I"m leaving the country next week - ROAD TRIP!- to drive up to Toronto (which is kinda like New York City, if it were run by the Swiss). When I get there, I'm going to pick up a three-month supply of a diabetes drug that demonstrates just how crazy our system has become. It's called Onglyza. It's a little pill that I started taking five years ago, when my feet started tingling and a blood test (H1C) showed my three-month blood sugar level at 14.1, which is twice the level for diabetes. Since I began taking Onglyza, my H1C level has been cut by more than half....my blood sugar level is below diabetic levels, the tingling (neuropathy) in my feet has stopped, and all the other early symptoms of diabetes have abated. It's great!
The retail price of the drug is listed by my Medicare Part D provider as something like $900 for 90 tablets. But, since I'm on Medicare Part D, I pay $35 a month on my plan to get cheaper drugs. And my co-pay is $90 for a three month supply. Easy? Not on your life. It gets crazy. Bat-shit cray-cray. The cost computations will cross your eyes and cause a disturbance in your mind, but please try to follow along.…
The $90 co-pay only works for me the first nine months of the year, because of something in Part D called the coverage window, AKA the “donut hole.” After you spend a certain retail amount each calendar year on drugs, you fall into what's called the "coverage gap." After you spend something over $3000 (retail), you have to pay half of the retail price of your drugs. You're stuck in that gap until you spend a much higher amount, and then you get "catastrophic" coverage, where they pay most everything. When you're in the gap, you pay much more.
The “donut hole” last year was $3300, this year — thanks to President Obama — is goes up to $3750. He worked every year to make it smaller and less painful.
The key here is that after three 90 day supplies of Onglyza, and adding in my other meds, I fall into the coverage gap, and they want $447 for my fourth 90 day supply of Onglyza under Medicare Part D each year. If I were buying it retail, it would be $900. Yet in Toronto, I can get a 90 day supply for something like $310CAD at the Wal-Mart or the Real Canadian Superstore or some other discounter. And, since the Canadian dollar is worth about 75 cents against the Yankee dollar, I'm paying $232.50USD on my Amex Card. Oh, and I have to go to a walk-in clinic to get an Ontario doctor to co-sign the scrip, and that's about 30 dollars. So we're talking $262 for a 90 day supply of a life-sustaining drug that would cost me $447 with my Medicare Part D "drug benefit" (for which I pay an extra $35 every month), or it would cost me $900 if I had to buy it retail. (I told you you'd need a slide rule and computer to figure this stuff out!)
Same drug. Same quality. Same company. It's just the the Province of Ontario, like all Canadian provinces, negotiates drug prices with the suppliers. Here in the U-S, Congress passed a law and the President George W. Bush signed it, forbidding Medicare from negotiating the price of drugs. Trump, when he was running for President, said the price of drugs was too high and he'd do something about it. Well, he did. Three weeks into his term, he changed course from his campaign promise and said we can't stop innovation. So what he did was say he now wants to keep the current corrupt scheme in place, thus keeping Big Pharma fat and sassy. And that's why Astra Zeneca charges American taxpayers - who subsidized the development of Onglyza with all the university research and infrastructure - $900 for a 90 day supply of a life-saving drug that costs $232 in Canada.
Trump promised cheaper drugs. He lied. I’m shocked. Shocked, I tell you!
And that same damned cartel that is ripping us off on life-saving drugs has used those profits to send detail men to doctors and hospitals all over the country, distributing hundreds of thousands of sample blister packs of opioids so that people coming in with minor injuries or physical ailments could get free seven-day supplies of drugs that ruin lives, families, and communities.
It's like pushers giving out the first shot of heroin free. They know the recipient will likely be back.
And that includes those patients who finally go to see doctors when they got medical coverage through ACA. In fact, the drug epidemic is especially rampant in those areas, such as West Virginia, where ACA also has had the greatest impact in increasing coverage among the poor and working poor. That's exactly where the detail men handed out the most samples of opioids per capita: Trumpalachia.
So here's the takeaway from all this: I owe these bastards my health and maybe even my life because they developed and market a drug that stopped my diabetes in its tracks. They developed the drug here in the USA with the help of a medical infrastructure subsidized and paid for by US taxpayers. They charge us far more for the drugs than they charge people in other countries. They make enormous profits. And they use those profits to expand their domestic market by giving away millions of dollars worth of opioids, spawning a nationwide drug crisis that is ruining lives and communities, destroying families, and killing hundreds and hundreds of Americans every single day.
And the people on Capitol Hill who are behind the high drug prices and enabling the detail men just can’t wait to take away the medical coverage from millions of Americans. They’ll probably say those stories about millions losing access to medical care are fake news and the truth is President Obama and the Democrats caused the opioid epidemic.
It’s less than an eight hour drive from DC to the Canadian border. Cold beer, poutine, common courtesy, political sanity, and reasonably priced prescription drugs. Hopefully, they’ll keep out the welcome mat. I don’t think Justin has any plans to build a wall on their southern border, thank goodness. I promise to drive safely and will report back upon my return.