July 8, 2010: Pharmaceutical coupon bill

>> Emily: EVERY STATE IN THE

COUNTRY ALLOWS PATIENTS TO CLIP

COUPONS FROM DRUG MANUFACTURERS

TO OFFSET THE COST OF EXPENSIVE

BRAND NAMED DRUGS EXCEPT

MASSACHUSETTS.

NOW A BILL MAKING ITS WAY

THROUGH THE LEGISLATION COULD

CHANGE THAT, BUT CRITICS SAY WE

COULD BE PAYING MORE THAN WE

BARGAINED FOR.

LAST AUGUST, MICHAEL ROOFERTY

GOT A CALL THAT CHANGED HIS

LIFE -- THE DOCTORS HAD A

PERFECTLY MATCHED LIVER WHO WAS

DYING FROM AN AGGRESSIVE FORM OF

CANCER.

HE WAS ON THE OPERATING TABLE

HOURS LATER.

>> I INTRODUCE YOU TO THE BATTLE

WOUNDS.

LET'S SEE, THIS SCAR GOES DOWN

HERE.

AND THAT WAS 22 STAPLES AND LIKE

SEVEN STITCHES.

>> Emily: WAS THE NEW LIVER CAME

AN EXPENSIVE REGIME OF DRUGS.

AT FIRST, HIS INSURANCE COVERED

MOST OF THE COSTS, BUT WITHIN

MONTHS THE NONPROFIT HE WAS

WORKING FOR CLOSED, LEAVING HIM

WITHOUT INSURANCE AND PAYING

FULL PRICE FOR HIS MEDICATIONS.

>> IT WAS ABOUT $1,000.

AND THEN THE OTHER ONE WAS

$1,000 AN'T MOE AND THEN YOU ADD

IN THE OTHER MEDICATIONS ON TOP

OF THAT.

>> Emily: IT ADDS UP TO $25,000

A MONTH AND IT COULD BE OFFSET

IF THE COUPON BILL PASSES.

IT WOULD ALLOW COMPANIES TO

OFFER COUPONS TO CUT THE COSTS

OF DRUGS.

>> THE ONE PHARMACEUTICAL

COMPANY THAT GOT ME STARTED IN

THIS WHOLE PROCESS HAS A PROGRAM

WHERE THEIR COUPON WOULD OFFER

UP TO $2,400 A YEAR.

>> Emily: MASSACHUSETTS IS THE

ONLY STATE THAT HASN'T PASSED

THE BILL.

SOMETHING THAT BRIAN ROSSMAN OF

HEALTHCARE FOR ALL IS A GOOD

THING.

>> THE DRUG COMPANIES ARE NOT

CHARITIES AND NOT DOING THE

COUPONS TO BE NICE TO PEOPLE.

THEY'RE DOING IT TO BOOST THE

PROFITS.

>> Emily: HE SEES IT AS A

MARKETING PLOY.

WHEN THE COUPONS RUN OUT, THE

CUSTOMERS ARE LEFT FOOTING THE

BILL.

>> SO BY ENCOURAGING TO TAKE THE

EXPENSIVE BRAND-NAMED DRUGS THAT

RAISES THE PRICE OF

PRESCRIPTIONS FOR EVERYONE.

>> Emily: ROSSMAN SAYS THE

SOLUTION IS COMPREHENSIVE

HEALTHCARE REFORM THAT MAKES

THEM LESS EXPENSIVE.

>> SOME COST THOUSANDS OF

DOLLARS A MONTH AND THAT'S THE A

RIPOFF.

>> Emily: A RIPOFF FOR HIM, BUT

A LIFE LINE FOR HIM.

>> IF I DON'T TAKE IT, MY BODY

REJECTS IT AND I DIE.

>> Emily: JOINING ME IS ROBERT

COUGHLIN, WHO SUPPORTS COUPONS

FOR PRESCRIPTION MEDICATIONS.

AND WELLS WILKINSON OF COMMUNITY

CATALYST WHO IS AGAINST IT.

WELCOME TO BOTH OF YOU.

>> THANK YOU, EMILY.

>> Emily: THIS STARTED BACK IN

1988 WHEN MASSACHUSETTS SIGNED

ON THE FEDERAL LAW THAT SAID

THAT IT WAS REALLY AN ANTI-KICK

BACK SO THAT NO ONE WAS

BENEFITING FROM MEDICAL --

ANYTHING MEDICAL.

NOBODY WAS MAKING HIGHER PROFITS

OFF OF MEDICAL DEVICES AND

PRESCRIPTION DRUGS.

IF THEY TAKE THAT AWAY, AND THAT

WAS THE NOTION BACK IN 1988, WHY

WON'T IT AUTOMATICALLY DRIVE

PRICES BACK UP?

>> WELL, IS IT OKAY IF I GO

FIRST?

>> Emily: YES.

>> HOUSE BILL 4689, WE REFERRED

TO IT AS THE CO-PAYMENT

ASSISTANCE BILL.

WHAT THIS WILL ENABLE IS THE

MANUFACTURERS OF THESE PRODUCTS

TO TAKE CARE OF AND GIVE A

COUPON TO COVER THE COPAYMENT

THAT'S ASSOCIATED WITH THIS

DRUG.

