Ahead of Midterms, Trump Unveils His Proposal to Slash Prescription Drug Costs

Published in Woonsocket Call on October 28, 2018

With mid-term elections looming, President Trump moves to block Democrats tying the high cost of prescription drugs to an unresponsive Republican-controlled Congress and to GOP efforts to undo health care protections for people with preexisting medical conditions, one of the most popular provisions of the Affordable Care Act, referred to as Obamacare.

According to recent Roll Call poll, health care is a top issue for Democratic and Independent voters in key battle ground states while the GOP tout’s immigration and the economy and jobs as its priority.

Last Thursday, afternoon, at the Department of Health and Human Services (HHS) with Secretary Alex Aza, FDA Commissioner Scott Gottlieb and CMS Administrator Seem Verman standing by President Trump, he announced major changes as to how Medicare pays for prescription drug to bring down costs by making prescribed medications more affordable to seniors, making pricing of U.S. drugs fairer relative to costs paid by other countries.

Bringing Down Medicare’s Skyrocketing Drug Costs

“We’re taking aim at the global freeloading that forces American consumers to subsidize lower prices in foreign countries through higher prices in our country,” said Trump at the Oct. 25 press conference in his 14-minute speech. He noted that the costs for the same pharmaceutical drug in some countries are 20 percent less than those purchased in the United States even though it was made by the same manufacturing company.

“At long last, the drug companies and foreign countries will be held accountable for how they rigged the system against American consumers,” says Trump.

Trump rattled off specific examples of how Medicare pays higher prices for the same pharmaceutical drugs that are cheaper in other developed countries. For instance, one eye medication that prevents blindness would annually cost about $187 million rather than $1 billion dollars if Medicare paid the same prices other countries pay, he said.

Another example, a highly used and very effective cancer drug is nearly seven times as expensive for Medicare as it is for other countries, said Trump, noting that “this happens because the government pays whatever price the drug companies set without any negotiation whatsoever.”

Under Trump’s unveiled proposal, a new Medicare model, the International Pricing Index (IPI), is created to bring down Medicare drug costs to ensure seniors get a “more fair deal on the discounts drug companies voluntarily give to other countries.”

Currently, Medicare sets payments for physician-administered drugs at the average sales price in the U.S. market—plus a price-based add-on fee. Trump’s proposal would allow Medicare to set the payment of these drugs at a Target Price, based on the discounts drug companies give other countries. With the model fully implemented, it is estimated that total payment for these drugs would drop by 30 percent.

Under the IPI model, described in an Advance Notice of Proposed Rulemaking, Medicare’s payments for select physician-administered drugs would shift to a level more closely aligned with prices in other countries. Overall savings for American taxpayers and patients is projected to total $17.2 billion, with out-of-pocket savings potentially totaling $3.4 billion over five years.

Medicare beneficiaries not covered by the IPI model could also see their drug costs lowered, because the average price used to calculate traditional Medicare reimbursement will drop.

Trump’s drug pricing proposal still needs to be refined and put though a federal rule-making process and its impact may not be seen for years.

Is Trump’s Efforts to Lower Drug Costs Just Election Year Posturing?

“It’s hard to take the Trump administration and Republicans seriously about reducing health care costs for seniors two weeks before the election when they have repeatedly advocated for and implemented policies that strip away protections for people with pre-existing conditions and lead to increased health care costs for millions of Americans,” says U.S. Senate Minority Leader Chuck E. Schumer in a statement.

“Once again, the President’s plan doesn’t go far enough to bring down the costs of prescription drugs. Democrats have proposed letting the HHS Secretary negotiate the prices of all drugs covered under Medicare, as well as new tools to ensure transparency and accountability when companies try to raise their prices. Without these critical steps, the President’s plan is just more words with little substance,” says Rhode Island Congressman David N. Cicilline.

Pharmaceutical Research and Manufacturers of America (PhRMA) president and CEO Stephen J. Ubl, opposes Trump’s proposal to lower Medicare’s drug costs, warning that it would “jeopardize access to medicines for seniors and patients with disabilities living with devastating conditions such as cancer, rheumatoid arthritis and other autoimmune diseases.” Trump’s proposal severely alters the Medicare Part B program by reducing physician reimbursement and inserting middlemen between patients and their physicians,” charges Ubl.

