Skyrocketing drug costs stump insurers, Oregon lawmakers

by Saerom Yoo,
Statesman Journal. March 28, 2015

Sarah Truman pays more than $3,000 per month out of pocket for the medications that alleviate her psoriasis and psoriatic arthritis symptoms enough to allow her to work and live a normal life.

Jim Huls is a multiple myeloma patient who has maxed out two credit cards and lost his home to the bank while trying to balance his medical and pharmaceutical bills.

Both are Oregonians who are appealing to state lawmakers to do something about the rising costs of prescription drugs.

Drug prices have been going up for a long time. However, in 2014 drug spending rose 13.1 percent — the largest annual increase since 2003, according to a report by Express Scripts. Specialty drugs, such as those taken by Truman, largely drove the increases.

Last year, the U.S. Food and Drug Administration approved Harvoni, a $1,125-per-tablet drug for hepatitis C patients. An estimated 3 million Americans have hepatitis C, according to Express Scripts. It is drug prices such as Harvoni's that have policymakers, patients and health plans on alert.


Health care law did not end discrimination against those with pre-existing conditions.

Demonstration at Humana corporate headquarters, Louisville, KY

Demonstration at Humana corporate headquarters, Louisville, KY

The letter urges action against discriminatory benefit designs that limit access for patients that were subjected to pre-existing conditions restrictions prior to the ACA. They spell it out. Some plans do not include all the drugs prescribed for enrollees. Some plans don’t cover critical medications including combination therapies. Plans can remove medications during the plan year. Some plans are restricting access to drugs by requiring prior authorization, step therapy, and quantity limits. The network of physicians and hospitals in some plans is so narrow as to deny patients the specialty care needed. Much of the information needed for patients to choose the most appropriate plan is not available

by: Kay Tillow
FireDogLake Friday March 6, 201

In 2010 the giant health insurance company WellPoint created an algorithm that searched its database, located breast cancer patients, and targeted them for cancellation of their policies.

A few years earlier Michael Moore’s stunning documentary, “Sicko,” showed an unending list of illnesses that had been used by insurers to refuse to sell people policies, to charge them much more, or to deny payment for “pre-existing conditions.”

The public became acutely aware of these harmful, widespread practices and sharply condemned them.  So it was not by chance that this insistent popular support resulted in inclusion of a ban on these practices in the Affordable Care Act (ACA) that was passed in 2010.

The government website explains.  “Your insurance company can’t turn you down or charge you more because of your pre-existing health or medical condition like asthma, back pain, diabetes, or cancer.  Once you have insurance, they can’t refuse to cover treatment for your pre-existing condition.

Even some Republicans who are trying to repeal the ACA insist that they stand for keeping a provision against such discrimination.  “We would protect people with existing conditions,” say Reps. Paul Ryan, John Kline, and Fred Upton.

Regardless of opinions on mandates or the health reform law in general, the entire nation embraced the part of the legislation that outlawed discrimination on the basis of illness.

So we’ve won, right, at least this much reform?  Sadly, no.


John Oliver: How Big Pharma Makes Doctors Into Drug Pushers [Video]

In this hilarious and chillingly honest video, John Oliver reveals the stunning truth about how doctors are bribed to push drugs. It turns out that nine out of the top ten drug makers spend more money on marketing than they do on research. And most of that money is spent not on marketing to consumers, but rather, on marketing to doctors. Watch and share!

Comment by a Mad as Hell Doctor

When I was doing my internal medicine thing in Albany from '63 to '79, I offered to schedule all the drug reps to meet with me on 1 day a year. Most were incredulous and declined, but still would leave free samples. This was the policy at Mayo during my residency and I agreed with it.

When I was employed at several group practices, regular lunch meetings were the method of most Big Pharma companies to pitch their wares. I eschewed them and got the "stink eye" from colleagues and staff who attended and saw nothing wrong in it!

This satirical muckraking by John Oliver is brilliant and deserves your attention, IMHO. It is also, sadly, too true.  Please know these practices of Big Pharma, and those health professionals who are "on the take", have been strongly condemned by ethical journals and doctors.  Know also that HCAO using Single Payer will fix the problem, just another benefit, among many.  

Joseph H. Eusterman, MD; MS(Med); FACOEM; CIME; AME (Ret.)