>> Emily: THE CO-PAYMENT

ASSOCIATED WITH THE DRUG.

>> YEAH.

>> Emily: HOW MUCH WOULD THAT

BE?

>> IT DEPENDS ON YOUR HEALTH

PLAN AND, YOU KNOW, WHEN YOU

TALK ABOUT MANY OF THESE

BLOCKBUSTER BIOLOGIC DRUGS,

MASSACHUSETTS CURRENTLY HAS THE

HIGHEST UTILIZATION OF GENERIC

DRUGS.

RHODE ISLAND WAS THE LAST STATE

PRIOR TO US NOT TO ALLOW THIS

PRACTICE AND THERE IS NO DATA --

>> Emily: WHY NOT REDUCE THE

PRICE OF THE DRUG?

>> WELL, YOU NEED -- THAT'S A

BIGGER PROBLEM.

YOU NEED TO REDUCE THE COST TO

MANUFACTURE AND INVENT THE DRUG

AND THE COST OF THE DRUG WILL

COME DOWN.

THIS IS AN ACCESS ISSUE.

THERE ARE PATIENTS OUT THERE

SUFFERING FROM CHRONIC ILLNESS

THAT CAN'T AFFORD THEIR

CO-PAYMENTS, AND I BELIEVE THAT

ORGANIZATIONS LIKE HEALTHCARE

FOR I AND THE MANUFACTURERS OF

THE DRUGS AGREE IT'S ABOUT

ACCESS.

IF A PATIENT CAN'T AFFORD A

CO-PAYMENT, THEY GO WITHOUT THE

DRUG AND THEY COST THE SYSTEM

MORE AND THE ONLY PERSON -- THE

ONLY GROUP THAT BENEFITS IS THE

HEALTH PLAN THAT DOESN'T HAVE TO

PAY FOR THE DRUG.

>> Emily: I WAS THINKING TODAY,

WELLS, WAIT A SECOND, THE

FEDERAL GOVERNMENT DOESN'T

REGULATE ANY OTHER KIND OF

COUPONS BUSINESS.

I MEAN, COUPONS HAVE BEEN AROUND

FOR, YOU KNOW, DECADES.

AND, YOU KNOW, YOU COULD MAKE

THE SAME ARGUMENT ABOUT PROCTOR

& GAMBLE PRODUCT, THAT THE

COUPON GETS YOU HOOKED ON IT AND

YOU GO BACK AND BUY IT.

I KNOW YOU CAN'T EQUATE

SOMEBODY'S, YOU KNOW, HEALTH AND

LIFE AND DEATH ISSUES WITH THAT,

BUT WHY WOULD YOU REGULATE IT

FOR ONE COMPANY AND NOT THE

OTHER?

>> YOU'RE RIGHT, EMILY, THE

COUPONS ARE VERY DIFFERENT IN A

CONSUMER PRODUCT CONTEXT THAN

THEY ARE IN THE PRESCRIPTION

DRUG CONTEXT.

YOU CAN GO OUT TO, YOU KNOW,

LOTS OF PLACES AND BUY CONSUMER

PRODUCTS.

YOU KNOW EXACTLY HOW MUCH YOU'RE

PAYING FOR THE PRODUCT, THE

TOTAL PRICE.

WITH PRESCRIPTION DRUGS, THEY

ARE SO UNSAFE THAT YOU CAN ONLY

TAKE THEM UNDER THE CONSENT AND

ADVICE OF A PHYSICIAN, AND ALSO

AFTER THEY'RE DISPENSED BY A

PHARMACIST.

YOU HAVE TWO MEDICAL TRAINED

PROFESSIONALS MAKING SURE YOU'RE

TAKING THE DRUGS AND IS

SUPERVISE AND DRUGS ARE

INHERENTLY UNSAFE.

BECAUSE, YOU KNOW, THEY'RE --

THEY'RE SERIOUS PRODUCTS AND

ADDRESS THE SERIOUS HEALTH

ISSUES.

SO THIS IS ONE REASON WHY

COUPONS ARE REGULATED AROUND

PRESCRIPTION DRUGS BECAUSE THE

FEDERAL GOVERNMENT PLAYS A VERY

ACTIVE ROLE REGULATING THE

PROMOTION OF PRESCRIPTION DRUGS.

COUPONS ARE ALL ABOUT PROMOTION.

THIS IS NOT ABOUT HELPING

CONSUMERS ACCESS MEDICINES.

YOU KNOW, OUR ORGANIZATION AND

LOTS OF OTHERS ARE ABOUT

PROMOTING ACCESS TO NEEDED

PREDSON AND COUPONS ARE ABOUT

DRIVING EXPENSIVE BRAND NAME

DRUGS AS OPPOSED TO INEXPENSIVE

GENERIC DRUGS.

>> Emily: THE OTHER PART OF

THIS, I HAD TO TAKE A DOUBLE

TAKE ON IT.

BUT WE TALKED ABOUT THE

ANTI-KICK BACK REGULATION.

