Wednesday, Aug 20, 2008
Pharmaceutical companies are apoplectic over Gore's prescription drug pricing proposal
Aug 31, 2000 | As the Bush campaign unleashed a new television ad Monday attacking Al Gore's prescription drug plan for senior citizens, 73-year-old Violet Quirion was on a bus from Waterville, Maine, to the Canadian border town of St. Stephen, New Brunswick, to purchase a three-month supply of the medicines she takes for arthritis and a stomach condition.
Quirion, a retired quality-control worker at the local Hathaway Shirt factory, walks with two canes and lives on $1,000 a month from Social Security and a small pension. And as one of 70 million Americans who has no prescription drug coverage, she offers a glimpse into the emerging battle over prescription drug prices in this year's presidential race.
Quirion was heading for Canada because she can purchase her drugs there -- Relafen, an anti-inflammatory arthritis drug, and Prilosec, which treats her stomach problem -- for nearly 60 percent less than she would have to pay at the drugstore in Waterville ($399 instead of $979). Like many seniors on fixed incomes, Quirion is acutely sensitive to the price of prescription medications, which have risen at rates of 10 to 14 percent in the past five years and are projected to rise another 10 percent annually until 2008. She says she simply can't afford to pay U.S. prices for all the medications she needs.
"I skip 'em a lot and buy the cheapest meals I can find," she says. "Otherwise I couldn't get by. I see a lot of my friends cutting pills in half or skipping meals or their drugs."
The vision of low- and moderate-income seniors across the country skimping on servings of potato salad to afford a heart drug that could keep them alive is just the sort of nightmare that has politicians from both parties falling over one another to convince seniors they're on the case. But where Gore, in his recent populist incarnation, has been accusing the drug industry of "price gouging" and has made the drug companies one of the cardinal bogeymen of his campaign, Bush appears to have recognized only belatedly that senior citizens view skyrocketing drug prices as a colossal problem.
Bush's decision to attack Gore on this particular issue is more than a little perplexing. He still doesn't have a plan of his own for voters to examine. Nor does he seem to realize that it's not only Gore who is out in front of him on this issue. A sizable number of state legislators, including many from his own party, are pushing initiatives that are far more radical than anything the Texas governor is likely to come up with, and far more consistent with the approach Gore is taking.
The Gore campaign has been hitting two big points in this debate. The first has to do with a new government-financed drug benefit under Medicare, which provides coverage to 39 million elderly and disabled Americans. The second has to do with whether the government can force down the prices it pays for drugs provided under Medicare.
Gore and many state legislators are proposing efforts that would have government or government-authorized agencies negotiate drug prices with manufacturers. This may not seem like a terribly radical idea, given the fact that government negotiated prices are the rule in just about every other country in the world. But these proposals are making the drug industry apoplectic because it fears that government entities representing millions of consumers could effectively try to dictate the price they pay for drugs.
Bush's new television ad attacks Gore for "pushing a big government plan that lets Washington bureaucrats interfere with what your doctors prescribe." In fact, the only limitations on drugs would be decided by the same sort of pharmacy benefit managers who make such decisions for Medicare patients today in hospitals around the country. The new managers would simply be choosing drugs for a vastly larger population at, presumably, a substantially reduced price. The big difference between Gore and Bush is that Gore would provide drugs free to the poorest seniors and pay up to half of the drug bill for other seniors until they had paid out $5,000 and everything on top of that, while Bush seems to favor something closer to a plan approved by House Republicans that would help seniors buy insurance to pay for their drugs. Bush has yet to suggest any plan for reducing the cost of drugs purchased either by the government under Medicare or by ordinary citizens.
In the abstract, Bush's claim that he will provide seniors a "choice" of providers to pay for their drugs rather than a single government-mandated plan may sound appealing. But when the governor takes the details of his program on the road, he's likely to find that many Republican state legislators are so exasperated by the huge drug price increases and the clamor against high prices from their constituents that they are ready to take some very un-Republican measures to force lower drug prices down the throats of the pharmaceutical manufacturers.
"The pharmaceutical companies are getting away with murder in this country," says Florida state Rep. Nancy Argenziano, a Republican in a key presidential battleground state with a huge population of senior citizens. "And until someone has the gumption to tell them they have to come to the table and talk [about lowering prices], we're going to have to threaten them with price caps on drugs."
Argenziano, whose mother lives on an income of $900 a month and has a difficult time paying for her medications, insists that manufacturers should be forced to negotiate discounts of at least 25 percent for senior citizens. "I'm a Republican. I believe in private enterprise," she says, but "Americans are subsidizing all of these other nations," because all other countries mandate lower prices. Argenziano plans to introduce legislation that would have Florida buy drugs in bulk for all uninsured senior citizens.
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