Tony
Zito had been battling long-term depression when he ran into trouble several
months ago. Zito, 57, takes the anti-depressants Prozac and Wellbutrin but
doesn’t have any health insurance. He was finding that he couldn’t afford to
pay for his prescriptions, which cost hundreds of dollars a month out of
pocket.
“It
would be [medications] or groceries,” he says. He tried halving his medication
doses to save money, but that dropped him into an even deeper depression. He
needed his meds, and he needed them cheaply.
That’s
when he found out about Webster resident Charlie Bell, who operates The
Medicine Express, a website dedicated to providing financially strapped people
the prescription drugs they need for much less than what local pharmacies
charge. Bell immediately took up Zito’s cause. “He didn’t know what he was
going to do,” Bell says.
Bell
serves dozens of people by locating drug suppliers in Canada and the United
Kingdom, where consumer prices are radically cheaper than in the States. Local
consumers like Zito then purchase their meds from those foreign providers. The
process probably saved Zito’s life.
Many
critics say vulnerable customers shouldn’t be placed in such a precarious
position. They say pharmacies charge exorbitant amounts for the most common
prescription drugs in order to maximize profits. Says Bell: “It’s the biggest
hoax they’ve ever put on people. It’s all money, and the politicians and the
pharmacies will get richer and richer.”
But
representatives from major corporate pharmacies dismiss such charges. “That’s
just not true,” says Debbie Parker, Wegmans’ director of pharmacy operations.
CVS spokesman Mike DeAngelis says his company only reaps a 2- to 3-percent
profit from its pharmacy business. “We are not overcharging customers,” he
says.
True
or not, there apparently are enough people who are dissatisfied with the
prescription-drug system that numerous consumer-protection efforts have cropped
up in the Rochester area. Some of them, like Bell’s Medicine Express, are
operated by individual citizens. Other movements have the full support of the
government — or at least one section of it.
Miriam
Faulkner is a diminutive, soft-spoken senior, but when she discusses her mission,
she is unmistakably resolute.
As
president of the AARP’s Southeast Monroe County chapter, Faulkner has
spearheaded the group’s partnership with the New York State Attorney General’s “AG
Rx” program, which has volunteers survey drug prices at selected pharmacies and
then posts the prices at www.nyagrx.org.
Faulkner
and other members of her AARP chapter are aware of many local residents who
lack any health-care coverage and struggle to afford their medication. “That’s
why we feel strongly about this,” she says.
(The
AARP has pushed the issue on a national level as well. In April, the
organization released its annual report on the cost of prescription
medications, announcing an average increase of 7.1 percent in wholesale prices
of roughly 275 drugs.)
Under
the New York AG program, 31 members of the Southeast Monroe AARP collect prices
of 150 popular medications at numerous area pharmacies. State law requires
pharmacies to produce, on demand, a list of their prices for those 150 drugs.
While
some pharmacies fail to post their lists in public view and others express
anxiety about coughing up the information, the vast majority of stores have
followed the law. “The pharmacies,” Faulkner says, “have been very
cooperative.”
However,
even though many pharmacy reps assert that manufacturing costs are a big reason
for the high prices, “the Attorney General feels it’s not just the drug
companies, but also the pharmacies themselves” who are responsible for the
prices, Faulkner says.
We
need programs like “AG Rx,” says AG spokesman Marc Violette, because the prices
of prescription drugs simply aren’t regulated. “There is no one in Albany or
Washington looking over the shoulder of the pharmacies to keep prices in line,”
he says. Adds Carlos Rodriguez, an attorney in the AG’s Rochester branch: “It’s
buyer beware.”
Without
any government regulations on drug costs, consumers are often forced to deal
with the ever-increasing price of medication on their own, a fact that Violette
says spurred the AG to create the program and website.
“This
is a case where the government is not regulating the cost of medications but is
giving consumers a chance to make a more informed decision,” he says.
So what have
the AARP volunteers found? Both Faulkner and Violette say prices often vary greatly from
store to store within the same area. Pharmacies as little apart as 10 miles
frequently show radical differences in price, even between stores owned by the
same company. The New York Public Interest Research Group, which surveyed more
than 100 pharmacies across the state earlier this year, found the same thing.
The
success of the AG/AARP efforts no doubt influenced state leaders this past
summer: Before concluding its June session, the legislature adopted legislation
requiring all New York pharmacies to submit their prices for 150 popular drugs
to the state Health Department. Governor George Pataki signed the bill in
August.
(State
officials are unsure how long it will take to collect all the required data and
make it public, although the state Health Department must submit a progress
report to the legislature by January 31.)
While
he wasn’t one of the sponsors of that legislation, Assemblymember David Koon,
D-Fairport, says he has supported other efforts to address the cost of
medications, including an unsuccessful attempt to create a so-called “preferred
drug list.”
