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Prescription drug coverage debated

The Associated Press
Tuesday September 12, 2000

The Associated Press 


SACRAMENTO — Prescription drug use is up, prices are higher and those who need the medications most are least likely to have insurance coverage for them, health care experts said Monday. 

The Center for Health and Public Policy Studies at University of California, Berkeley, held a roundtable event at the Capitol to address growing concerns about prescription drug coverage. 

It included discussion of coverage by HMOs; Medicare, the federal government’s health coverage for the elderly and disabled; and Medi-Cal, a state-federal plan for low-income Californians. 

“A significant portion of the population doesn’t have coverage for prescription drugs,” said Janet Lundy, an author of a recent Kaiser Family Foundation study. “A lack of coverage can mean that prescriptions doctors prescribe don’t get filled.” 

Though coverage of prescription drugs has increased, 23 percent of the non-elderly and 31 percent of Medicare beneficiaries still have no coverage, according to the national study by Kaiser, a nonprofit health care foundation unrelated to the health insurer Kaiser Permanente. 

Finding a way to help people get coverage for prescription drugs is imperative as drug costs and use rise dramatically, Lundy said. 

Prescription drug use rose 37 percent between 1992 and 1998, while the population grew 6 percent, according to the foundation’s study. 

Retail prices for drugs have increased 6.7 percent per year since 1991 – a rate higher than both general inflation and medical care inflation, the study found. 

As a result, out-of-pocket expenses for medication, both for the insured and uninsured, are projected to rise, Lundy said. 

All of that adds up to a system that “hurts people’s ability to stay alive,” said David Gross of the AARP Public Policy Institute in Washington D.C. 

The topic is one of the hottest in this year’s presidential race, with both major-party candidates touting plans to expand coverage. 

Democratic nominee Al Gore would incorporate prescriptions into Medicare. Republican George W. Bush has suggested four years of grants to states to provide coverage for low-income seniors while a national program was established. 

Two panelists at Monday’s roundtable, Dr. Sharon Dean, a pediatrician from Kaiser Permanente, and Robert Seidman, of Blue Cross of California, said they were troubled by the increase in pharmaceutical marketing directly to consumers. 

The pharmaceutical industry spends about $8 billion per year to promote its products, with more than $1 billion of that spent on advertising to the general public, the study found. 

A Blue Cross study found a 600 percent increase in advertising of antihistamines on television and in magazines, Seidman said. 

“If they’re marketed like candy, they should be sold like candy and you shouldn’t need a prescription,” Seidman said. 

The drug industry opposes attempts at price controls or HMOs using restrictive plans that allow doctors to prescribe only the lowest cost drugs, said Chris Ward, a consultant for the Pharmaceutical Research and Manufacturers of America. 

It supports expanding coverage under Medicare, Ward said.