National Institutes of Health. This is a form of corporate welfare. No other industry gets this sort of help.

“Besides flogging their drugs, American drug companies also spend hundreds of millions lobbying the government. Last year alone, their lobbying tab came to $171.5 million, according to the Center for Responsive Politics.

“That’s more than oil and gas, insurance, or any other American industry. It’s more than the formidable lobbying expenditures of America’s military contractors. Big Pharma spends tens of millions more on campaign expenditures.”

And you wonder why your drugs cost so much.

"'This [proposal] is not doing anything to fundamentally change the drug supply chain or the drug pricing system,' said Gerard Anderson, a health policy professor at Johns Hopkins University,” quoted at CNN.

The so-called American Patients First proposal is not a bill and while a small number of the proposals would require Congressional legislation, most can be put into effect with regulations or guidance documents.

So much for lowering the price of prescription pharmaceuticals. Like most everything else in the Trump administration, this proposal is gift to big business.

You can read the full, 44-page proposal here [pdf].


Comments

The con man in chief is good at one thing and one thing only - making a rotten deal sound good to the gullible loons. The administration promises the moon while fleecing the public with the hand hidden behind his back.

When will his uneducated followers finally wake up? I guess they might see the light when it keeps hitting their pocketbook. Unfortunately, that will come only after it's too late to undo the damage. And only after the conservative pundits stop blaming everything this sociopath does on Obama.

That will be too late for the elders who will suffer the most as they will have died off. I sometimes think that's the game plan.

I'm trying to stay alive long enough to see Mueller subpoena -rump and his cabinet.
Am I angry? You betcha.

Canada is not a lot better than the USA in many respects, when it comes to health and Human Resources, but by and large, we don’t bankrupt our children, our disadvantaged or our elderly.

I take a medication (let's call it med A) that was prescribed off-label - i.e. used to treat a condition for which it was not originally intended for 40 years. It cost 50 cents a tablet and was the best treatment available for the ultra-rare genetic disorder I and about 3,000 Americans have. But it was not approved by the FDA to treat my genetic disorder, even though it had a 40 year successful track record.

In 2000 the manufacturer introduced a new (and *much* more expensive) drug for the condition med A was designed to treat. However because patients were loathe to move from the 50 cent a tablet treatment to a $300 a month treatment, their new treatment was not proving successful. So they pulled Med A off the market, leaving patients like me without an effective treatment. We begged, pleaded, went to Congress, all to no avail.

Fifteen years pass and manufacturer sells patent to Med A to another pharmaceutical company, who by referring to numerous double-blind studies conducted over the previous 40 years and conducting a one year open trial, gained FDA approval to market Med A under a different name. Price = $150.00 USD A TABLET. For someone like me, who takes four tablets a day, add it up. $216,000.00 a year.

So far, this new manufacturer is providing the med free of charge to US patients whose insurers won't pay this exorbitant price, and whose financial resources are limited. At the same time they are providing services to our largely forgotten disease, genetic testing, physician education (most physicians have never seen a case of our disorder and misdiagnose it, or dismiss patients' symptoms as hysterical or psychiatric. So they haven't been all bad, but I think patients would have preferred lower drug prices and less horn-blowing on the part of the company.

A jump from 50 cents a tablet to $150.00 a tablet is hard to justify, especially when the company did NO R&D, and every gesture of "help" is so heavily branded as to make it feel like a neon sign.

I've been so angry at Big Pharma for so long that I have no words left. Angrier still that I can't boycott them because my life and health depend on their products. And topped off by Big Government entities that instead of controlling them are giving them the farm.

I had been taking a generic drug, with a negligible out-of-pocket cost, for some time before I went on Medicare. When I started on Medicare, the drug was on the non-formulary list of my Part D plan, so I had to get a letter from my doctor stating that it was necessary. No problem. This year, when I had to renew the letter, the drug was denied. While we were appealing, I ran out and was off the drug for a week. I was in so much pain by the end of the week that I could barely move. My husband went to the pharmacy and bought me some to get me through ($7/pill; I take 2/day.) The appeal was also denied, due to the high cost - $1250 for a 3-month supply. The doctor wrote me a Rx for a different drug, but it was not effective. She then wrote me a Rx for the original drug that my Part D plan had denied, but to a Canadian company. I will now be getting the drug through this company, shipped to my home directly from the UK, where it is manufactured, for $115 per 3-month supply (shipping included.) This is the exact same generic drug, at less than 10% the cost of the U.S. company price! It all boils down to one simple thing: greed.

Scarier and scarier.......and yes, the weaker populations are targeted, those whose very needs make it difficult for them to defend themselves. This is how fascism works, it is not populism, it is fascism in the making.

Now to read this again. Thanks, Ronni, for doing the heavy lifting.

I feel your frustration. I just wish that your government U.S.A., would kind of embrace our (Canada) style of health care and coverage for us older folk. Not saying ours is perfect by any means, but it is ALL inclusive. My many U.S. relations always were jealous, but their thinking was that it is socialism and the powers that be wouldn't think of it. Well maybe, but we are taking (or trying) to take care of fellow Canadians, who otherwise wouldn't be able to afford it. Our federal and provincial governments are thinking pharmaceuticals should be totally covered and the government would negotiate with the drug companies. The Brits have a similar program as well. Does it not boil down to big business taking care of themselves and to heck with the "smaller" people. Maybe I sound like a socialist or commie, but I am far from that. Like to have money, but also like to help others. Well that's my diatribe.

I live in California and buy my Rx drugs from PharmStore.com in Canada. The costs are less than the co-pay of the best Medicare Rx plans.

In the past a number of (most?) US credit card companies wouldn't allow purchase of foreign prescription meds, but American Express did, so I used that. PharmStore now urges customers to use their bank payment plan, which I presume works and is legal in the US.

Fraud and counterfeiting abound, but just as much in big US pharmacy houses as in off shore places, so I believe you can avoid any added risk by looking around. Try

We have a retiree health plan that covers Rx drugs. Otherwise, we'd be in the same boat as a lot of elders who have to make choices that should NEVER have to be made--and we live in a "1st world" country.

The problem didn't start with The Emperor of Trumpistan but his recent action certainly did nothing to improve matters. Big Pharma has accumulated far too much power and money over many years. One of the darkest days in American medical history, IMO, is when direct advertising of drugs to the public was approved. Most of the money we pay for drugs goes to advertising, lobbyists and exorbitant executive salaries. There's not much left over to make prices affordable for ordinary Americans--even if anyone cared, which under our current "Emperor" is demonstrably not the case.

Like so many issues, those whose salaries in Congress we pay do little or nothing to represent the best interests of the nation’s people when it comes to our health care. We all know this and countless expose’news reports plus print articles keep hammering the data home but little or nothing is done to rectify the matter. How many more years do we have to contend with this? What is wrong that voters aren’t enraged, fail to see the snake oil sales people including our illustrious leader, are just ‘shuffling cards’ and not really demanding reasonable pharma pricing? Appreciate your analyzing this latest charade of pharma reform.

I'm an old man, and most likely I will not be around to see any meaningful healthcare plan for Americans. The only hope for the next generation is that they see through this attempt to screw the American public at every turn and vote for people who genuinely have the health and well-being of their constituents as a primary objective. I wish them luck.

Republican candidate for governor of Okla., Christopher Barnett thinks euthanasia for poor disabled people is the way to go, so maybe there is something to the republican's agenda for us old folks...just saying

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