Thursday, July 24, 2008

Pharma, allies disingenuous, practicing misdirection on real purposes of proposed legislation on sale of controlled substances over the Internet

In a rare show of unity, the U.S. Senate passed the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (S. 980), introduced by Senators Dianne Feinstein (D-CA) and Jeff Sessions (R-AL).

The bill is named in honor of the tragic death of the youthful Ryan Haight. The following is from the web site in honor of Ryan:

“Ryan Thomas Haight overdosed and died on February 12, 2001 on narcotics that he had easily purchased on the Internet. A medical doctor on the Internet that he never saw prescribed them, an Internet pharmacy mailed them to his home. He was only 17 when he purchased them, he was only 18 when he died. We are dedicated to educating and providing information for parents, families and our communities on issues concerning the Internet and Drug Abuse. It is too simple to get dangerous prescription drugs on the Internet. It is too easy for our youths to get information about drugs and to find out how and where to get them.”

Now, in a series of moves that are reprehensible in tone and manner because it does not reflect the purpose of the proposed legislation or a solution to the problem, pharma and its allies are attempting to co-opt the legislation for their own purposes by acting as though the legislation and the tragedy itself are somehow related to the safety and efficacy of legitimate, on-line pharmacies and prescription medicines from outside the United States.

In House of Representative hearings, a pharmacy industry witness conveniently lumped licensed, registered pharmacies from countries that face oversight that matches or exceeds that of U.S. pharmacies, actually purloining the intent of the hearing which was supposed to examine ways to stopping the sale of controlled substances by any pharmacy, including those in the U.S. A FDA spokesperson took the same tact, while a well-meaning lawyer from GoDaddy.com tried to explain how and why additional oversight was needed, but did not deal with the subject of licensed pharmacies from outside the U.S. making safe, affordable prescription medicines available to Americans.

Now, The Healthcare Distribution Management Association (HDMA) has issued a statement commending Representatives Bart Stupak (D-MI), Lamar Smith (R-TX) and Mary Bono Mack (R-CA) for introducing bipartisan legislation (H.R. 6353) to combat illegal online sales of prescription medicines.

Since this is the companion legislation in the U.S. House of Representatives to S 980, the HDMA is the latest to employ misdirection regarding the intent of the legislation—intent which we have verified with well-placed sources in Washington that S 980 is not associated in any way with the question of ‘reimporation’ of prescription medicines and their availability to U.S. citizens.

Need proof? Consider this explanation of the intent of the proposed legislation included in a release from Congressman Smith's office:

"The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 is a companion to legislation introduced in the Senate by Sen. Dianne Feinstein (D-Calif.). The legislation is designed to stop Internet pharmacies that sell controlled substances without a valid prescription."

It is a matter of record that pharmacies such as those who are members of the Canadian International Pharmacy Association doing mail order business over the Internet do not sell controlled substances,and, that they sell no medicine without a proper prescription from a physician.

It is time to truly distinguish between the healthcare benefits provided to Americans by legitimate, licensed pharmacies from outside the U.S. and ‘Bad Meds.’
And, it is time for pharma and its allies to stop attempting to confuse the American public by incorrectly associating the tragedy of Ryan Haight to legitimate, licensed pharmacies that are practicing the highest standards of healthcare professionalism.

Wednesday, July 23, 2008

Patients buying fewer Prescription Drugs

Posted by Daniel Hines,
Publisher, www.TodaysSeniorsNetwork.com

Proof of the failure of Medicare Part D and the growing number of all Americans not having access to the health benefits of prescription medicines has come forth in a Wall Street Journal story describing how more and more U.S. citizens are unable to afford prescription medicines.

While it is still too early to measure what the harmful effects of this upon Americans' health might be, it is only logical that many people will suffer poorer health. This should end once and for all the approach by many groups and organizations who attempt to divide debate and discussion about comprehensive health care reform into segments based upon the "pet issue" or that particular groups, organizations or policy-makers.

Such an approach virtually guarantees that without including defining how to make safe, affordable prescription medicines more widely available into discussions about healthcare, we are risking the health and well-being of a growing number of Americans. The growth in costs, the decline in consumption and the potential health effects make it imperative that true competition be introduced into the U.S. pharmaceutical market by allowing U.S citizens to exercise their freedom of choice and purchase safe, affordable medicines from identifiable legitimate pharmacies outside the U.S.

Consider: The growth in prescriptions filled by U.S. pharmacies is at its slowest in at least ten years, as increasing health care costs and a slowing economy are making medication harder to afford.

According to the Wall Street Journal article, the drug industry usually remains stable in economic downturns, because patients still require medicine.
However, the number of prescriptions filled in the second quarter of 2008 may have actually decreased, due to higher numbers of Americans without health insurance and “skyrocketing out-of-pocket drug costs” putting the cost of some medications out of reach.

Patients are facing additional burdens as the health care industry has forced consumers to shoulder larger percentages of many costs.
A Kaiser Family Foundation study found that for a “preferred drug” through a tiered insurance plan, average co-payments rose 67 percent from $15 in 2000 to $25 in 2007.

