House prescribing wrong prescription

Published 7:48 pm Monday, February 26, 2007

By By Jo Bonner
In 2003, Congress passed the Medicare drug benefit which went into effect January of last year. By all accounts, the program has been even more successful and more beneficial than first envisioned, not to mention cheaper.
More than 38 million seniors have drug coverage today, and polls consistently show that 80 percent of those seniors enrolled are satisfied with their plan. In Alabama's First District, 81 percent of Medicare beneficiaries have enrolled in the program.
Monthly premiums, which were projected to cost $37, average just $22, down from a monthly average of $23 last year. Seniors, on average, are saving $1,200 a year on their prescription drug bill. In fact, the most recent estimates from the Centers for Medicare and Medicaid Services (CMS) show that net Medicare costs are $189 billion lower that originally predicted when the benefit was created.
Part D recipients have also seen a 13 percent increase in the number of prescription drugs available, and Medicare Part D is accepted at 55,000 neighborhood pharmacies throughout the United States with home delivery available for those who need it.
Unbelievably, with all of the success this new program has enjoyed, the House last month voted to require the federal government to negotiate drug prices – removing the free and open market competition that has allowed Part D to cost seven billion dollars less than originally expected.
I continue to wonder, why is the House majority attempting to "fix" Medicare Part D if it isn't broken?
The Medicare bill that House Democrats recently passed will transform Part D to resemble the Veterans Administration (VA) drug benefit program where the government negotiates a price on the drugs it can get the cheapest and limits access to those medicines it can't. All of this will lead to fewer choices when it comes to medicine and less access when it comes to which pharmacies will dispense the medicine.
The VA covers some 1,300 drugs – just 30 percent of the 4,300 drugs available on Medicare's market-priced formulary. This excludes some of the most innovative treatments now currently available for diseases such as arthritis, high cholesterol, and breast cancer.
The VA is able to secure big discounts of a few drugs in each class by promising not to offer competing drugs.
Earlier this month, a woman in Montgomery wrote a letter to the Montgomery Advertiser regarding the unintended consequences of allowing the federal government to negotiate drug prices.
In her letter, she wrote, "My experience with kidney cancer has shown me how few treatment options are available to patients. Some treatments work for some patients and not for others. Further, those treatments that are effective for particular patients may lose effectiveness over time, thus necessitating the need to move on to another available treatment.
"If the government chooses to negotiate directly with drug companies, I worry that kidney cancer patients and other people facing cancer may not have access to the best treatment options.
"As the Senate now considers different bills, I ask that the medical needs of patients are not lost in the debate. Ensuring the best possible care and treatment for all cancer patients is critical in the personal battles we face and in our nation's war against cancer."
She couldn't be more correct. On average, it takes three years for new drugs to make it onto the VA's formulary – or list of approved drugs. Not to mention, these prescriptions can only be filled at about 350 government-run facilities nationwide.
Last month, before the House passed this new Medicare bill, the nonpartisan Congressional Budget Office (CBO) issued a letter to House Energy and Commerce Chairman Dingell stating that the Secretary of Health and Human Services would be "unable to negotiate prices across the broad range of covered Part D drugs that are more favorable than those obtained by Prescription Drug Plans (PDPs) under current law."
It is clear, fixing prices won't lead to lower cost for seniors; it will only lead to fewer options. We should not restrict seniors' access to the prescriptions they need and the pharmacies they use.
More than 30 million seniors say they are happy with the drug benefit Congress established four years ago. And I am of the firm belief that the decision regarding which medicines a senior takes should be made with their doctors and not the federal government.
My staff and I work for you. If we can ever be of service, do not hesitate to call my office toll free at 1-800-288-8721 or visit my website at
Jo Bonner is a U.S. congressman. His column appears weekly.

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