Adds, Frederick Isasi, executive director of Families USA, in his statement: “The data is clear. The way we currently pay providers and pharmaceutical companies for drugs administered in doctors’ offices and hospitals creates perverse financial incentives for providers to select extraordinarily expensive drugs that may not be best for their patients. “

“Medicare Part B is the perfect example of misaligned incentives, and the proposed rule, if implemented, could pilot significant new ways to pay for drugs that align incentives so that patients get the highest value care, they have the best outcomes possible, and costs come down, says Isasi.

Like many, Isasi hopes that Trump’s proposal of using the power of the federal government to reduce Medicare drug costs is “not just election year posturing” but truly reflects a policy shift to using federal negotiating power to get unstainable prescription drug prices under control.

Next year, after the dust settles after the mid-term elections, Congress must work together to hammer out a comprehensive legislative strategy to lower pharmaceutical drug costs and to provide health care to all Americans. Listen to the polls.

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Looking to Enhance Your Mental Health and Well-Being? Take a Trip

Published in the Woonsocket Call on October 21, 2018

Just days ago, Washington, DC-based AARP releases survey findings tying health and wellness benefits to just planning and taking a leisure trip. According to the 45-page study, authored by Vicki Gelfeld, those who travel reported better emotional and physical health and improved personal relationships and even increased productivity at work. Additionally, overall well-being is one of the biggest advantages of taking a trip, with the benefits starting during the initial planning and extending beyond the trip. The longest lasting travel benefit reported by the survey respondents is improved relationships with loved ones – lasting six weeks on average.

The AARP Travel Research study, “The Health Outcomes of Travel: Perceptions of Boomers” released Oct. 16, shows 4 in 5 boomers experience at least one health benefit during a trip and 73 percent notice at least one health benefit after coming home. By far, boomers get the greatest boost of health benefits during their trip (56 percent). One in 5 say they experience health benefits before, during, and finally after the trip equally. But, Millennials experience a far bigger benefit from planning a trip (23 percent) than boomers (6 percent).

“When it comes to travel, getting away with your buddies or girlfriends is the lease stressful type of trip as is Spring Break. On the other hand, family reunions, holiday travel, and/or wedding/graduations tend to have the most stress, although predominately still low stress levels,” says the survey’s findings.

“This research shows there are many health and wellness benefits during all stages of travel across generations, and seeing those benefits significantly improves their satisfaction with the trip,” said Alison Bryant, AARP Research Senior Vice President, in a statement. “Any type of travel, whether it’s a weekend getaway or a week-long trip, can be an effective way to renew and recharge and the benefits far outweigh the short-lived drawbacks,” adds Bryant.

According to the AARP Travel Research’s survey findings, 21 percent or the survey respondents say they experience health benefits before, during, and after the trip equally. Of the 73 percent of boomers responding who noticed health benefits post-trip, the most unexpected benefits are better sleep (51 percent), more energy (50 percent) and increased productivity (46 percent).

Additionally, these survey findings also indicated that 72 percent of the boomer respondents credit their travel health benefits simply to relaxation and fun and 67 percent to spending quality time with loved ones. They also indicate that health benefits that most improve during a trip include improved emotional well-being (54 percent), connection with loved ones (52 percent), amount of energy (35 percent), intellectual curiosity (34 percent) and finally, mental clarity (30 percent).

Additionally, planning a trip completely focused on wellness is not done by many and does not differ by generation. The survey findings reveal that a wellness-focused trip is most likely a result of more intergenerational travel happening within the younger group surveyed. When planning and taking a trip, wellness is not thought of as an underlying reason to travel, but as a by-product. However, most are open to just letting the feeling of wellness happen. A significant majority of boomers (96 percent) who planned a wellness activity on their trip, but did not exclusively focus on it, said they were “somewhat or very satisfied.”

As Others See AARP’s Travel Survey Findings …

“This further verifies what we have known for some time,” said AARP Rhode Island Communications Director John Martin. “Not to be glib, but for Rhode Islanders ‘travel’ can also mean crossing a couple of bridges or driving from, say from Coventry to Newport for a night out.”

Martin says, “What I mean to say is that the benefits of travel are not limited to expensive, week-long vacations to distant destinations. Clearly a week in the Caribbean or a trip to relax and enjoy one’s children and grandchildren in San Diego are examples of fulfilling travel. But with so many older Rhode Islanders living on tight retirement budgets, that kind of getaway can be infrequent. When AARP hosts fun events such as a recent vineyard tour and wine tasting in Middletown, the people we see are active and engaged. They arrive full of energy and you just know they are making the effort to regularly leave home and that they understand that being active is a big part of their health and wellbeing.”

