Wednesday, June 7, 2017

THE GOD-AWFUL STORY OF MEDICINES

By Robert P. Bomboy

            My wife and I live on Social Security, and last year we spent, out of pocket, more than $11,000 on GHP Gold, Geisinger physician visits, and prescription medicines. I consider myself in good health, yet between sun-up and sundown I swallow a total of nine different prescription medicines every day.

My wife also takes nine prescribed medicines, which include insulin. Her GHP coverage hit Geisinger's "donut-hole" last September, and for the final three months of 2016, despite this health insurance, she paid full price for her insulin and other prescriptions.

That didn't include a total of $50,263.74 for a hospitalization in September or the $2,568 that went directly to Geisinger from our Social Security.

            That was certainly a lot - the money we spent out of pocket came to one-third of our Social Security payments last year, and that's been about the same every year - but it paled in comparison to what families, many in this area, pay for medicines to fight major debilitating illnesses such as cancer, multiple sclerosis, Hepatitis C, and other diseases.
America's drug companies are gouging us every day with high prices on the medicines we - you and I - need to lead healthy and productive lives.

Our for-profit system rewards the biggest pharmaceutical companies with overwhelming monopoly power, and Big Pharma uses that power to charge Americans more than any other country in the world - so much, in fact, that nearly one in five Americans do not fill their prescriptions because they can't afford it. President Trump's god-awful health bill, now in the Senate, will make the situation even worse.
The prescription drug industry is one of the most profitable in the country. It is morally wrong that people have to choose between filling a prescription and putting food on the table for their families.
            Drug companies bleat like lambs about the cost of research and testing, but the truth goes to something much deeper and darker. The drug companies are shameless, and they charge what they can get away with. And, with President Trump's new budget, they will get away with much, much more.
As doctors at the Mayo Clinic put it, “The question is whether current pricing of drugs is based on reasonable expectation of return on an investment or whether it is based on what prices the market can bear.”
            Beyond that, investigators are drilling down to something worse: the rise of nationwide charities connected to Big Pharma itself. These charities say they are helping patients pay the out-of-pocket costs of their medicines, which can range, for example, from $150,000 a year for the latest cancer drug to $300,000 a year for Cystic Fibrosis medicines.
After all, if a patient can't afford out-of-pocket costs of $5,000 for a $100,000-a-year drug, for example, the drug company gets nothing. But if the drug company or the charity pays the $5,000, the patient gets the drug and the drug company receives $95,000 from the patient’s insurance. The drug company also gets very lucrative tax deductions on that money it's "giving."

I actually know someone who's made many millions of dollars on 15 little words you've seen at the bottom of your television screen: "If you can't afford this prescription drug, Big Pharma may be able to help you."

This guy looks before he leaps. He spent several years meticulously inspecting the laws in every state, looking for a loophole that would let him make a gazillion dollars on prescription drugs. When he found the loophole he was looking for, he pitched his tent in Texas.

          Here's the deal: He sets up, in Texas, a charitable foundation with all the trimmings. He and his foundation solicit contributions nationwide to help stricken families where a mother has cancer or a child has Cystic Fibrosis, one of the most heart-rending diseases imaginable. He has a big call center whose operators, with the most piteous voices, plead for donations.
          He rakes in a lot that way, and his foundation actually helps people. But his big money comes from the drug company itself, which paid him $84 million in one year alone. You heard right - $84 million! And there was plenty more after that. Remember, for every sick child he helped, Big Pharma was getting $95,000 and much, much more in round numbers, from the insurance.
          He built a big mansion. He bought a Learjet, had his own pilot, and flew his friends and family to Las Vegas. He had a condo in the Florida Keys and a tax-hiding offshore account in Guyana. He diversified, bought three restaurants, and made millions more on a range of other investments.
          Although he's a skonk, under Texas law he wasn't doing anything illegal, nor was the drug company unless it billed Medicare, which is a no-no.
How does all this affect the price of prescription drugs? In the situation I've been describing, the drug company raised the price of its medicine from $40 a vial to $28,000 a vial. Yes, you heard right, $28,000!
          To cut to the heart of this chicanery, Senator Bernie Sanders and 15 other Democrats are pushing a bill called the Improving Access to Affordable Prescription Drugs Act. It would:

·       Roll back Big Pharma's monopoly, to increase competition and make medicines affordable for everyone;
·       Hold to account companies that engage in price-gouging, fraud, and other abuses;
·       Let Medicare negotiate fair drug prices and lower out-of-pocket costs for older people;
·       Require transparency from drug companies, including financial information like profits and pricing data.
States, including Pennsylvania, are considering similar legislation. Some states  would require drug companies to disclose their manufacturing, marketing and advertising costs, the history of price increases ($40 to $28,000!), their profits on particular drugs, and the money they spend providing financial assistance to patients. Pennsylvania’s bill would let insurers refuse to pay for a drug if the drug company didn't file the required report.
But the drug lobbies are strong. It's one thing to write a bill; it's another to pass it. There are 18 lobbyists for every congressman and senator in Washington. Sadly, the Pennsylvania bill is languishing in the General Assembly.


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