The drug tour 

Medicare pitch faces skepticism in Flathead

Montana Rep. Dennis Rehberg’s Medicare Constituent Services Representative Linda Price has been touring Montana in recent weeks to educate prescription drug users on the new, temporary discount prescription drug cards being used as a stop-gap until the new Medicare prescription drug benefit kicks in in 2006. Over the course of Thursday and Friday, Aug. 5 and 6, Price spoke to seniors in Whitefish, Polson, Kalispell and Libby.

At the Whitefish Golden Agers Senior Center, Price told a seven-person audience that some low-income seniors could qualify for a $600 per year drug benefit.

“My messages were: number one, see if you qualify for the $600; number two, [the drug card program] is voluntary; and number three, call the State Health Insurance Assistance Program,” or SHIP counselors, at 1-800-551-3191, Price says.

Kalispell SHIP counselor Robin Redpath says seniors have approximately 250 drug card options.

“We can’t keep up with how many cards there are,” Redpath says.

Redpath says she typically advises callers to ask their usual pharmacist what card might be appropriate for them, depending on their medication needs.

The added tasking of pharmacists bothers Jess Johnson, a 78-year-old Whitefish resident and retired pharmacist who sat on the Montana Board of Pharmacy for six years in the 1980s. From his folding Golden Agers seat, Johnson peppered Price’s presentation with questions.

“What I’m trying to figure out is why anyone thinks this is a good idea,” Johnson said. “It’s a terrible program. The intricate details of it are almost impossible for most people to figure out.”

“I have to agree,” said another elderly gentleman in attendance, Whitefish resident Elmer Bastrow.

Bastrow’s qualm was not limited to the new Medicare drug card program, but extended to the entire Medicare Prescription Drug, Improvement and Modernization Act of 2003, commonly referred to as MMA.

“Any good bill is going to be a co-pay bill based on ability to afford [medicines],” Bastrow said. “Those are the facts that people need to know.”

Betty Beverly of the Helena-based Montana Senior Citizen’s Association agrees, noting that the new bill has not eradicated the need for some seniors to cut their pills in half in order to be able to afford to take them at all. Beverly has counseled 25 seniors who have called her organization seeking guidance on prescription drug cards and the low-income government credit.

“Of those, there have only been a couple who were eligible for the $600,” Beverly says, adding that seniors seeking straight talk should call her at the Senior Association at 1-800-553-5341.

“I’ve attended a couple of those Rehberg presentations, and I feel that they don’t have all the knowledge there that they need,” Beverly says.

At both the Whitefish and Kalispell presentations, Price told seniors that if they signed up for new Medicare cards, which require a mandatory one-year enrollment, pharmaceutical companies would not be able to raise prices whenever they wanted without justifying a hike to Congress.

But according to Beverly, it won’t be hard for major drug corporations to provide such justification regardless, as the industry has consistently pointed to the rising cost of doing business—including the need to provide profits to stockholders and cover marketing and public relations expenses.

A study by the non-profit health care consumer advocacy group Families USA of nine of the largest pharmaceutical companies found that all but one spent twice as much on marketing, advertising and administration as on research and development, with much of the cost passed on to the consumer in the form of higher prescription prices—a situation that former pharmacist Johnson feels won’t surprise anyone who owns a television.

“I was working in the yard today and I had the TV on,” Johnson said in a phone interview following the Whitefish presentation. “I bet I heard 15 Cialis ads.”

Price says the new discount drug cards are creating savings of 10 to 25 percent for consumers, and Amy Astin, Rehberg’s health liaison, says the new Medicare prescription program is having the desired effect.

“What we’ve been seeing happening is that the rates have been going down because the market is working,” Astin says.

While prices have fallen in the past few months according to a recent House Committee on Ways and Means report, prices rose faster in the 12-month period ending in March of 2004 than in any of the four years prior to passage of the MMA, according to AARP research. Thus the statistical “prices are rising/prices are falling” debate comes down to whether one is looking at the long term or short term. Some have speculated that drug companies intentionally spiked prices over the past year in order to claim a decrease with the advent of the new cards. One such skeptic is Families USA, which contends that recent price decreases are analogous to “used car buyers drawn by the promise of a rebate—only to find that the base price has risen dramatically…”

The new Medicare bill, which was also supported by Montana Senators Max Baucus and Conrad Burns, prohibits the federal government from negotiating with drug corporations for the lowest Medicare drug prices, a stipulation that Beverly considers the worst part of MMA.

“I haven’t seen that part of the bill,” claims Rehberg spokesman Brad Keena, who notes that “there may be ways to tweak” the law.

However, President Bush has publicly promised to veto any changes to the new law.

“I’ve been telling seniors, ‘Vote like your life depends on it,’” says Beverly, “because it does. It’s not going to be changed unless we have a new administration, no matter what Congress does.”

While senior advocates such as Beverly and Rehberg’s congressional staffers may have differing opinions on the merits of the temporary drug cards, and the bill that spawned them, both agree that seniors who qualify for the $600 aid should take it, and that, for most Montanans, cheaper drugs from Canada may still be the best option.

Prior to the Kalispell Senior Center meeting, one gentleman in attendance turned to a companion and said, “Let’s see if this will save us trips to Canada.”

Price put a hand up to her mouth and responded in a mock whisper, “It’s probably not going to save you money over Canada.”

“Why are we here then?” the gentleman wanted to know.

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