With the punishing price of prescription drugs, it’s no wonder individuals, especially older ones, and the governments that subsidize them are looking for any way possible to save money on drug purchases. The latest is the free New York Prescription Card announced by Gov. Paterson Monday, which will provide 50- to 64-year-old, low-income New Yorkers with significant discounts on both generic and name-brand drugs starting April 1. It’s a good, badly needed program — these are people who don’t qualify for Medicaid, probably don’t have health insurance with drug coverage, and are too young for Medicare.
But the program, which relies on negotiated deals with pharmacies and drug companies, doesn’t do anything for the non-old and the non-poor, as a similar card being distributed by Schenectady, Fulton, Saratoga and 11 other counties does. That’s too bad, because there are plenty of others in those groups who are heavily burdened by the price of drugs. Also because the state, with its greater purchasing power, is able to get greater savings from the pharmacies and drug companies than the counties can. Unfortunately, the Senate Republicans last year wouldn’t go along with such a plan and insisted that the program be limited.
Another proposal designed to help seniors afford prescription drugs is more problematic. Sen. Ruben Diaz (D-Bronx) wants to allow for the import of drugs from Canada under the state’s Elderly Pharmaceutical Insurance Coverage program (EPIC). Pharmacists, not surprisingly, oppose the idea, but they have some good arguments. One is that it wouldn’t save the state much money because EPIC already gets excellent deals from the drug manufacturers (in some cases 40 percent or more off the average wholesale price), and EPIC participants pay a maximum of $20 in co-payments and as little as $3. Another is that seniors tend to take a number of different prescriptions, and it is safer to have someone dispensing the drugs who knows and can monitor them.
In addition, there is the whole issue of drug importation, which is a difficult one. Even in cases where there is real money to be saved — Schenectady County has saved $5.8 million since 2005 by encouraging its employees to purchase drugs from Canada — it is currently illegal under federal law (although the U.S. Food and Drug Administration turns a blind eye).
One reason imported drugs are not formally allowed is concerns about safety; the FDA cannot inspect the plants where they are made or make sure they are not tampered with. This could be addressed through legislation now before Congress that would set up a regime for drug importation.
Another concern is that drug companies have high research and development costs, and price-controlled imports will either deny them enough profits to plow back into R&D or require them to raise prices for their drugs at home. We would have more sympathy for that argument if the drug companies didn’t spend far more on advertising and on marketing to doctors than on R&D.