Medicare patients can't afford many life-saving drugs

This from "Daily Kos" -- our Government is criminal, as are the drug companies. Why not just DENY ALL TrEATMENT, and say, "we have ours, and we don't give a damn!"? Wouldn't that be more honest, and let folks know what those who HAVE mean by "self reliance"?

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Medicare patients can't afford many life-saving drugs

by Joan McCarter
prescription bottle

Here's one way to fix Medicare: drug price negotiation. This is criminal.

WASHINGTON – Facing a life-and-death struggle with kidney cancer, Rita Moore took her prescription for a new kind of chemotherapy pill to her local drugstore.

She was stunned when the pharmacist told her the cost for a month's supply would be $2,400, well beyond her income.

Medicare drug plans that cover seniors like Moore are allowed to charge steep copayments for the latest cancer medications, whose cost can run to tens of thousands of dollars a year. About 1 in 6 beneficiaries aren't filling their prescriptions, according to recent research that has put numbers on a worrisome trend....

Private insurance companies that deliver the Medicare prescription benefit say the problem is that drug makers charge too much for the medications, some of which were developed from taxpayer-funded research. The pharmaceutical industry faults insurers, saying copayments on drugs are higher than cost-sharing for other medical services, such as hospital care.

Others blame the design of the Medicare prescription benefit itself, because it allows insurers to put expensive drugs on a so-called "specialty tier" with copayments equivalent to 25 percent or more of the cost of the medication.

Drugs for multiple sclerosis, rheumatoid arthritis and hepatitis C also wind up on specialty tiers, along with the new anti-cancer pills. Medicare supplemental insurance — Medigap — doesn't cover those copayments.

"This is a benefit design issue," said Dan Mendelson, president of Avalere Health, a research firm that collaborated in a recent medical journal study on the consequences of high copayments for the new cancer drugs.

Cost-sharing should only be used to deter wasteful treatment, he explained. "It is hard to make the argument that someone who has been prescribed an oral cancer medication doesn't need the drug," added Mendelson.

The study last month in the Journal of Oncology Practice found that nearly 16 percent of Medicare beneficiaries did not fill an initial prescription for pills to treat cancer, a significantly higher proportion than the 9 percent of people with private insurance who did not follow through.

Forty-six percent of Medicare beneficiaries faced copayments of more than $500, as compared to only 11 percent of patients with private insurance. Among people of all ages, 1 in 4 who faced a copayment over $500 did not fill their prescriptions. Cancer is more prevalent among older people.

Moore ended up applying to Pfizer's prescription assistance program, a process that took two months. During those two months, her cancer was untreated and spread.

Here's a solution: forcing pharmaceutical companies to negotiate drug prices without increasing premiums for beneficiaries. They're making plenty of money off of the rest of us. They are maximizing profits at the cost of actually saving lives—presumably the whole reason they are in business