IS THIS -- DOCTORS IN A SENSE

CAN ACCEPT KICKBACKS.

TRUE OR FALSE?

>> NO, THIS IS A CO-PAYMENT

ASSISTANCE BILL.

THIS WILL ENABLE MANUFACTURERS

OF DRUGS TO GIVE A COUPON TO

COVER --

>> Emily: SO THE DOCTOR GETS

NOTHING?

>> THE DOCTOR GETS NOTHING.

IT'S NOT HEALTH CARE INSURANCE.

THE PROBLEM WITH OUR HEALTHCARE

SYSTEM IS ACCESS TO THESE DRUGS.

YOU HAVE PEOPLE WITH MULTIPLE

SCLEROSIS, YOU HAVE PEOPLE THAT

HAVE RHEUMATOID ARTHRITIS THAT

CANNOT AFFORDTARY CO-PAYMENTS.

IF AN INDUSTRY IS WILLING TO

STEP UP AND COVER THAT COST,

THIS IS --

>> Emily: BUT NOT FOREVER.

THAT'S THE IDEA.

THEY'D BE LIMITED AND BE BACK

WHERE THEY ARE?

>> WHETHER IT'S LIMITED OR NOT,

IT'S PRETTY IMPORTANT TO THE MAN

YOU HEARD IN THE SEGMENT.

>> Emily: WELL, WHY CAN'T HE GO

TO ONE OF THE STATES, AND FILL

THE PRESCRIPTION AND USE THE

COUPON?

>> THAT'S A GOOD QUESTION.

I'M NOT SURE WHAT WOULD PRECLUDE

HIM FROM DOING THAT.

BUT TO OTHER PEOPLE IN THE

SITUATION, THERE ARE LOTS OF

PROGRAMS THAT DRUG COMPANIES CAN

SET UP.

PATIENT ASSISTANCE PROGRAMS

WHERE THEY RECOGNIZE THAT

SOMEONE LIKE HIM HAS LOST HIS

DRUG, DOES NOT HAVE INSURANCE

AND NEEDS THE MEDICINES.

THEY PROVIDE THE DRUGS AT FREE

OR REDUCED COST ON A CASE BY

CASE BASIS OR INCOME BASIS.

BUT COUPONS DON'T DO THAT.

COUPONS EXPIRE, THEY RUN OUT.

WHAT THEY END UP DOING IS

SHIFTING COSTS ON TO PEOPLE'S

HEALTH PLANS.

SO WHAT YOU HAVE TO REALIZE IS

IF YOU USE ONE COUPON FOR A DRUG

LIKE NEXT YUM INSTEAD OF TAKING

THE GENERIC ALTERNATIVE, YOUR

INSURANCE WILL PAY FOR THE --

>> Emily: BUT WHAT ABOUT ONCE

THE COUPONS RUN OUT HE CAN

SWITCH ON TO ANOTHER DRUG?

>> DOCTORS DON'T LIKE YOU

SWITCHING ON AND OFF A DRUG.

THEY LIKE TO KEEP YOU ON THAT.

>> FOR BIOLOGICS THERE ARE NO

GENERIC ALTERNATIVES.

WHAT DO YOU DO FOR THE ARTHRITIS

PATIENT WHERE THEY CAN'T AFFORD

THEIR CO-PAYMENT, FOR THEIR

WEEKLY OR MONTHLY INFUSION OF

HUMERA?

WHAT IS THE ALTERNATIVE?

THERE IS NONE.

>> THAT'S NOT TRUE.

>> I THINK IT'S IRONIC --

>> THE MANUFACTURER --

>> IN MASSACHUSETTS, WE MAN DATE

HEALTH INSURANCE AND WE ALSO

MANDATE THAT WE CANNOT USE A

COUPON ASSISTANCE PROGRAM.

WE'RE THE ONLY STATE IN THE

NATION THAT DOESN'T ALLOW IT.

THERE'S NO DATA THAT EXISTS THAT

WOULD SHOW THAT IT INCREASES THE

COST OF HEALTH CARE OR

DECREASES --

>> Emily: WHY NOT TRY IT?

>> WE DO AGREE THAT SOME OF THE

DRUGS ARE FAR TOO EXPENSIVE.

THAT'S ABSOLUTELY TRUE.

BUT IF THE DRUG COMPANY IS GOING

TO RESPECT AND HONOR A COUPON,

THEY COULD LOWER THE PRICE.

THAT WOULD BE THE SOLUTION FOR

DRUGS THAT COST $3,000 OR $4,000

A MONTH.

I WAS TALKING TO A PERSON WHO IS

ON THE DRUGS AND IT COST HER

$350,000 A YEAR FOR THIS DRUG.

THOSE PRICES -- THEY'RE

OUTRAGEOUS.

>> Emily: IT IS OUTRAGEOUS.

>> IT'S A NO-BRAINER.

IT'S A NO-BRAINER.

>> Emily: THANKS SO MUCH.

I APPRECIATE YOU COMING.

>> THANK YOU.

>> Emily: WHEN WE CONTINUE, WHY

A UNIQUE ART STYLE IS SUDDENLY

GAINING ATTENTION.