12-26-02: Agency helps area people with drug expenses

12-26-02: Agency helps area people with drug expenses

Prescriptions take big chunk of senior citizens' incomes

    This is the first in a series of three stories on problems created by the high cost of prescription drugs, some solutions and suggestions and Ohio's attempt to address the problem after the failure of the U.S. Congress to do so.

By PAT ROYSE
The Daily Standard

    Roy Russell of Rockford had been paying more than half of his $762 monthly income for the prescription drugs to treat his multiple health ailments for some time.
    But thanks to Gloria Miller at the Mercer County Council on Aging, the 85-year-old said he found a patient assistance program run by a drug manufacturer that allows him to get the drug for his emphysema, normally costing more than $100 for a 30-day supply, for $5 instead. The program is run by GlaxcoWellcome.
    His total monthly $393 drug cost - which he said was once nearly $500 - has dropped.
    "If it wouldn't have been for Gloria, I would have been hurting," Russell said.
    He can use the GlaxcoWellcome card only on one of his prescriptions, which is the pattern with most of the drug manufacturers' assistance programs. Typically, the approval lasts for three months, then Russell and others on similar programs will have to reapply.
    Miller is working on other programs for a couple of Russell's other drug needs.
    Russell was born in Kossuth, worked first in the paper mill in St. Marys, and when that closed, in a uniform factory there. His last job was at an insulation company in Mendon and Indiana, which he thinks might have contributed to his later breathing problems.
    He is being treated for emphysema, a bleeding ulcer and Lupus, he said. Russell in the past has had shingles and was operated on in 1986 for prostate cancer. But he feels pretty good and alert, he said, although he admits to occasional memory loss. He said he has no problem driving; it is the walk from his Rockford Villa Apartment at 419 N. Holly Drive to his parked car that leaves him short of breath and restricts his getting around.
    His four adult children are somewhat scattered, a son and a daughter in Florida, a daughter in New Bremen and a son in Delphos. He still makes the drive to visit those closest occasionally.
    Russell agreed to talk about his prescription cost woes and the help he found through the council so others in his situation would know they also might find some relief in the manufacturers' patient assistance programs.
    He is not alone in his struggle to pay for prescription drugs.
    Prescription drugs are now an important part of medical treatment but drug prices are rising at a rate three times faster than inflation. The amount spent for medicine has increased significantly with average retail prescription costing more than $45 in 2000 and probably higher now.
    According to an article in the AARP Bulletin last spring, "Older adults spend more than $700 a year filling prescriptions, almost twice the national average."
    It hurts those most who have multiple or chronic conditions and who may need several kinds of drugs, reports a staff member in a local doctor's office who did not want to be identified. "Multiple medications can wipe out a Social Security check in no time at all," she said.
    Just ask Nora Elsworth, 83, who lives with her daughter Alice Spahr at 226 Forest Drive, Celina.
    Elsworth has multiple breathing problems (emphysema, asthma and
allergies) for which she takes at least three prescriptions, as well as
using an inhaler and other breathing treatments. She was spending $641 of
her $1,210 monthly Social Security check on prescription drugs and
treatments.
    Now, her cost is 40 percent less than it was a short while ago.
    After hearing of the help the Council on Aging might be able to provide,
she applied with Miller's help for the Together Rx card. The card combines
the programs of eight pharmaceutical companies and discounts the cost of drugs 20 to 40 percent.
    Another senior citizen, with multiple problems, also found out about the Together Rx from Miller. The 85-year-old, who didn't want to be identified, said she was being treated for high cholesterol, high blood pressure and arthritis. With the discount card, the last time she filled her prescriptions it cost her only $41 a month, half of what she had been paying.
    At doctors' offices, staff members worry that with increased publicity on patient assistance programs offered by drug companies, they will be overwhelmed with requests and paperwork.
    "The drug companies are trying hard to help those people who fall between the cracks," said one staffer. "But they are not giving away free medicine. These programs are primarily for the truly indigent."
    A news story on the manufacturers' patient assistance programs in the Wall Street Journal in July 2000 said the companies gave away or discounted a total of $2.8 million in prescription and gave away samples totaling $500 million in 1998. By comparison, however, U.S. prescriptions sales that same year reached more than $125 billion.
    In its newsletter, The Medicare Rights Center in New York City said 48 percent of people on Medicare in 1999 did not have prescription drug coverage of any kind and almost half of all seniors have incomes of less than $15,000 per year, which is still higher than the federal poverty level.
    Most, but not all, of the drug manufacturers' programs apply to those whose household income falls below the federal poverty level (which in most states is $8,860) and who have no other prescription drug coverage. Excessive drug expenses are sometimes taken into account.
    Almost all are for seniors who are on Medicare insurance, although a few may apply to those on disability assistance also. They may require proof of income status, such as copies of social security checks, tax forms and other income verification. They may be lengthy, as well. It is up to the seniors to do the research.
    Said one staffer from a local doctor's office, "We don't really ask these kinds of questions. We don't invade their privacy." She also warned some programs apply only to a certain diagnosis. So if a drug is used to treat more than one thing, the program may not apply.
    So far, doctors' staff members have helped when they can. But drugs and programs change so often and they already have other paperwork responsibilities, so if requests increase much they may not be able to continue to fill out the patient assistance forms.
    Miller will help with the forms but patients also have some responsibility. The forms must include a copy of the prescription. The drugs themselves are often sent to the doctor's office or to the health or social service agent verifying the application. Miller can act as such an advocate/representative for at least one of the programs, but each program has its own rules, she said.
    Finding the right program is a nightmare for most seniors, Miller said. They are ultimately responsible for researching the manufacturer of the drug prescribed and getting the form from the company if she doesn't have one on hand. (She has a few but not nearly all.) She suggests checking out the Physicians Desk Reference at the local library where seniors also can use the computers to gather more information.
    Then, Miller says the patient must remember to reapply when the assistance runs out, usually at three months, and get the physicians signature on the renewal forms and copies of any income proof, if required.
    The Pharmaceutical Research and Manufacturers of American (PhRMA) puts out a Directory of Patient Assistance Programs and the 2002 copy obtained by The Daily Standard from NeedyMeds.com listed 56 different programs and 56 sets of rules. It is available free at 800-762-4636 or Medicare.gov (click on prescription drug assistance programs), as well as NeedyMeds.com.
    Based on the pamphlet and on a quick scan of the programs, some require documentation of income and some will take your word via signature.
    The Medicine Program at 573-996-7300 (www.themedicineprogram.com) will do some research for you for a $5 fee if you need it.
    There also is help from the state at www.ohioaging.org, which identifies several links that make recommendations to help with prescription drug costs, including the NeedyMeds site.
    In Part II of the series on Friday: What the state program, which is not income based, will do and who pays for it.

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