Asclepios
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How Much Is Your Life Worth?
April 17, 2008 • Volume 8, Issue 16How much should we pay to save your life?
That is the question that underlies the outrageously high prices—$100,000 or more for a course of treatment—that pharmaceutical companies are charging for new treatments for life-threatening diseases like cancer, Gaucher’s disease and multiple sclerosis.
The drug manufacturers say their prices are based on “health economics” and will remain high as long as there is “pressure on society to use strong and good products.” Translated into English this means:
The ransom for your life is the price of the drug.
Who pays?
We all do. Our taxes pay when these drugs are covered by Medicare, Medicaid and other programs, such as those covering children or people with HIV/AIDS. The premiums we and our employers pay for health insurance are higher because of these treatments. Increasingly, insurance companies, both in the commercial sector and in Medicare, are shifting more of the cost of these drugs onto patients, requiring them to pay thousands of dollars in copayments.
The market—the “health economics” manipulated by the drug manufacturers—is not working for consumers. Manufacturers are using the monopoly power that comes with a drug patent, granted even when government research was instrumental in developing the drug, to hold the entire health care system hostage. Insurance companies, whether in the private market or under the Medicare drug benefit, have no ability to negotiate lower prices for these treatments because there are no therapeutic alternatives. Even Original Medicare is generally required by the law governing Part B to pay the prices established by the manufacturers.
Any effort to extend health coverage to the uninsured, as well as any effort to shore up Medicare’s finances, must deal with spiraling health care costs. Any effort to deal with rising health care costs must use the full power of the federal government to rein in the prices charged by drug manufacturers.
It is time to stop paying ransom.
It is time to rescue our health care system.
Medical Record
“I am a social worker at a cancer treatment clinic and find my patients having more difficulty since Part D began. Many of the oral medications that our patients take are considered specialty drugs, which are tiered at a much higher copay amount, and with the cost of the drugs they reach the coverage gap very early. Even with catastrophic coverage, the cost of the drugs is too much for patients to afford” (Story submitted to the Medicare Private Health Plan Monitoring Project, Medicare Rights Center, January 2007).
“Insurers say the new system keeps everyone’s premiums down at a time when some of the most innovative and promising new treatments for conditions like cancer and rheumatoid arthritis and multiple sclerosis can cost $100,000 and more a year. But the result is that patients may have to spend more for a drug than they pay for their mortgages, more, in some cases, than their monthly incomes” (“Co-payments Soar for Drugs with High Prices,” New York Times, April 2008).
“‘As we look at Avastin and Herceptin pricing, right now the health economics hold up, and therefore I don't see any reason to be touching them,’ said William M. Burns, the chief executive of Roche's pharmaceutical division and a member of Genentech's board. ‘The pressure on society to use strong and good products is there’” (“A Cancer Drug Shows Promise, at a Price That Many Can’t Pay,” New York Times, February 2006).
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Medicare Part D Appeals Help for Advocates Is Here!
MRC’s new Medicare Part D Appeals: An advocate’s manual to navigating the Medicare private drug plan appeals process offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples, a glossary of important appeals terms, a sample protocol for advocates, and links to important resources.
Register for a FREE copy of this great resource.
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Medicare Part D Monitoring Project
The Medicare Rights Center (MRC) would like to hear about your experience, or that of someone you know, enrolled in a Medicare private drug plan. With information about what the issues are with Medicare Part D, we will be able to demand that those problems be fixed.
Submit your story at www.medicarerights.org/partdstories.html.
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The Louder Our Voice, the Stronger Our Message
Asclepios—named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly e-newsletter designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today.
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The Medicare Rights Center (MRC) is the largest independent source of Medicare information and assistance in the United States. Founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care.
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