Democratic Party members of Shaftsbury, Vt., have been hosting monthly information sessions about key issues for Vermonters. This month’s meeting focused on the crisis the state faces with regard to funding prescription drug programs, which have increased at an alarming rate under the state’s VSCRIPT program and Medicaid. The tight budget for Fiscal Year 2003 prompted Gov. Howard Dean to single out prescription drugs as encroaching on the state’s budget, putting pressure on the Legislature either to raise income through taxes (such as an increase on the cigarette tax), or else cut these prescription drug benefits. Since 1998, Vermont’s Medicaid program has increased spending on prescription drugs from $40 million to $100 million this year — a 150 percent increase. He recommended cutting the expanded VSCRIPT program for this year’s budget.
Yet the problem goes beyond simple monetary figures, according to speakers at the Shaftsbury forum. The problem needs to be addressed at its roots. A culture has been created that allows pharmaceutical companies free reign to influence consumers through prolific advertising, to influence politicians through campaign contributions and closed-door lobbying sessions, and even to influence physicians themselves, through an aggressive "detailing" campaign in which company representatives brief doctors on which drugs they should prescribe. As a result, expensive drugs are often prescribed before generic equivalents, and the political establishment — especially at the federal level — seems unable to make any significant headway in reform, because legislation becomes bogged down with loopholes or held up in a conference committee.
According to state Rep. Alice Miller (D-Shaftsbury), who moderated the forum, Americans pay an average of 40 percent more for the exact same prescription drug than Canadians. This, despite the fact that much of the research and development money comes from the American taxpayer. Americans, in other words, are getting a raw deal. Why does the Canadian government (with a much smaller population) have so much leverage in negotiating prices of medications, compared with its neighbor to the south? "Politicians need to realize that Americans cannot afford the high cost of prescription drugs," said Miller.
While the federal government seems hapless on this issue, at the state and regional level, politicians are taking a stand. Cheryl Rivers, who was on the Vermont Senate for 11 years before resigning last October to become executive director of the New England Legislative Association of Prescription Drug Programs (NELAPDP), told guests at the forum about her organization, which is trying to aggregate many states together to leverage better deals with the pharmaceutical companies. "Skeptics say, ‘This is a national problem ... What can little Vermont do?’ ... But the problem has gotten to the point where we can’t sit back and wait," said Rivers. “If more states work together, we have more leverage against the pharmaceutical companies.â€
The initiative began back in February of 2000 when a group of senators and legislators met at the State House in Boston to discuss strategies and ideas about how to bargain with managed health care and the major pharmaceutical companies. Many members of the bipartisan group had different ideas on approaching the subject, but the biggest initiative was how to decrease the price of prescription drugs.
U.S. Rep. Bernie Sanders (I-Vt.) opened eyes in 1999 when he led a group of women on a trip to Canada, where they met with a Canadian doctor and were given prescriptions to Tamoxifen at 90 percent savings from what they were paying in the U.S. The coalition of states included all six New England states, as well as a representative from New York and Pennsylvania. Rivers said her group is comprised of those six states, and will be meeting on May 17 in Washington, D.C. The District of Columbia is interested in joining, and Rivers said the governor of West Virginia also wants to learn more about the program. She said more states would join, but it becomes difficult to send a representative to the meetings when the trip requires cross-country travel.
The coalition has a few suggestions for the short term, Rivers said. They will be helping small- to large-sized businesses to better negotiate with health care providers on pharmaceuticals. She explained that within the system of managed health care, are middle men called "pharmacy benefit managers," who advise HMOs and large employer groups on which drugs to carry, and what benefits to give. Rivers said several lawsuits are currently being pursued because these pharmacy benefit managers have been getting "back-door deals" from the pharmaceutical industry. She said "a whole can of worms is about to be opened" with regard to corruption in this industry.
State governments can also work together to get better programs for their employees. Rivers pointed out that NELAPDP represents more than 46 million citizens in the eight states.
MedicineAssist
In fact, Southern Vermont is a hot spot in the crusade against high-priced pharmaceuticals. Dr. Elizabeth Wennar of the Bennington-based United Health Alliance, told guests about the MedicineAssist program, through which anyone in the U.S., who suffers from a chronic debilitating disease that requires medication, can receive that medication through a Canadian pharmacist, at Canadian prices. This program has been going on for about two years, and was written about in Newsweek and other places. It uses a loophole in the Canadian system that allows a pharmacist to send a prescription (up to three months’ worth) to an American doctor. The doctor faxes the prescription order to the MedicineAssist program, the patient pays for the medicine with a credit card (in Canadian dollars), and the medicine arrives at the doctor’s office, where it is given, unopened, to the patient.
Wennar said that although reimportation laws make it illegal to re-import an item for resale, it is not illegal to re-import for personal use. Information about MedicineAssist can be found at www.unitedhealthalliance.com, which includes a price list and instructions on complying with the program. Wennar said they are constructing a separate web site for MedicineAssist, because of such high traffic. “People from Puerto Rico to Alaska are taking advantage of this program,†said Wennar.
And last week, United Health Alliance also formed the Coalition for Access to Affordable Prescriptions (CAARx), which has already garnered more than 2,000 members. It is an advocacy group that will help put pressure on government and drug companies to play fair in the drug-pricing game. To join, go to www.unitedhealthalliance.com.
Vermont developments
Alice Miller said the House recently passed a bill (which still needs Senate approval) that would eliminated coverage for dentures under Medicaid, created a $1,000 deductible on Medicare, and put the Medicaid budget into a separate fund (usually, Medicaid is part of the General Fund). While the House passed a 36-cent cigarette tax (as opposed to the 67-cent increase proposed by Dean) that raises $15 million, according to Miller only $4 million of that will go into health care. The rest will go to the General Fund. Additionally, $20 million will now be put into the budget to eliminate the sharing pool in Act 60 funding. “Where are our priorities when we can give $20 million to Gold Towns but we must cut basic health care programs for our most vulnerable citizens?†asked Miller.
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Mystic, Conn., Rolls Past SteepleCats
iBerkshires.com Sports
NORTH ADAMS, Mass. -- Camden Righi went 3-for-5 with a double Tuesday to lead the Mystic Schooners (5-1) to a 12-2 win over the North Adams SteepleCats in New England Collegiate Baseball action at Joe Wolfe Field.
Parker Camelo was 2-for-3 at the plate for North Adams, which scored both its runs in the bottom of the ninth.
North Adams used six pitchers in the loss. James Morr and Joe LaPrade each provided an inning of no-hit relief.
The SteepleCats (0-3) are at Martha's Vineyard on Wednesday night.
Cassidy Flynn scattered five hits in a complete-game effort in the circle as Lenox upset top-seeded Hoosac Valley, 3-2, in the quarter-finals of the Division 5 State Tournament. click for more
Brayden Durant struck out seven and walked one in a complete-game effort on the mound Saturday to pitch the Drury baseball team to a 6-0 win over Keefe Tech in the quarter-finals of the Division 5 State Tournament at Joe Wolfe Field. click for more
