Call her “Margaret” if you want; her name is not all that important.
About a week ago — the evening of Thursday, March 22, to be exact — she told her pharmacist that she would not be filling her prescription for Xeloda, an oral chemotherapy tablet that is supposed to stop cancer cells from growing. She is 76, a retiree from Albany County government, and she has leukemia. Under her insurance coverage, the co-pay for Xeloda would be $449 a month. Just can’t afford it, she told the pharmacist.
“If I die, I die,” was the way she put it.
It sure would be good to report that “Margaret” is an anomaly, an exception to the rule. Hardly. A recent study (don’t you hate those words, except this study really is pretty important) shows that 20 percent of Americans over age 50 try to save on health costs by making up their own rules for taking prescriptions. They often make those changes on their own, not running it past the doctor who prescribed the stuff in the first place.
I will spare you further numbers; suffice it to report that about a quarter of these folks lower the dosage, split pills in half or simply stop taking the drug altogether, without informing the prescribing physician. Hey, I know some seniors who will skip doctor’s appointments because they feel a prescription is likely. And those who do these things, as you might expect, tend to be in poorer health than those who do not.
“I am not surprised by the numbers,” says John McDonald, the licensed pharmacist who took care of “Margaret.” McDonald is the vice president of Marra’s Pharmacy in Cohoes, a family-owned drugstore that’s been there on Remsen Street for eight decades. McDonald also happens to be the mayor of that city.
“I see these people every day of the week,” he says. “Most of them won’t tell you that they cannot afford the co-pay; they’re too embarrassed. These are people who took care of themselves all their lives and all of a sudden, they can’t afford to pay for the medicine to keep themselves healthy. Sad.
“Used to be the co-pays were like two, maybe three dollars. Now, because the insurance company is paying so much more for the drug, they’re $10, $30, maybe $50 and all of a sudden, the economy and all, these people can’t afford that.”
So they don’t tell McDonald that they eliminated Lipitor, but the pharmacist knows. First off, McDonald knows just about everybody in town. And by simply pushing a couple of computer buttons, he’s able to see their prescription-buying history. All of a sudden, that script is among the missing.
He says old-timers will stop taking medications that treat things where you don’t necessarily feel symptoms, like hypertension or bad cholesterol. No aches, no pain, so they convince themselves that maybe the hypertension is all gone. Their doctors might not understand that logic, but their doctors are not living on Social Security payments.
John McDonald says seniors can avoid taking these risks if they can put aside their pride. Look, he does not want every deadbeat in the area flocking to Marra’s Pharmacy, but McDonald says they’ve beenmaking “accommodations” for those who cannot pay for many of those decades. But forget about that. Whether it’s his or some other pharmacy, McDonald says things can be done. Doctor’s samples. Generics. Coupons. Patient assistance programs from the drug companies.
“You might be paying $3.75 a day to take Lipitor,” he says. “Your pharmacist will call your doctor and see if you can take a generic statin that will cost you 12 cents a day. Mostly, the doctor says yes. If that doesn’t work, the pharmacist — if you’re honest with him — will find you an assistance program from the drug company.”
That’s what McDonald did for “Margaret,” who is now taking Xeloda and talking less about dying.
You probably read a couple of days ago that state lawmakers had restored $30 million to EPIC, the state’s effort at assisting old-timers with pharmaceutical buys, assuring that no one forks out more than $20 for a co-pay — and assuring New Yorkers also that Albany sometimes gets it right.
“Margaret” never joined EPIC because she was getting her insurance for free from the county, so for the time being, she will continue getting assistance from the drug firm.
“Nice lady; hope it works for her,” says John McDonald.
Oh, by the way (and I know this is the oldest cliché-gimmick in the business), we Americans spend $24.4 billion (yes, that’s with a B) each year on medications for our pets.