Report: Advocacy visits to Senators Beyer and Edwards

by David Ivan Piccioni, HCAO Eugene

At one of my visits Wednesday with Lee Beyer I told him my story which I had made into a letter to editor. It is bellow for reference:

Drug price disparities are unfair     
Register Guard 9/1/2014  (Labor Day)
I recently had a biopsy performed to check for liver damage due to hepatitis C. Medicaid excluded me from treatment because my liver looked good enough that they didn’t believe it will be the cause of my death.
Talking to the doctor, I learned that Medicaid wouldn’t pay to treat my condition because of the cost: $84,000.
He said I could take my prescription to Canada and buy the drugs there for $48,000. But that wasn’t what blew my mind; he also said for the price of a round-trip ticket to Iran or Saudi Arabia, or many African countries, I could buy the medication for a thousand dollars.
What? Who says America’s the land of the free? Free to be ripped of by dog-eat-dog capitalism.
I can’t figure out why pharmaceutical corporations are willing to bankrupt Americans while not doing the same to foreigners — after all, they only care about maximizing their profits.
Gilead, the company that currently owns the intellectual property for the medication, will eventually lose some of its loot to other chemists who will modify Sovaldi just enough so it still works but is novel enough to be patented.
Problems such as this are why the Affordable Care Act is far from what the Eugene group Health Care for All Oregon is advocating: single-payer or expanded Medicare for everyone.

I told Lee Beyer that our obstacles were the Insurance companies and the fact that we can't negotiate for prices with big pharma. He agreed about the Insurance, but said that negotiating with the drug companies is impossible because of a congressional clause which prohibits the gov't from bargaining with them. Some people think that the fact that drugs are cheaper in other countries means the big pharma companies are doing them a favor on the back of Americans who pay inflated prices. This is not so. Drug companies always get the most they can in any country. The fact that they negotiate fairly is credit to other countries' leaders and laws. It seems that if there are differences of 84 to 1 in American drug prices vs. say Saudi Arabia shows that this is one of the first problems to tackle: that congressional prohibition that inhibits fair business transactions and negotiating.

Also in a room full of people prompted by one of my questions, Chris Edwards disclosed that the Insurance companies have always offered him money. He said at first he turned it down, but then as he said "because I always vote against them I decided to take their money" "if they are dumb enough to give me money even though I vote against them, I'll take it". I am not mentioning this as an attack on senator Edwards, but I told him it was hard for me to believe the corporations would throw away money and really get nothing. And I told him health insurers are very powerful and they are not "dumb"; there might be strings invisible but real none the less.


How the High Cost of Medical Care Is Affecting Americans

Health Care Costs.jpeg

New York Times/CBS News Poll:

  • A bill of over $40,000 for the 20 minutes it took a doctor to stitch a cut.
  • An ambulance ride of only 200 feet that cost $3,421.
  • A healthy, insured couple “slowly going under” because their premiums, co-pays and deductibles are now twice as high as their mortgage and food costs.

Over the past two years, the New York Times series Paying Till It Hurts has examined the high costs of ordinary medical care in the United States, exposing the reasons and chronicling the human fallout behind the nation’s extraordinary $2.9 trillion medical bill. In response, more than 10,000 readers shared individual experiences like the ones above.

But how does a collection of often heartbreaking, often startling tales reflect national experiences and attitudes? The available data did not answer all of my questions. So, using reader comments as a starting point, The Times designed a questionnaire with CBS News and conducted a national poll this month.

Here is a snapshot of the American experience with the cost of medical care.


Big Pharma: Crony Capitalism Out of Control

CounterPunch, November 24, 2014

Two recent news items about the voracious drug industry should call for a supine Congress to arouse itself and initiate investigations about the pay-or-die drug prices that are far too common.

The first item—a page one story in the New York Times—was about the Cystic Fibrosis (CF) Foundation, which fifteen years ago invested $150 million in the biotechnology company Vertex Pharmaceuticals to develop a drug for this serious lung disease.

On November 19, the Foundation reported a return of $3.3 billion from that investment. Kalydeco, the drug developed with that investment, is taken daily by CF patients (who can afford it) and is priced at $300,000 a year per patient. Who can pay that price?

The second news release came from the drug industry funded Tufts Center for the Study of Drug Development. The Center’s Joseph DiMasi asserts that the cost of developing a new prescription medicine is about $2.558 billion, significantly higher than the previous estimate of $802 million that the Center claimed in 2003.

The drug industry promoters use this ludicrous figure to justify sky-high drug prices for consumers. Unfortunately, the criticism of this inflated number does not receive adequate media attention.