In fact, 23 percent of respondents to a Kaiser foundation poll failed to fill a prescription in the last year for cost reasons, up from 20 percent in 2005.
Additionally, 19 percent either skipped doses or split pills, an increase from 16 percent in 2005.

Prescription Meds from outside U.S. offer lifeline to Part D

Posted by Daniel Hines
Publisher, www.TodaysSeniorsNetwork.com

(Part One of how and why safe, affordable prescription medicines from licensed, registered phamacies from outside the U.S. can benefit not only American's health, but can relieve the strained budgets of governmental services at the local, state and Federal levels. Part Two will deal with how local governments can generate vast savings for employee benefits, savings that can then be applied to other local services.)

As the U.S. economy continues to reel, the increasing cost of Medicare Part D threatens the very essence of a program that was claimed to be designed to address the prescription medicine needs of the country's aging population.

Increasingly, abuses of the system are apparent. Most recently, the Center for Medicare Services says that private plans that are woven in the fiber of Part D, have 'misinterpreted' the intent of CMS when the Part D was launched by developing a practice of 'locking in' a price structure in which PBMs charge a higher rate to insurers with whom they have contracted to administer their drug benefit than what they pay pharmacies to dispense the drugs to beneficiaries. The PBMs then keep the difference, according to an article in the Wall Street Journal.

Ironically, a CMS administrator says that the agency thought it had a "clear policy"
prohibiting lock-in pricing when Part D launched. "We learned that there are different ways of interpreting a policy statement," she adds in a classic understatment.

Actually, since its inception, Medicare Part D has been flawed. It did not allow price negotiation to guarantee the lowest prices thereby generating savings for the Federal government and the intended beneficaries. The abomination of the 'Doughnut Hole' virtually eliminated hundreds of thousands of seniors who would receive little or no benefit unless they had staggering out-of-pocket costs which increase each year. And, the pharmaceutical industry continues to raise prices on brand name drugs, which makes Part D increasingly costly, although a "PR Spin" has been attempted to make it look as though savings have occured since the amount expended is lower than earlier estimates. The fact is that a large part of this claimed savings is due to lower than anticipated enrollment in plans.

In what can only be described as an American Tragedy, many policy-makers attack the claimed original intent of Part D, to help seniors enjoy the health benefits provided by prescription medicines, by labeling Part D (and Social Security and Medicare generally) as 'entitlement' programs that are burdensome to the country. One author even suggests that there is no alternative other than to cut Part D to 'save Medicare':
"In sum, Part D costs are soaring, and they could harm Medicare's core mission and the elderly. Because a tax increase is out of the question, one obvious solution is to amend the law and limit the drug benefit to save Medicare..." Quote from Spyros Andreopoulos is director emeritus of the Office of Communication and Public Affairs at Stanford University Medical Center.

Another approach comes from The Medicare Rights Center, on whose Citizens' Advisory Board I serve (Midwest Region). MRC advocates support of the Medicare Prescription Drug Savings and Choice Act, introduced by U.S. Senator Dick Durbin (D-IL) along with U.S. Representatives Jan Schakowsky (IL-09) and Marion Berry (AR-01). The bill creates a Medicare administered prescription drug plan to provide seniors an alternative to the privately administered prescription drug plans currently offered under Part D.

The problem is that both of the above approaches suffer from the blinders that too often are worn by policy-makers and advocacy groups, blinders that prevent them from looking at the totality of the factors that can favorably influence a solution to challenges such as the increasing costs of Medicare plans.

The fact is that access to safe, affordable prescription medicines from outside the U.S. must be included in the discussion to the complete (debate) (discussion)on healthcare reform in this country. Such access not only offers a potential benefit to improved health for all Americans, but can almost instantly create savings that will favorably impact Medicare administration by allowing access to lower-cost, but safe medications.

Unfortunately, a Washington-based staff member of MRC says that she is interested only in the passage of the Medicare Prescription Drug Savings and Choice Act, on initiatives of the MRC, and has no interest in even exploring the potential contribution of providing savings and choice by allowing access to prescription medicines from outside the U.S.

Also, a highly informative source in Washington has told us that he fears that in the next Congress in 2009, there will be such a rush to enact 'comprehensive health care reform' that it will be nothing more than a 'trading bloc' for a number of individual Senators, Congressmen, pharmaceutical industry and insurance company reps, each with their own particular agenda, be it liberal, conservative, or even anti- or pro-pharmaceutical and insurance industry oriented. He said he fears that pharma particularly will offer its support for some form of 'comprehensive health care reform' in return for the role of providing continued access to safe, affordable medicines from outside this country to U.S. citizens being discarded.

That's like throwing the baby out with the washwater. It is time for Congress to take action to provide such access to all Americans, and to do so in a fashion in which the role of prescription medicines from licensed, registered pharmacies in Tier One countries not only can maintain or even enhance the quality of healthcare in the U.S., but can provide fiscal savings that can actually help pay for other initiatives that will finally get this country on the road to an improved national health care policy.

