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Prescription for disaster

Consumer Reports News: July 17, 2008 03:20 PM

Diabetes, epilepsy, and high blood pressure are treatable conditions thanks to medications that can keep them under control. But for many Americans, like Kathy from Earlville, N.Y., who doesn’t have health insurance and doesn’t quite qualify for Medicaid, they are simply unaffordable. As she put it, she’s committing suicide slowly because diabetes affects all her organs. Sacrificing her health because she can’t afford her medicine is something no one should have to do. And yet this unfortunate scenario is playing out all too often from coast to coast.

I saw another troubling example of this in a recent e-mail forwarded to me by a neurologist colleague. The young woman wrote to say that she took two types of epilepsy medicine for almost 10 years, which cost her $45 a month. But with a new job came a new health plan, and now she says she has to pay more than $450 a month for the same drugs. She says she has to choose which bills to pay: rent, food, gas for her car, or medicine. “I have no money,” she writes. The worst part is that she is no longer taking any medicine for her epilepsy because she can’t afford the brand-name drugs, and generic versions aren’t available. She says she has applied for a prescription drug assistance program but has been denied because she has health insurance.

A recent USA Today/Kaiser Family Foundation/Harvard School of Public Health survey revealed that in the past two years, 29 percent of respondents have not filled a prescription because of the cost, 23 percent have skipped doses or cut pills in half to make a prescription last longer, and 16 percent say payment for prescription drugs is a serious problem for them and their families.

Even those with “good” prescription plans have seen a rise in co-payments, with average co-pays rising from $8 to $11 for generic drugs, $15 to $22 for preferred drugs, $20 to $35 for nonpreferred drugs, and fourth-tier drug co-pays rising from $48 to $74. Prescription drug assistance programs are designed to help people who don’t have health insurance or drug coverage pay for their prescription medicines, but people like the woman with epilepsy, who has a poor plan, and Kathy, who has some assets, fall between the cracks.  As the Cover America Tour is finding out, flaws in our health-care system have placed many people in no-win situations. Which would you choose to forgo…food, rent, or medications?

Orly Avitzur, M.D., medical adviser to Consumers Union

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