Accidental Drug War

Medicare benefits that bankrupt


“Drug coverage under Medicare will save our seniors from a lot of worry,” President Bush proclaimed in November 2003, just before signing the drug benefit into law. As younger generations worry about how to pay for $30 trillion in unfunded Medicare obligations during the next 75 years, it would be nice to think at least one demographic could rest easy. But drug makers say the bipartisan drive for public largesse is forcing them to end charitable patient assistance programs, leaving even seniors worse off.

In January drug maker GlaxoSmithKline announced on its Web site that “any patient who is Medicare-eligible”â€"in other words, 65 or olderâ€"would be dropped from its “Bridges to Access” program, which offers free and discounted drugs to low-income seniors. “We are disappointed by the guidance of the Office of the Inspector General,” the letter sighed, explaining that the company had been advised to cut off Medicare beneficiaries lest it run afoul of fraud and anti-kickback laws. Citing the same issue, TAP Pharmaceuticals announced that it would drop beneficiaries from a similar program in March.

A November bulletin from the Department of Health and Human Services (HHS) acknowledged that these programs have “long provided important safety net assistance to patients of limited means” and worried that there might not be enough independent charities to help poor seniors afford premiums when the drug benefit started. Yet it advised pharmaceutical companies to stop offering aid to anyone enrolled in the program.

The new Medicare benefit is widely acknowledged to be one hole-ridden safety net, and very poor seniors will still not be able to afford medications without charity. The HHS memo pointed out that companies eager to help seniors can avoid legal snafus by donating cash and drugs to independent organizations. But neither TAP nor GlaxoSmithKline has announced plans to ramp up third-party donations. A possible explanation: Company-sponsored programs help businesses boost their reputations. Handing out free meds to charities, where the drug maker can’t trumpet its munificence throughout the distribution process, has less appeal.