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¶ … Health Care and the Law - Are Preferred Drugs Lists Helpful or Harmful to Low-Income Patients?
Pear, Robert. (April 6, 2004) "U.S. Appeals Court Backs State Efforts at Drug Cost Control." New York Times. Article Retrieved at http://www.nytimes.com/2004/04/06/politics/06DRUG.html?pagewanted=print&position=
One of the most controversial issues today when questioning how the nation's health care system will deal with the spiraling cost of prescription drug care is how to manage the cost of prescription drugs within the Medicare system. The escalating cost of vitally necessary drugs has driven many otherwise law-abiding American consumers to make use of the Internet, purchasing their drugs from dubious sources around the world -- or Canada, which has nationally controlled, subsidized health care, a system that both limits costs and care. However, low-income patients do not even have this recourse, and are at the mercy of their physicians, the legal system, and the pharmaceutical industry.
On Friday of last week, as this article U.S. Appeals Court Backs State Efforts at Drug Cost Control." Illustrates a U.S. Appeals court recently rejected a challenge by the pharmaceutical industry. Pharmaceutical Research and Manufacturers of America, a lobby for...
Michigan's Tommy G. Thompson, the secretary of health and human services of the state in 2002, approved Michigan's strategy for encouraging low-income patients to use lower-cost medicines.
According to the article, "a rapidly growing number of states have adopted 'preferred drug lists'" as a way to control drug costs, redirecting patients to particular drugs because of cost. Although interpreted as a victory for such low-income patients facing escalating drug costs, on first examination this remains rather a dubious proposition -- do the drugs in question really have the same value as their higher-priced competitors. In some cases they may. Also, the pharmaceutical giants' resistances to such laws as Michigan may have its roots in economically motivated reasons, rather than humanist and compassionate reasons.
Still, there is concern about patients being diverted, based purely on their ability to pay, towards less medically viable treatment. The idea should raise a 'red flag' for any individual involved in either the medical or legal system. One judge on the appellate court noted "non-preferred drugs" would still be "available as an option if a doctor certifies that they are medically…
Also significant was the fact that the drug companies bringing the suit "had argued that Michigan was improperly using the Medicaid program to benefit elderly people and pregnant women at the expense of Medicaid recipients." But the court decided the state was in its rights, noting that more resources will be available for existing Medicaid beneficiaries." (Pear, 2004)
Indeed, Janet Olszewski, director of the Michigan Department of Community Health said that by encouraging doctors to use the list of preferred drugs, the state had sharply reduced the growth of Medicaid drug spending. "In the three years before the program took effect, Ms. Olszewski said, that Michigan saw annual increases of 11% per prescription, "now it's just 4.2%." (Pear, 2004)
However, the director did not note if health care, in terms of quality, had been maintained or improved, amongst the pregnant or elderly or any of the individuals in question supposedly benefiting from the program. Cost alone was mentioned, quantified, and cheerfully reported.
This relationship has an effect on the payment rates that CMS sets. Higher cost pharmaceutical therapies are systematically reimbursed below acquisition cost (i.e., the payment system is biased against full reimbursement for higher cost therapies). Reimbursement compared to acquisition cost for the top IO pharmaceuticals by total expenditures indicates that 9 of the 10 are significantly under reimbursed." Clinical Trials Report: Congress established Medicare beneficiaries numbering 40 million with a prescription
38 per share on the company's common stock for the first quarter of 2005. The dividend is payable January 3, 2005 to stockholders of records at the close of business on December 3, 2004. Growth in the ZETIA and VYTORIN franchises are expected to continue. T There are currently several candidates in Phase III that Merck plans to file in 2005 as well as Type 2 diabetes treatment and three vaccines.
There are two constant irritations in U.S. pharma companies' relationships internationally: Some developing nations, such as India, Brazil and South Africa, are chipping away at the patent situation, trying to shorten the time until the drugs can be brought out in generic form. The U.S. has supported high prices as the cost for innovation. Since other countries are not playing along, this means that their citizens are benefiting from the innovation paid
For example, before its paten ran out, "the price of Schering-Plough's top-selling allergy pill, Claritin, was raised thirteen times over fives years, for a cumulative increase of more than 50%, over four times the rate of general inflation." In 2002, the average price of the fifty drugs most used by senior citizens was approximately $1,500 for a year's supply, and although this refers to what the companies call the
McKesson Corporation (Mckesson) is an American pharmaceutical distributor with operations mainly in the U.S. The firm has been in operation since 1833, and boasts extensive market share, robust financial strength, and strong market power. The firm has built strong relationships with its key stakeholders, which adds to its strengths. Nonetheless, limited diversification and market focus as well as the threats of competition, unfavourable regulatory changes, and counterfeits present significant concerns
Pharmaceutical Ethics Issues Generally, business ethics is a concept that has not been upheld or exemplified to any high standard by the modern pharmaceutical industry. It is an industry frequently plagued by unethical marketing decisions and practices, the pursuit of business strategies and policies that violate public trust in spirit if not necessarily in the written word, and that has embraced research practices that are sometimes highly questionable. In the modern