Under
the proposal, the state would purchase 30 to 40 high-demand drugs in bulk, then
sell them to patients at reduced costs. Koon’s also sponsoring legislation that
would make fully disabled citizens eligible for the state’s EPIC prescription
drug program now available to seniors.
While
Koon says many state residents need relief from high drug costs and should try
to shop around for lower prices, he adds that he isn’t aware of any individual
pharmacies engaging in price gouging. If such practices were going on, he says,
the AG would step in. But at this point, he says, “We haven’t found any
pharmacies doing that.”
Bell is well
aware that many politicians receive campaign contributions from the drug industry —
an April report revealed that the Pharmacy Political Action Committee of New
York donated nearly $130,000 to state legislators last year, ranking it 16th on
a state PAC list — and he believes such contributions can go a long way in
influencing an elected official’s votes. “The lobbyists,” he says, “run the
country as far as pharmaceuticals go.”
It’s
a small part of a huge industry that Bell distrusts intensely, an industry
driven by a single motive, he says: “outright, naked greed.”
Bell
sits in the basement office that has become the headquarters for The Medicine
Express. Bell operates the non-profit effort from his modest duplex home in
Webster’s Summit Knolls development. He doesn’t handle any medications himself
and doesn’t accept any money for his services (any donations he does receive go
to Lollypop Farm). A devout churchgoer, Bell calls The Medicine Express his
ministry, “my way to serve.” He adds: “If they don’t have insurance, we’re
going to help them.”
One
person helped by Bell is Gary Romano, who sits across a desk from Bell in the
Meds-Ex office. Romano, who lives off a pension from a plumbers’ union, says he
saves thousands of dollars a year with Bell’s help. “He’s one of the greatest
men in the country,” Romano says.
The
Medicine Express was launched more than three years ago, after Bell found that
the meds he takes cost one-third as much in Canada as they do in the U.S. “When
that happened,” he says, “I said, ‘I’ve got to share this.'”
And
recent news that the Canadian government plans to restrict online pharmacies
from selling meds to Americans hasn’t dampened Bell’s spirit; he says he can
just find medications in other countries. “People who need medications will
still get them,” Bell says.
A
key component of Bell’s operation is his website, www.meds-ex.com, which, like the AG’s website, lists the costs of
dozens of medications at various local pharmacies. The site then shows how much
can be saved a year on each medication by going through The Medicine Express.
Dressed
scruffily in blue jeans, brown flannel shirt, and casual brown shoes, Bell
later on listens to Tony Zito tell his story over speaker phone. Zito says Bell
and The Medicine Express helped give him physical wellness and mental peace of
mind. “It takes the pressure off,” he says of the service.
Bell
sinks into his swivel chair and sighs, then smiles. He says cases like Zito’s
prove that such efforts are needed — and that they can work. “How are you not
going to feel excited, to feel joyful?” he says of Zito’s situation. “If he
didn’t get that medication, he’d be out of it.”
The
69-year-old Bell pauses. “I’ve made a friend,” he says. “I’ve helped him live.”
Critics like
Bell acknowledge that pharmacies have a right to make money — what Bell
would call a “sensible profit” — but industry representatives say there isn’t
much profit to be made.
John
Carlo, Wegmans’ director of managed care and product procurement, says that for
every dollar his company takes in on prescription drugs, 82 cents are directed
back to the production of the drugs. Most of the rest is spent on the
pharmacy’s operational costs. “The pharmacy only takes 2 cents,” he says. “The
vast majority goes back to manufacturing costs” like research and development
of new drugs.
Such
figures match those given by CVS spokesman DeAngelis. “When looking at
prescription prices,” he says, “the manufacturers set the prices, then
pharmacies have to factor in the cost of doing business.”
Some
of those costs, he says, are the special services CVS provides to customers,
such as drive-thru pharmacies and stores that are open 24-7. He also points to
the various cost-saving programs the company offers, such as senior discounts
and the Extra Care Loyalty Card. In the end, he says, CVS doesn’t just charge
for drugs, it also charges for such services.
Wegmans’
Carlo understands why pharmacies often take the brunt of the criticism from
consumers who feel they pay too much for their meds. After all, he says,
pharmacies are “the last point of contact” for consumers and therefore (at
least in the minds of many customers) the most visible culprits for the high
costs. As a result, he says, Wegmans remains sensitive to the issue.
“There’s
no question such criticisms come back to us,” he says. “We feel we provide an
extremely critical service to health-care patients. We’re very concerned with
the costs of drugs.”
But
for the millions of people who struggle to afford the drugs they need to
survive, simple corporate concern doesn’t go far enough. That’s why citizens
like Charlie Bell and Miriam Faulkner decided to put their concern into action.
And, judging from the state’s recent actions, activists like them seem to be
making a difference.
To
learn more about The Medicine Express, visit www.meds-ex.com.
This article appears in Sep 21-27, 2005.
