Suffocating from the high cost of meds in Maine

By Sun Journal,
Posted Oct. 22, 2013, at 6:24 a.m.

An asthma attack feels like breathing through a pillow that is being held to your face. No matter how hard you work to draw in breath, you can’t get enough air. Panic sets in, and it becomes even harder to breathe.

In this country, nine people die of this chronic disease every day.

Nine. Every day.

Maine has an unusually high rate of asthma in adults and children. And, of the people who struggle with asthma, half of them suffer an asthma attack every year.

Fortunately, with the right care and the right combination of medications, chronic asthma can be well controlled.

The only thing needed is money. And plenty of it.

Last week, The New York Times published a startling report titled “The Soaring Cost of a Simple Breath” looking at the manufacturing and cost of prescription drugs used to treat asthma.

According to that report, albuterol — a commonly prescribed emergency inhaler used to open airways and ease an asthma attack — generally retails for between $50 and $100 in the United States. It wasn’t always that expensive, though.

About a decade ago, it cost less than $15, but when it was repatented to remove chlorofluorocarbon propellants, that required a redesign of dispensers and the price shot up even though the medicine is the same.

In Canada, albuterol is available for $24.95 in the updated dispenser. In Europe, it is free to asthma patients.

Here’s another example of uneven pricing here versus elsewhere:

In the United States, ProAir HFA — another emergency inhaler — retails for $60. In Europe and Canada, it’s about $40.

The price difference is quite a bit more stark for maintenance drugs prescribed to asthmatics.

For instance, Advair Diskus — available only as a brand name drug — retails for more than $300 for a month’s supply in the United States. In Canada, the same dosage costs $42.95.

Singular, another maintenance drug, retails for about $100 for a month’s supply here. In Europe, it costs $36 for the same amount.

A QVAR inhaler, which reduces airway inflammation and has no generic substitute, retails for around $200 here; in Europe it’s $40.

Asmanex Twisthaler, often prescribed to children to control their symptoms, retails for $200 here. In Europe, it’s half that, at $100.

For many patients, multiple asthma drugs are prescribed to best manage their symptoms, which means they’re buying a combination of all of the above. For those who have insurance, they are dishing out the maximum co-pay for each prescription, and for those who don’t have insurance, they’re paying the highest price in the world for these medications.

Don’t have asthma?

Think this doesn’t affect you?

It does.

Thousands of the sickest asthma patients in Maine are covered by MaineCare and more by Medicare. In fact, according to the Maine Department of Health and Human Services, adults and children on MaineCare have higher asthma prevalence than individuals who carry other types of insurance.

Of the $5 billion this country spends on asthma meds every year, much of that medication serves the Medicaid/Medicare patient pool.

The reason the prices are so much lower in Europe and Canada is because those governments negotiate prices with drug suppliers. That doesn’t happen in this country because Big Pharma — which the NYT report noted spends more to lobby Congress than even the defense industry — has always successfully stopped any move by the feds to negotiate prices for Medicaid/Medicare patients.

As a result, we taxpayers are paying too much for medications that are — quite literally — necessary for people to breathe.

That’s particularly painful in Maine where, according to the state’s Center for Disease Control and Prevention, we have some of the highest rates of asthma in the country.

In Maine, 10.7 percent of all children have asthma compared to 8.7 percent elsewhere. And 10 percent of adults here have asthma compared to 7.8 percent, on average, across the country.

Maine’s minority population is particularly hard hit; 16.5 percent of the state’s non-white population has asthma.

Children living in Rumford’s river valley are more likely to end up in the emergency department than most other child asthmatics in Maine. In Androscoggin County, it’s people aged 15 to 34 who are most likely to seek emergency treatment.

What all this means is that in Maine, we suffer from asthma more than most Americans, and we live in a country that pays the world’s highest prices for prescriptions to manage this illness.

It’s downright debilitating.

It gets worse.

Since we Americans pay for much of the research and development of these prescription drugs, we’re paying upfront costs that the rest of the world is not burdened by.

It would be logical (if this nation’s health care system were based on logic ) that if we foot the bill for R&D we should get a break on purchase. But we don’t. In fact, we’re getting hosed.

And not just when buying asthma meds.

In the United States we pay more than $250 for a month’s supply of 40 mg Lipitor, once known as the most-prescribed cholesterol-reducing drug on the market. Europeans paid 10 times less.

When Pfizer’s patent expired last November, the generic atorvastatin came on the market and is now available ranging from $74 to $175 for a month’s supply in the U.S. In Europe, it’s 14 times less expensive as Teva Pharmaceuticals Industries, Mylan Inc., Sandoz and others cut prices in the fight for market share.

Again, our tax dollars pay for the research and others get the discounts.

It’s enough to make a person, ahhh, sick.

In recent weeks we’ve seen just how uncompromising some in Congress can be. It would be swell if they used just some of that backbone to stand up to Pharma, negotiate prescription prices through Medicaid/Medicare and, now, the Affordable Care Act, and give us the same opportunity non-Americans have.

For people dependent on medicine to live and breathe, it may really be all that matters.

The opinions expressed here reflect the views of the ownership and the editorial board of the Sun Journal.

 

http://bangordailynews.com/2013/10/22/opinion/suffocating-from-the-high-cost-of-meds-in-maine/ printed on October 31, 2014