Wyeth Double Crosses New Yorkers

I am copying below an email from Shawna Irish, a Health Advocacy graduate student and Medicare Rights Fellow. Shawna has been counseling older people about Medicare Part D (see her posted comment about AARP Medicare Part D plan on a previous blog).

Friends and fellow advocates,

I am sending this email to alert you of a huge action recently taken by Wyeth Pharmaceuticals. As many of you may know, EPIC - NY state's pharmaceutical assistance program, provides excellent drug coverage to New Yorkers over the age of 65. What's great about EPIC is that it covers most drugs, has pretty low copays, and is creditable to the Medicare Prescription Drug Benefit. New Yorkers love EPIC and want it to keep providing great coverage. Sadly, Wyeth Pharmaceuticals has pulled out of EPIC (see attached). This means that drugs such as Ativan, Effexor, Premarin, Prempro and Protonix will no longer be covered by EPIC, leaving many seniors having to foot the entire bill themselves. Truly, a sad day for many seniors.

I'm not sure if this is a worthwile venture, but I'm at a loss for any other ideas. I have included the address for 2 headquarters for Wyeth. I am suggesting a letter
writing campaign. The Medicare Rights Center has gotten the word out to the press about the situation, but really is not able to do much else. If anyone has any better ideas, please share them with me. This is a huge upset, as Wyeth drugs are quite popular and often hard to substitute.

Here are the addresses for Wyeth:
Wyeth Worldwide Headquarters
5 Giralda Farms
Madison, New Jersey 07940

Wyeth Pharmaceuticals Worldwide Headquarters 500 Arcola Road
Collegeville, PA 19426 Phone 610-902-1200

Thank you,
Shawna Irish

This is the letter New Yorkers received from EPIC, which includes a list of the medications they will no longer be able to get discounted through the State program:

Dear EPIC Participant:
Wyeth Pharmaceuticals has announced it will no longer participate in the EPIC Program. As a result, the drugs listed below will no longer be available through EPIC and you will need to either talk to your physician about substituting another drug or pay the full price of Wyeth Pharmaceutical products.

Wyeth Pharmaceuticals has indicated that the reason they are withdrawing from the EPIC Program is that they are no longer willing to provide discounts required by law that help make sure New York State pays reasonable prices for their drug products. As a result, EPIC will no longer be able to cover drugs that are manufactured by Wyeth Pharmaceuticals.

As noted above, if you are now taking any drugs manufactured by Wyeth Pharmaceuticals, please speak to your physician as soon as possible to find out if there is another product which can be substituted. Most other manufacturers do participate in EPIC, and may offer products which can be used instead of the Wyeth Pharmaceutical products.

The following lists the Wyeth Pharmaceutical drugs being used by EPIC enrollees that EPIC will no longer be able to cover as of February 1, 2006.

Ativan Inderal Materna Phenergan Protonix Sectral Zosyn Cordarone Inderide Minocin Phospholine Iodide Pyrazinamide Sonata Declomycin Ismo Mylotarg Premarin Rapamune Tenex Diamox Isordil Neumega Premphase Reglan Zebeta Effexor Lodine Oruvail Prempro Rheumatrex Ziac

Again, we urge you to consult with your physician or your pharmacist before you need to have your prescriptions filled. We deeply regret the decision by Wyeth Pharmaceuticals to withdraw from the EPIC Program. If you have any questions, please feel free to call the EPIC Helpline at 1-800-332-3742.

