The Real Drug War: Beware, Drugmakers. with Senior Citizens Struggling to Afford Their Prescriptions, Soaring Pill Prices Are Turning into an Explosive Issue
Living in senior housing on $1,000 a month, plagued by arthritis and severe stomach problems, Viola Quirion has been forced to make some hard choices. "I had to skip my drugs and I had a lot of pain," says the 73-year-old resident of Waterville, Maine, who worked for 40 years in a shirt factory. "I tried to skip some meals, I bought the cheapest food I could." Quirion is a Medicare recipient with no prescription-drug coverage--the federal medical insurance program doesn't cover outpatient prescription drug costs for anybody. She pays more than $200 a month for the medicine she needs: Prilosec for her stomach and Relafen for her arthritis. "When I skip the Relafen, my inflammation comes back," she says. "And if I skip the Prilosec, I can't digest my food." Twice last year, she traveled by bus with other Maine seniors to Montreal, four hours from her home, where she saved almost $200 on a three-month supply of medicine. "It's pretty rough," she says. "We're a bunch of senior citizens with canes and crutches and oxygen."
Except for the trips to Canada, a random advantage of living in a border state, Quirion's story is hardly unique. She could be the poster patient for what has emerged as one of the election year's most explosive political issues. Quirion is one of an estimated 13 million elderly Americans with no prescription-drug coverage. This doesn't just affect poor people: many middle-class seniors without additional private insurance struggle to pay for the drugs they need. To get by, some occasionally go without their medicine. Some break pills in half. Others take fewer pills than their doctors prescribe. All are victims of what critics of the drug industry call price discrimination. Even Hollywood recognizes the drama of the issue. On "ER" last week an elderly woman, in a potentially fatal move, took her husband's blood pressure medicine because she couldn't afford her own.
Drug companies are scrambling to make sure that the mounting crisis won't be fatal to their profits, currently among the highest in American industry. The clash pits the well-connected pharmaceutical companies, with projected U.S. sales this year of more than $100 billion, against an equally formidable foe, the influential senior-citizens lobby. For politicians, the issue and the photo ops are irresistible. Last week, Al Gore was snapped helping an elderly woman buy her medicine at a pharmacy. George Bush favors a plan to help low-income seniors buy coverage from private insurers. Up in Maine, legislators are debating a bill that could make it the first state in the nation to limit what drug companies charge for prescription drugs. The landmark legislation could be signed as soon as next week, and similar bills are in the works in states from New York to Arizona.
The stretched seniors are pushing to correct a basic imbalance in the drug marketplace. Bulk drug buyers like HMOs and big health insurers are able to negotiate with pharmaceutical makers for discounts and rebates of up to 40 percent. Meanwhile, foreign countries, such as Canada and Mexico, impose price controls to help consumers. But U.S. seniors without drug coverage end up paying full price for their prescription drugs. Studies have shown that they regularly fork over twice as much as those who get the best deals, and in some cases their costs are four times higher. The prices of the 50 drugs seniors use most increased last year at nearly double the rate of inflation, according to a new study. "The most profitable industry in the country is charging the highest prices in the world to the Americans who can least afford it," says Democratic Rep. Tom Allen of Maine, who is pushing a bill to force drug manufacturers to give all 39 million people on Medicare the same steep discounts the Department of Defense and other government agencies get. …