DMI Blog

Corinne Ramey

High Cholesterol, High Prices, and Why Medicare Needs a Makeover

Blog Post About DMI's TheMiddleClass.org

Let's say you wanted to buy some Zocor, a popular drug for patients with high cholesterol. Prescription in hand, you would go to the local drugstore, where you might shell out $1,825 for a year's supply. But let's say that you're the US Department of Veterans Affairs. With all those high-cholesteroled vets behind you, you have some serious negotiating power. So that same one-year dosage of Zocor would cost you about $127.44, a real bargain. But even better, what if you're the federal government and have the collective buying power of 43 million Medicare beneficiaries? Wouldn't you be able to strike a bargain with the pharmaceutical industry and get a real deal, even better than what the VA could do?

Wrong. You can't. The lowest price for a year's worth of Zocor under Medicare Plan D is $1,358.52, about 1,066 percent higher than the VA's price.

So why isn't the government negotiating for all these Medicare beneficiaries? Do we all have to go out and become veterans in order to get some affordable drugs?
It all comes down to the Medicare Modernization Act of 2003. This law prohibited the government from negotiating with drug companies, eliminating the massive negotiating power of all those needy Medicare patients.

But in 2007, things were looking up when the Medicare Prescription Drug Price Negotiation Act showed up in the House and the Medicare Fair Prescription Drug Price Act was voted on in the Senate. Both bills would have given the federal government negotiating power, leading to an estimated savings of $30 billion in 2008 alone by taxpayers and Medicare beneficiaries.

Unfortunately for the middle class -- and fortunately for the pharmaceutical industry! -- neither one of these bills got off the ground. Although the House version passed in January, the Senate version failed 55-42. The vote would have required a supermajority of at least 60 for passage. Looks like big pharma won, and the middle class lost.

The bills were slightly different. The House bill would have required the Secretary of Health and Human Services to negotiate prices for bulk drugs, but the Senate version would have allowed the Secretary to do so by eliminating the current ban on negotiation in Medicare Part D. The Senate bill also required data collection on the efficacy of private drug plans under Plan D to reduce drug costs.

Obtaining cheaper prescription drugs is an important issue for America's middle class senior citizens, many of whom live on fixed incomes and struggle with prices that are increasing at astronomical rates. According to the AARP, between 2000 and 2006 the cost of brand-name drugs commonly prescribed to seniors has increased 53.6%. We've written about Medicare Plan D and Maine's successful plan to lower prescription drug prices on the DMI blog.

Corinne Ramey: Author Bio | Other Posts
Posted at 5:06 AM, Oct 30, 2007 in Health Care | TheMiddleClass.org
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