Adds Dan Sullivan, Jr., CEO of Pawtucket-based Collette, “We’re excited to see that the AARP Travel survey closely aligns with Collette strategic thinking in terms of the benefits of travel. For years, we’ve really looked at the benefits of pre-travel when the anticipation factor sets in. For boomers, having travel as something to really look forward to it, is invaluable.”

The AARP Travel survey results can be found at: http://www.aarp.org/travelwell.

AARP Travel, (go to http://www.aarp.org/travel/) a valuable resource for Americans age 50 and over, who spend over $125 billion annually in leisure travel, helps travelers stretch their dollar and itineraries while also stretching their minds and possibilities. AARP Travel provides all interested travelers with vacation ideas, tips and inspiration for their next getaway.

For details about Collette “one of a kind” tours and vacations, go to http://www.gocollette.com/en.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, healthcare, and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Caregivers Can Take Advantage of Free Credit Freeze Law

Published in the Woonsocket Call on October 14, 2018

Attorney General Peter F. Kilmartin touts a new federal consumer protection law, signed into law by President Donald Trump on May 24, 2018, that protects seniors from becoming victims of financial exploitation. Rhode Island’s Attorney General says that this law enhances Rhode Island’s law prohibiting credit reporting agencies from charging fees for credit freezes,(also referred to as a security freeze).

With enactment of the Economic Growth, Regulatory Relief, and Consumer Protection Act, all consumers can now freeze and unfreeze their credit file for free for one year. Before this new law, fees were assessed, usually costing from $3 to $10 (though some states were free) to restrict access to your credit file, making it harder for others to open new accounts in another person’s name.

The new law lets people with certain legal authority to act on someone else’s behalf to freeze and unfreeze their credit file. It defines a “protected consumer” as an incapacitated person, someone with an appointed guardian or conservator, or a child under the age of 16. In addition, it extends the duration of a fraud alert on a consumer’s credit report from 90 days to one year. A fraud alert requires businesses that check a consumer’s credit to get the consumer’s approval before opening a new account.

“Many instances of financial exploitation include a person opening up credit cards or using the credit file of another for personal gain and identity theft. This added layer of protection will allow a guardian or financial caregiver the ability better safeguard the older person from being taken advantage of by a stranger or even someone they know and thought they could trust,”says Kilmartin.

To place a credit freeze on their accounts, consumers will need to contact all three nationwide credit bureaus: Equifax, Experian, and TransUnion. If you’re acting on behalf of a protected consumer, you must give the credit reporting agencies proof of authority before you can freeze and unfreeze the protected consumer’s credit. Proof of authority includes: a court order (such as an order naming you guardian or conservator; a valid power of attorney, and proof of your identity, which can be a Social Security card, birth certificate, driver’s license or other government issued identification.

Whether consumers ask for a freeze online or by phone, the credit bureau must put the freeze in place within one business day. When consumers request to lift the freeze by phone or online, the credit bureaus must take that action within one hour. (If consumers make these requests by mail, the agency must place or lift the freeze within three business days).
To place a fraud alert, consumers need only contact one of the three credit bureaus, which will notify the other two bureaus.

Rhode Island’s Credit Freeze Law

Filed at the request of Kilmartin and enacted earlier this year, the Rhode Island law eliminates a provision of existing state law that allows reporting agencies to charge up to $10 to consumers who ask for a credit freeze.

The legislation, which the sponsors introduced on behalf of Rhode Island Attorney General Kilmartin, stems from the Equifax security breach last year during which the credit information of 143 million Americans was exposed. Initially, Equifax was charging consumers who asked for a credit freeze to protect themselves from its own security breach, although it stopped after intense public outcry and pressure from numerous attorneys general.

At the time the law was enacted, Kilmartin said, “This is a big victory for Rhode Island consumers, giving them greater control over who can access their personal and financial information. Credit bureaus make money from selling our personal information to third parties. They should not be able to profit off consumers who decide to take control over who has access to their personal data.”

Protecting Rhode Island’s Seniors

“AARP applauds all efforts to protect older Rhode Islanders from phone and online credit scams that lead to identity theft,” says AARP Rhode Island State Director Kathleen Connell. “Clearly, many consumers, and especially many of Rhode Island’s 134,000 caregivers, will consider taking advantage of this new option. It certainly complements the work we are doing as part of AARP Fraud Watch to thwart con artists who prey relentlessly on people of all ages.

