Monday, June 13, 2005

Increasing Prescription Drug Costs; Can't Afford? What to Do?

This Blog presents some statistics about the future cost of American Health Care in general, and prescription drugs in particular. If you do not already have a Health Insurance Plan that contains a prescription drug coverage component, you might seriously consider getting one soon. If you cannot qualify for one, or cannot afford one, the later part of this Blog provides criteria and requirements for enrollment into Free Medicine Plans.

Consider the following facts about American Health Care costs (source: the National Coalition on Health Care).

1) In 2003, health care spending in the United States reached $1.7 trillion, and was projected to reach $1.8 trillion in 2004.
2) Health care spending is 4.3 times the amount spent on national defense.
3) In 2003, the United States spent 15.3 percent of its Gross Domestic Product (GDP) on health care. It is projected that the percentage will reach 18.7 percent in 10 years (by 2013).
4) Although nearly 45 million Americans are uninsured, the United States spends more on health care than other industrialized nations, and those countries provide health insurance to all their citizens. Health care spending accounted for 10.9 percent of the GDP in Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5 percent in France, according to the Organization for Economic Cooperation and Development.
5) Total out-of-pocket spending (that is, out of your pocket and my pocket) on health care rose $13.7 billion, to $230 billion in 2003.

Bringing this information a little closer to home, we find that in many cases, prescription drugs are too high relative to the cost of living for a segment of the population. And,a large proportion of senior citizens literally can’t afford to both buy drugs and put food on the table.

However the numbers get crunched, we are paying more for our medicines. The popular sleeping pill Ambien, which is advertised directly to consumers, jumped 11.9 percent last year. A month's supply could cost about $100, more than $3 per pill.The price of your medicines might give you a migraine, but treating it will be pricey. Imitrex, one of the most successful migraine medications, can run $20 a tablet.OK, what if you cannot afford your medical costs. Or, like the woman mentioned above, you can pay for your medications or your food. What can you do?

There are programs available, for those who qualify, where your medications will be paid for for you. Consider the following.

Who can be Approved for Free Medicine Enrollment?
People of ALL AGES nationwide.
Seniors and retired people.
People on Social Security.
People on Social Security Disability or SSI.
People on a fixed income.
Single people.
Working people.
People without jobs.
People who are taking care of loved ones and paying for their prescription medication because they (the people who need the medications) can’t.

OK, I'm in one of these "who" categories. Now, what are the requirements for qualification?

Requirements for Free Medicine Enrollment are:
1) People without prescription insurance coverage (public or private).
2) People with household incomes at a level that paying for medicine at retail prices poses a hardship. (I'm sure that this will have to be documented.)
3) People who make too much money to qualify for public assistance e.g. Medicaid.

General Income Eligibility Criteria: Individuals with family incomes ranging from below the national poverty level up to $38,000, and in some cases, families with annual incomes as high as $60,000 can receive free drugs.

Each sponsored drug has it’s own eligibility criteria.

Circumstances that may also allow for free medicine eligibility:
1) People who have maxed out their prescription insurance coverage.
2) People on Medicaid, (state public assistance) but have prescriptions Medicaid does NOT cover or have exceeded the prescription drug limit for this calendar year.
3) People on Medicare with no outpatient prescription coverage.
4) Some, but not many sponsors offer help for people who cannot afford their co-insurance fees.
5) People who have reached a cap on their outpatient prescription drug insurance coverage.
6) People who have medical insurance coverage, but NOT prescription coverage.

On occasions, some sponsors will make an exception on a case-by-case basis or in extreme or extenuating circumstances. It never hurts to ask.
Leading drug companies have pledged, “No patient in need of medicines will do without them.”

So, you believe that you, or someone you know qualifies for free medicine. How do you go about getting it?

1) First of all, if you have access to a computer (and they are available in public libraries), and if you have a prescription with a leading drug company, use a search engine to look up that drug company's website. There should be a "contact us" button that should allow you to contact the company and inquire if they offer a program.

2) Most states have a place where you can inquire about free medicine plans.

Best of luck in your search.

Vioxx, Bextra, Celebrex CURRENT (6-05) Alternatives

How many of us taking Vioxx, when it was taken off of the market, changed to Bextra? ME!! Then, when Bextra was taken off of the market, how many of us changed to Celebrex? ME, again! What will happen to us when Celebrex is taken off of the market? We need to explore this situation, look at today's alternatives, and, in discussions with our Doctors, decide what we do then; and, decide now, before then gets here!

Remember: this blog in no way prescribes any course of action; it does not offer any medical advice; that is between you and your Doctor(s). Its purpose is to empower you with information to assist in those conversations, to get the help that you need to live as high a quality of life that you can.

First and foremost, and, not to sound too much like a broken record, we each need to know our symptoms - all of them - and their direct and specific impact on us.

Next we need to know about Vioxx, Bextra, Celebrex, and what the current alternatives are. Then, we can discuss these alternatives with our Doctors.

OK, you have to do the part about your symptoms yourself. For assistance check out the website

Finally, before we begin, I found the following information in over a doxen of websites, and have summarized the data here for you.

What are Vioxx, Bextra, and Celebrex?

These three drugs are part of a large group of drugs called "nonsteroidal anti-inflammatory drugs" or NSAIDS. They are part of a further subset within NSAIDS called "Cox-2 inhibitor (selective)". Now, there are a lot of additional NSAID medications; there are even "Cox-2 inhibitor (preferential)" drugs.

Alternative Suggestions

Alternative suggestions generally fall within three categories.

1) Other NSAIDS with a specific dosage calculated for only you, based on your symptoms (see why they are so important to document?). These seem to fall within OTC (over-the-counter) medications of Aleve, Motrin, and Advil. However, your Doctor can prescribe specific dosages for you.

2) There are certain additional drugs in the "Cox-2 inhibitor (preferential)" category that might be effective for you, based on your symptoms. These you will have to discuss with your Doctor to get the names.

3) "Natural Alternatives" These natural alternatives include, but are not limited to the following: curcumin, glucosamine with chondroitin, borage oil (containing high doses of gamma linolenic acid), or high doses of omega-3 fish oils. In addition, many suggest that accupuncture, non-impact exercises, and different diets.

If you have any additional suggestions or recommendations, we would love to hear them.