Monday, July 14, 2008

It’s time to set the record straight on what really are 'Bad Meds'...

Posted by Daniel Hines, publisher, www.TodaysSeniorsNetwork.com

Ever since increasing numbers of U.S. citizens started turning to legitimate pharmacies from outside the United States to purchase safe, affordable prescriptions via mail order and the Internet nearly seven years ago, the major charges against their use by those who fear such sales will lead to lower prescription medicine prices in this country have been based on trumped-up charges of legitimacy, safety and whether or not the prescriptions being purchased were counterfeit.

These charges have taken a variety of forms over the years, as ‘spokespersons’ for the pharmaceutical industry joined in a chorus of false charges about safety and efficacy. It was—and remains—a clumsy attempt by the pharmaceutical industry, to confuse the American public in an attempt to scare it away from what was its only opportunity to purchase safe, affordable and vital prescription medicines.

Backed by a seemingly unlimited bankroll, the pharmaceutical industry had no trouble in finding persons and ‘groups’ ready to engage in such scare tactics, ranging from college professors who raised the specter of counterfeit medicines being used to fund terrorist tactics ; to ‘Grandma’ Green, who toured the country in a John Madden-type bus talking about the dangers of Canadian pharmacies courtesy of funding from a misnamed ‘senior’ group which, some have charged, lacked any senior membership; to even media that used misstatements and stories lacking any basis in facts under the cover of claimed ‘investigative reporting.’

It did not matter to those making the charges that the prescriptions being purchased by countless numbers of Americans were in fact medicines manufactured by the pharmaceutical companies that were ironically claiming their own medicines were unsafe. It did not matter that the pharmacies supplying the prescriptions were subject to oversight and standards that met or exceeded those of the United States. It did not matter that our country’s Food and Drug Administration itself had stated that individual American citizens could purchase medical devices or prescription medicines from other countries if they were not available in this country. It did not matter that many argued that if a medicine was not affordable, it was not available in this country. It did not matter that the U.S. Congress has three times passed legislation to facilitate access to medicines from outside the U.S, only to watch as the pharmaceutical industry got the payback for its extensive political contributions and lobbying efforts with ‘poison pill’ amendments that effectively negated the will and intent of the U.S. Congress to the detriment of the American public it had been elected to serve.

Now, a new report from The National Center on Addiction and Substance Abuse (CASA) at Columbia University has clearly identified characteristics of bogus pharmacies. In so doing, it has laid out the differences between bogus pharmacies and legitimate, licensed and registered pharmacies in other countries. These important guidelines can help the public—and hopefully the media and policy-makers—put an end to the attempts at confusion and misdirection.


Here are some of the major points from the report followed by a description of the difference on each point between bogus pharmacies and legitimate ones from outside the U.S.:

• Bad Meds: Of the Web sites advertising or selling controlled prescription drugs, like OxyContin and Valium, Xanax and Vicodin, and Ritalin and Adderall, in the past year, 85 percent of Web sites selling such drugs do not require a prescription

Legitimate Pharmacy: No legitimate mail-order pharmacy from outside the U.S. advertises or sells controlled prescription drugs. No legitimate mail-order pharmacy will sell any medicine without a prescription from a physician.

• Bad Meds: The report found sites selling online "medical consultations" which enable Internet users to get controlled drugs online without a proper prescription.

Legitimate Pharmacy: No legitimate mail-order pharmacy from outside the U.S. will engage in schemes that remove the requirement that all medicines sold must have a prescription from the client’s doctor.

• Bad Meds: Of the few sites that require prescriptions, half permit the
Prescription to be faxed, allowing significant opportunity for fraud.

Legitimate Pharmacy: All legitimate pharmacies and services verify the validity of the prescription.

• Bad Meds: There are no controls blocking access to these sites by children and teens.

Legitimate Pharmacy: There would be virtually no chance of a teen or child to order from a mail-order, Internet-based pharmacy outside the U.S. because in addition to the oversight of authorities in its own country, almost all mail-order pharmacies have instituted rigorous controls of their own. Add to this the requirements that all client orders have a physician-ordered prescription, and the possibility of teens or children ordering medicines of any type from legitimate, professional sources are virtually nil.

The report notes that “last year, the Senate Judiciary Committee, chaired by Senator Patrick Leahy (D-VT), held hearings on "’The Ryan Haight Online Pharmacy Consumer Protection Act of 2008’ to control Internet trafficking of controlled prescription drugs which was introduced by Senators Dianne Feinstein (D-CA) and Jeff Sessions (R-AL). The Senate passed the bill in April of 2008. The Subcommittee on Crime, Terrorism and Homeland Security of the House Judiciary Committee held a hearing on the topic last month.”

It is important to note that according to highly placed sources of Rx for American Health, the Bill in no way was intended by the sponsors or those who voted for it to be a reflection upon the benefit of legitimate on-line, mail-order pharmacies and related services, such as provided by the Dorgan-Snowe bill.

It is obvious that it is time to end this subterfuge about the safety and efficacy of prescription medicines from such pharmacies and to deal with the facts.