“In the case of older Rhode Islanders, life savings can be at risk. “The new federal law allows caregivers to acquire legal authority to freeze a loved one’s credit reports, and that’s a good thing. But it is important to note that there are many things a caregiver should consider. Basically, caregivers need to have conversations about the threat and what everyone should be doing to protect against credit theft,” she added.

AARP’s John Martin said when he presents the Fraud Watch program to community groups he urges people to think about fraud prevention in the same way training and professional development is part of their work experience. “In the workplace, your job includes being up to speed on the latest policies, regulations and best practices,” Martin tells audiences. “Lawyers read law reviews, doctors read medical journals, tugboat captains read The Shipping News. Failure to do so could lead to a missed opportunity or a big mistake. Given the enormous threats out there, we all should consider keeping up on the latest scams and implementing precautions something like a part-time job that requires similar diligence. To do otherwise increases your risk and the stakes are frighteningly high.”

Connell warns not to forget the basics. “AARP provides common-sense advice, awareness and precautions as well as alerts when new scams are exposed or an old one reappears,” she says. “Don’t be passive and please do encourage older family members to be on guard. We are all in this together.”

Anyone can sign up for the free Fraud Watch Network service at http://www.aarp.org/RIFraudwatch to receive alerts and report scams or other suspicious activity.

Reporting Financial Exploitation

The Rhode Island Office of the Attorney General recommends that if you believe you or an older relative are victims of financial exploitation, contact your local police department, the Rhode Island Division of Elderly Affairs, or the Elder Abuse Unit at the Rhode Island Office of the Attorney General.

If you would like an investigator at the Elder Abuse Unit or an investigator with the Consumer Protection Unit to speak with your organization on the signs of elder abuse or how to protect from being a victim of a scam, please contact Mickaela Driscoll, Elder Abuse Investigator, at mdriscoll@riag.ri.gov or Martha Crippen, Director of the Consumer Protection Unit, at mcrippen@riag.ri.gov or by calling 401-274-4400.

Democrats Put High Drug Costs on Radar Screen

Published in Woonsocket Call on September 30, 2018

On August 21, at an afternoon Democratic Senate hearing titled “America Speaks Out: The Urgent Need to Tackle Health Care Costs and Prescription Drug Prices,” Senators Debbie Stabenow (D-MI), Ron Wyden (D-WA), Chris Van Hollen (D-MD), Tina Smith (D-MN), Richard Durbin (D-IL), and Joe Manchin (D-WV), gathered to hear the personal stories of witnesses who have struggled with paying for the high cost of prescription drugs and listen to an expert who tracks price trends for prescription drugs widely used by older Americans.

In the last 18 years prescription drug prices have risen 3 times faster than physician and clinical services,” says DPCC’s chairwoman Stabenow in her opening statement. “We pay the highest prices in the world. The outrages prices force people to skip doses, split pills in half and even go without the medication they need,” she says, calling this problem a “matter of life and death,” says Stabenow.

Democrats believe health care to be a basic human right, while the GOP considers it to be a commodity to go to the highest bidder, adds Stabenow, denoting the philosophical differences of the two political parties.

Wyden, Ranking Member on the Senate Finance Committee who sits on the DPCC, recalled that two years ago when then presidential candidate Donald Trump was on the campaign trail pledged to make sure Medicare would negotiate like crazy to hold down costs for seniors and taxpayers. While Trump is well into one year and a half into his term, Americans year ad half into his term Americans believe it is crazy that we are still not negotiating to hold down the cost of medicine.

Wyden and his fellow DPCC committee members also call for Medicare to allow Medicare to negotiate prescription drug prices with pharmaceutical companies.

Senate DPCCs Puts Spotlight on Rising Drug Costs

At the Senate’s DPCC’s hearing, Witness Nicole Smith-Holt, a Minnesota state employee, and mother of four children shared a tragic story about her 26-year old diabetic son, Alec, who had died because he could not afford his copay of $1,300 for diabetic supplies and insulin.

The Richfield, Minnesota resident recounted how her son tried to ration the insulin to make it last until his next paycheck, but he died as a result of diabetic ketoacidosis.

Stahis Panagides, an 80-year old Bethesda, Maryland retiree, testified that he could not afford to pay $ 400 per month for prescribed Parkinson’s medication. He could not pay for the new course of treatment, recommended by his neurologist, even with a supplemental Medicare plan, he says, so he just refused to take it.

