Huge drug cost disparities seen in health overhaul

[Omaha Steve]

Source: AP-Excite

By RICARDO ALONSO-ZALDIVAR

WASHINGTON (AP) - Cancer patients could face high costs for medications under President Barack Obama's health care law, industry analysts and advocates warn.

Where you live could make a huge difference in what you'll pay.

To try to keep premiums low, some states are allowing insurers to charge patients a hefty share of the cost for expensive medications used to treat cancer, multiple sclerosis, rheumatoid arthritis and other life-altering chronic diseases.

Such "specialty drugs" can cost thousands of dollars a month, and in California, patients would pay up to 30 percent of the cost. For one widely used cancer drug, Gleevec, the patient could pay more than $2,000 for a month's supply, says the Leukemia & Lymphoma Society.

FULL story at link.


Read more: http://apnews.excite.com/article/20130513/DA68AHR00.html

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In this May 3, 2013 photo, Daniel N. Mendelson, CEO of data analysis firm Avalere Health, poses for a photograph at their Washington office. Cancer patients could face high costs for medications under President Barack Obama's health care law, Mendelson warns. Avalere’s research shows that one in four cancer patients walks away from the pharmacy counter empty-handed when facing a copay of $500 or more for a newly prescribed drug. “It’s important that the benefit design not discriminate against people with chronic illness, and high copays do that,” he says. (AP Photo/Alex Brandon)

[Skittles]

1. no one could see THAT coming

naw

[MrSlayer]

2. In a Republican health care plan? No way!

Color me shocked.

[quadrature]

3. generics not good enough for some people .nt

nt

[Mnemosyne]

4. Maybe there are no generic drugs to substitute. I don't think this is a generic snobs issue. nt

[Yo_Mama]

5. Generics aren't available for all these drugs

And in some cases when they are, they are very expensive, sometimes due to shortages.

For example, there has been a doxycycline shortage - when I tried to buy some it turned out the local pharmacy had to pay $2,000 wholesale for a bottle of 500 capsules. That is a drug so cheap that normally it is included as a "free" antibiotic in many pharmaceutical programs, but no more, since the cost to the pharmacy was $4 a pill (which, mind you, they were willing to sell to me for $3.50 a pill, because of the urgency).

A lot of people literally won't be able to afford medication. Also if this is extended to diabetic supplies it is going to be dire.

When you force someone to choose between eating and getting meds, they don't get meds.

[valerief]

11. Considering all ramifications not good enough for some people. nt

[CarrieLynne]

6. i think i'd blame big pharma, more than I'd blame obama....

[SoapBox]

7. I'll ditto that!!!!!

[tblue]

9. He made a deal with Big Pharma

In exchange for these items, the White House agreed to:

1. Oppose importation
2. Oppose rebates in Medicare Part D
3. Oppose repeal of non-interference
4. Oppose opening Medicare Part B

/snip

White House agreed to oppose any congressional efforts to use the government's leverage to bargain for lower drug prices or import drugs from Canada -- and also agreed not to pursue Medicare rebates or shift some drugs from Medicare Part B to Medicare Part D, which would cost Big Pharma billions in reduced reimbursements.

/snip

"Non-interference" is the industry term for the status quo, in which government-driven price negotiations are barred. In other words, the government is "interfering" in the market if it negotiates lower prices. The ban on negotiating was led through Congress in 2003 by then-Rep. Billy Tauzin (R-La.), who is now the head of PhRMA.

The rebates reference is to Medicare overpayments Big Pharma managed to wrangle from the Republican Congress that Democrats are trying to recoup. The House bill would require Big Pharma to return some of that money. The rebate proposal would save $63 billion over ten years, according to the Congressional Budget Office. The White House, given the chance, declined to tell the Wall Street Journal for a July 17th article that it supported the effort to pursue the rebates.

The Medicare Part B item refers to "infusion drugs," which can be administered at home. If they fall under Part B, Big Pharma gets paid more than under Part D. The agreement would leave infusion drugs in Part B.

In the section on Big Pharma's concessions, "FOBs" refers to follow-on biological drugs. Democrats have pushed to make it easier to allow generic drug makers to produce cheaper versions of such drugs, an effort Big Pharma has resisted. The Senate health committee bill gives drug makers 12 years of market exclusivity, five more than the White House proposed

.

http://www.huffingtonpost.com/mobileweb/2009/08/13/internal-memo-confirms-bi_n_258285.html

[burrowowl]

14. Yes, he did

Makes you wonder.

[closeupready]

8. Just the IDEA of a co-pay for a maintenance med is offensive,

particularly when it comes to insurance coverage mandated by the government.

And the fact that people's lives are in the balance makes it doubly offensive, IMO.

Most people live paycheck to paycheck, something members of Congress wouldn't understand. Nor, for that matter, almost anyone who is a civil servant in DC these days.

[L0oniX]

10. Msg is ...co pays will kill ACA?

[Cal Carpenter]

12. Bu..bu...but... price controls and lower costs!

It was right there in an HHS press release!

[Pterodactyl]

13. That's not a bug, it's a feature.

[Duckwraps]

15. The ACA scares the holy heck out of me.

I fear the turmoil will be very, very bad. Particularly the shortage of physicians that will occur and which nobody is doing anything about.

[NCarolinawoman]

16. Former senator Byron Dorgan warned of this.

This was one of his pet issues. No one was listening or seemed to care.

After that, he decided not to run for re-election.

[forestpath]

17. Obama cares all right..about big pharma.