GOVERNMENT and LAW

Stakes are high in creation of Medicare drug benefit

The politics being waged over the Medicare outpatient drug benefit are "vicious ugly," warned John Rector, senior VP for government affairs and general counsel of the National Community Pharmacists Association. "There is virtually stark disagreement on all of the issues." He was speaking at the First Annual National Health Issues Symposium, hosted by the Nevada College of Pharmacy, in Las Vegas last month. The private college is graduating its first class of about 35 students this year.

Drug manufacturers are running scared from the Medicare drug benefit proposal, since it might mean price control and the loss of billions of dollars for them, Rector told the audience. And for pharmacists as well, he noted, a Medicare drug benefit controlled by pharmacy benefit managers is a concern. Pharmacists want to be able to negotiate with PBMs on contracts, and they want seniors to have freedom of choice regarding their pharmacy.

In the absence of a Medicare drug benefit, seniors are resorting to many tactics to lower their drug cost; they buy medications from Canada or use Rx discount cards from manufacturers, noted Steve Schondelmeyer, Pharm.D., director of the Prime Institute at the University of Minnesota.

But these measures are flawed, Schondelmeyer warned. In the case of purchasing cross-border drugs, that's "not exactly legal," he said. And as far as drug discount cards are concerned, many offer brand drugs when lower-cost generics are available or provide products that are rarely used by seniors, such as HIV medications. "These programs are entirely at the whim of the drug firm. They offer minimal discounts and squeeze money out of the pharmacists' pockets," he said.

Rector said he isn't sure if a Medicare drug benefit will make it through Congress before the 2004 Presidential race. He believes the final result will be a mix of legislation from both parties.

Babette May-Herrmann

The author is a writer based in Las Vegas.

Babette Herrmann. Stakes are high in creation of Medicare drug benefit.

Drug Topics

Jun. 2, 2003;147:58.