Retired social worker John Glaser, a long-time grassroots organizer for the Washington, DC-based National Committee to Preserve Social Security and Medicare, came before the Democratic committee, saying “Medicare drug benefits and the Affordable Care Act’s closing of the coverage ‘donut hole’ have made a huge difference in my life and are invaluable for the quality of my life. Without these improvements he would have spent about $5,000 one-of-pocket on prescription drugs last year, he notes.

Glaser also shared that his brother, who is afflicted with diabetes, heart problems, and kidney disease, takes over 50 pills every day. “If my brother had to pay the full price for all of those drugs, he’d be living on the street,” he says.

Marques Jones, who has Multiple Sclerosis (MS), told the Senators that his MS medication costs about $75,000 annually. Despite having robust insurance coverage, Jones’ annual out-of-pocket spending on drug co-pays and insurance premiums for his family of five is very high. This has caused the resident of Richmond, Virginia to become a vocal advocate for those who suffer from MS.

Finally, Leigh Purvis, Director, Health Services Research, AARP Public Policy Institute, a coauthor of the AARP Public Policy Institute’s annual RX Price Watch Reports, warned that today’s prescription drug price trends are not sustainable. “The current system is simply shifting costs onto patients and taxpayers while drug companies remain free to set incredibly high prices and increase them any time that they want,” says Purvis, noting that Congressional efforts to reduce prescription drug prices could save billions of dollars.

AARP Report Tracks Skyrocketing Drug Costs

One month after Senate’s DPCC’s hearing, a new AARP report, released on September 27, 2018, says that retail prices for many of the most commonly-used brand name drugs prescribed to older adults by older adults increased by an average of 8.4 percent in 2017, greater than the general inflation rate of 2.1 percent. The annual average cost of therapy for just one brand name drug increased to almost $6,800 in 2017, says the AARP researchers.

According to the new “Rx Price Watch Report: Trends in Retail Prices of Prescription Drugs Widely Used by Older Americans: 2017 Year-End Update,” released just days ago, revealed that for over a decade, brand name drug prices have “exceeded the general inflation rate of other consumer goods by a factor of two-fold to more than 100-fold.”

If retail drug price charges had reflected the general inflation rate between 2006 and 2017, the average annual cost for one brand name drug in 2017 would have been $2,178 instead of $6,798, said the AARP Public Policy report.

Taking multiple medications can be costly, says the AARP report. “For the average senior taking 4.5 medications each month, this would translate into an annual cost of therapy that is almost $21,000 less than the actual average cost of therapy in 2017 ($9,801 vs. $30,591), notes the findings of the AARP report.

“Despite years of relentless public criticism, brand name drug companies continue increasing the prices of their products at rates that far exceed general inflation,” said AARP Chief Public Policy Officer Debra Whitman, in a September 26 statement with the release of the AARP report. “It’s clear that we need long-term, meaningful policies that go beyond just hoping that the drug industry will voluntarily change its excessive pricing behavior,” adds Whitman.

“The average older American taking 4.5 prescription medications each month would have faced more than $30,000 in brand name costs last year,” adds Leigh Purvis, Director of Health Services Research, AARP Public Policy Institute, and co-author of the AARP report. “That amount surpasses the median annual income of $26,200 for someone on Medicare by more than 20 percent. No American should have to choose between paying for their drugs and paying for food or rent,” says Purvis.

Some highlights of AARP’s New Drug Cost Report

AARP report’s findings noted that brand name drug prices increased four times faster than the 2017 general inflation rate and that drug retail prices that year increased for 87 percent of the 267 brand name drugs studied.

Finally, research findings indicated that “retail prices for 113 chronic-use brand name drugs on the market since at least 2006 increased cumulatively over 12 years by an average of 214 percent compared with the cumulative general inflation rate of 25 percent between 2006 to 2017.”

In recent correspondence to the Secretary of the Health and Human Services, AARP calls for regulatory and legislative reforms that will allow the Secretary to be able to negotiate drug prices for Medicare, allowing the safe importation of lower cost drugs into the United States and ensuring that generic drugs can more easily enter the market. Now, AARP waits for a response.

Putting the breaks on the skyrocketing pharmaceutical costs might just be the bipartisan issue that the new Congress can tackle once the dust settles from the upcoming mid-term elections.

To watch DPCC’s August 21st Senate hearing, go to https://www.democrats.senate.gov/dpcc/hearings/senate-democrats-to-hold-hearing-with-americans-hurt-by-high-cost-of-prescription-drugs.

For a copy of AARP’s drug cost report, to http://www.aarp.org/rxpricewatch.