Sincerely, Julie A. Naglieri
Director

More about pharmacies & Medicare Part D

Last night I stopped at the local Duane Reade to pick up some toiletries and found they were prominently advertising one particular Medicare Part D plan—CIGNA’s. I don’t know what the partnership deal is here, but I recalled the popular (Democratic) NewDonkey blog noting a related problem with seniors relying on their pharmacists for advice on prescription drug plans. This is the NewDonkey blog from December 29:

I've been trying to sign up my mother-in-law for the Medicare Rx drug benefit, which her current insurer is forcing her to undertake under penalty of massive premium increases. And as anyone who's dealt with this particular beast can tell you, the new program is about as easy to navigate as The Name of the Rose. I know a fair amount about Medicare, and health insurance generally, but still, I'm terrified that I'm making serious mistakes. I cannot imagine what this is like for anyone without internet access or a rudimentary knowledge of the new system. I gather millions of seniors are depending on their pharmacists for guidance, which would be fine except for the fact that a number of drugstore chains are sponsoring or cosponsoring plans themselves, creating all sorts of conflicts of interest.

Medicare Part D—Again!

This is, I guess, an update/follow-up on Lin’s blog of November 28, “No Surprises Here.”

Today’s New York Times has an op ed. piece ("Attention Medicare Shoppers . . .") by a family doctor advising us to shop carefully for a Medicare Prescription Drug plan. “By asking the right questions and comparing plans, the savvy consumer can save more with Medicare than at Macy's,” suggests Lisa Doggett. She goes on to describe how, since she is routinely cost conscious when prescribing drugs to patients, and looks for substitutions and generics when possible, she applies this strategy to searching for a Medicare Part D plan for her grandmother. At first Doggett is “dismayed.” “The "best" plan cost $3,242 annually, even more than her current drug bill [about $3000] without any insurance.” But by being a smart shopper, she is able to reduce her grandmother’s cost for a plan significantly.

I studied her medication list and discovered that with a few medically insignificant changes, she would reduce her total drug costs substantially. The key is understanding that most medications are considered part of a "class" based on how they work, and each class usually includes two or more medicines of similar effectiveness. . . .

Reviewing my grandmother's medication list, I removed just one medicine, Prilosec, a heartburn drug. My grandmother was getting it by prescription, but since 2003 it has been available over the counter for less than $25 a month. By switching to the cheaper version, my grandmother lowered her projected costs, according to the Medicare Web site, to $1,945 annually, a net savings of more than $1,000.

Further switches among prescription cholesterol and blood pressure medications lowered her costs further, to only $960 annually if she chooses to receive the medicines by mail (or to $1,267 if she prefers the local pharmacy). I found these savings by reviewing the formularies on the Web sites of several different plans and switching her to medicines that were "preferred" under the drug benefit. Once her doctor agreed to the proposed changes, we signed her up.

Is this a model for the rest of us? Now really!!

Yes, most of us who are in the health professions could probably do what Lisa Doggett did, but first, as my mother always told me, time is money. I was already appalled at how long it took to compare plans on the Medicare site: you can only do three at a time. What is that all about? And some plans have no donut hole, so you really have to look carefully to do the comparison because premiums are deceptive. And then, if you are not an MD with some prior knowledge of these drugs, the research it would take to take the next steps Doggett advises is daunting: check to see if there are OTC equivalents, find the formularies, make reasonable judgments about substitutions, contact the various doctors and get approval for these changes. No, it is frankly an outrage that this kind of research is required in order to make the best decision about a Medicare “benefit” plan. Certainly this is a new kind of elitism: the small group of older people who have younger relatives who are doctors willing to spend this kind of time (primary care probably) form the elite group who will be able to make the smartest shopping decisions.

Now for the kicker. Remember how the AARP’s support put the votes over the line and enabled this outrageous prescription drug bill to be passed? I am now hearing repeatedly that people are choosing the AARP benefit. In fact, it seems to come up first in the list of benefits to compare. Funny thing about that. I called a pharmacist recently to see which plans the pharmacy was on (since the name did not come up in the list—another glitch in the Medicare.gov plan finder program) and the pharmacist, without prompting, advised me that most of his customers were choosing the AARP plan.

We can use the AARP actions as a case study in advocacy conflict of interest for our graduate students. But frankly, the whole picture makes me frustrated and furious. And, to be truthful, I have not yet found the best plan for my in-laws.