INSIGHTS ON PBS HAWAIʻI: High Cost of Prescription Drugs | Program
28
December

By Paul Henry / in , , , , , /


PRICES FOR PRESCRIPTION DRUGS
ARE ON THE RISE THEY HAVE BEEN FOR SEVERAL YEARS, ADDING TO THE
OVERALL INCREASE IN HEALTH CARE COSTS ESPECIALLY FOR SENIORS AND
OTHERS ON FIXED INCOMES WHY ARE DRUG PRICES GOING UP?
WHO’S TO BLAME? IS IT THE DRUG MANUFACTURERS? THE INSURANCE
COMPANIES? OR THE HEALTH CARE SYSTEM IN GENERAL? WHAT CAN
CONSUMERS DO ABOUT IT? TONIGHT’S LIVE BROADCAST
AND LIVE STREAM OF INSIGHTS ON PBS HAWAIʻI
START NOW. [INTRO MUSIC] ALOHA AND WELCOME TO INSIGHTS
ON PBS HAWAIʻI…I’M YUNJI DE NIES.
ANYONE WHO HAS A HEALTH CONDITION AND RELIES ON
PRESCRIPTION DRUGS TO MAINTAIN THEIR WELL-BEING HAS SURELY
SEEN THE RISE IN THE COST OF THEIR MEDICATION OVER THE PAST
FEW YEARS. FOR SENIORS AND OTHERS WHO MAY BE ON MULTIPLE
MEDICATIONS AS WELL AS A FIXED INCOME, THE INCREASED COST CAN
BE DEVASTATING. THERE ARE WAYS FOR CONSUMERS
TO CUT CORNERS, SUCH AS BUYING GENERIC DRUGS, IF THEY EXIST,
USING MAIL ORDER OR GOING TO ANOTHER COUNTRY WHERE THE SAME
MEDICATION MAY COST A FRACTION OF WHAT IT COSTS AT HOME. OR
IS THERE A LARGER SOLUTION TO THIS MULTI-FACETED PROBLEM?
OUR GUESTS TONIGHT INCLUDE REPRESENTATIVES FROM A
RETIREMENT ADVOCACY GROUP, THE MEDICAL CARE INDUSTRY AND A
DIABETIC PATIENT. WE LOOK FORWARD TO YOUR
PARTICIPATION IN TONIGHT’S SHOW. YOU CAN EMAIL, CALL OR
TWEET YOUR QUESTIONS. AND YOU’LL FIND A LIVE STREAM OF
THIS PROGRAM AT PBSHAWAII.ORG AND THE PBS HAWAIʻI FACEBOOK
PAGE. NOW, TO OUR GUESTS.
JESSICA WOOLEY IS THE ADVOCACY 2 DIRECTOR FOR AARP HAWAI’I AND
A FORMER MEMBER OF THE HAWAI’I STATE HOUSE OF
REPRESENTATIVES. CHIEN-WEN TSENG IS A FAMILY
PHYSICIAN AND IS ON THE FACULTY AT THE UH JOHN A.
BURNS SCHOOL OF MEDICINE. SHE IS A NATIONALLY RECOGNIZED
EXPERT ON MEDICARE PART D, WHICH PROVIDES DRUG COVERAGE
TO SENIORS AND DISABLED PERSONS.
CAMLYN MASUDA IS A DOCTOR OF PHARMACY. SHE IS AN ASSISTANT
PROFESSOR AT THE UH HILO DANIEL K. INOUYE COLLEGE OF
PHARMACY AND AN ASSISTANT CLINICAL PROFESSOR AT THE UH
JOHN A. BURNS SCHOOL OF MEDICINE. HER CLINICAL
INTEREST IS IN DIABETES. AND EMILE SLOBODA HAS BEEN A
DIABETIC FOR FORTY YEARS, AND MUST TAKE INSULIN EVERY DAY.
BEFORE WE GET STARTED WE WANT TO TELL YOU THAT INSIGHTS ON
PBS HAWAIʻI DID INVITE REPRESENTATIVES OF THE
PHARMACUETICAL INDUSTRY AND MEDICAL INSURANCE COMPANIES TO
PARTICIPATE IN THIS SHOW BUT THEY DECLINED.
MAHALO TO YOU FOR JOINING US TONIGHT –
I WANT TO START WITH YOU. CAN YOU WALK US THROUGH
BRIEFLY HOW DRUGS ARE ACTUALLY PRICED?
>>DRUGS ARE PRICED THROUGH A PROCESS BEGINNING WITH THE
MANUFACTURERS. MANUFACTURERS WILL SET A PRICE
FOR THEIR MEDICATIONS.>>IT CAN VARY DEPENDING ON
HOW MUCH IT TOOK THEM TO DEVELOP THE MET EDUCATION AS
WELL. AND AFTER THEY HAVE A PRICE
FOR THEIR DRUGS, THEN IT GOES TO A WHOLESALER.
WHOLESALER WILL PURCHASE IT FROM THE MANUFACTURER AND THEN
PUT A PRICE, THEN A PRICE ON IT TO ALLOW IT TO GET TO THE
PHARMACY. PHARMACIES WILL DISPENSE IT TO
THE PATIENT. GETS REIMBURSED BY THE PRICE
GETS RECOVERED.>>Yunji: WHERE IS THE
INCREASE IN THE TIER YOU’RE TALKING ABOUT?
WHERE IS THAT ACTUALLY HAPPENING?
>>TYPICALLY, IT CAN HAPPEN MOSTLY FROM THE MANUFACTURER
OF THE DRUG. THERE’S ALSO ANOTHER PIECE OF
THE PUZZLE. PHARMACY BENEFIT MANAGER.
SO PHARMACY BENEFIT MANAGERS ARE COMPANIES THAT PROCESS
YOUR CLAIMS FOR THE PRESCRIPTION, THEY GET FROM
THE PHYSICIAN. AND PROCESS IT THROUGH THE
INSURANCE COMPANY. MIDDLEMAN THAT ALSO CHARGES
INSURANCE COMPANY A FEE, BUT ALSO CHARGES THE PHARMACY A
FEE IN ORDER FOR THEM TO MAKE A PROFIT.
ADDS DIGS COST TO THE MEDICATION.
>>Yunji: HAVE WE SEEN THE PRICES GO UP EXPONENTIALLY
COMES TO DRUGS AS COMPARED TO PRICE OF GROCERIES OR OTHER
ESSENTIALS?>>THINK THAT’S A REALLY GREAT
QUESTION. WE’VE ASKED THE SAME QUESTION.
PART OF IT IS WHAT DR. MASUDA SAID.
PRICES CAN BE RELATED TO DEVELOPING ENOUGH DRUGS.
BUT ALSO PART OF IT IS BECAUSE IT’S AN OPEN MARKET, FREE
MARKET, SO PART OF THE PRICING 4 IS REALLY NEGOTIATED BETWEEN
THE HEALTH PLANS NEED TO PROVIDE THE DRUG TO PATIENTS,
OR PHARMACY BENEFITS MANAGERS THAT NEGOTIATE THE PRICE FOR
THEM. NEGOTIATED PRICE.
SO PHARMACEUTICAL COMPANIES IN THE NEGOTIATION, WILL TRY TO
GET THEIR BEST PRICE AND HEALTH PLANS TO GET THE BEST
PRICE. AS FAR AS WHY THE PRICE IS
INCREASING, PART OF IT IS SEEING MORE NEW EXPENSIVE
DRUGS COME OUT BECAUSE THEY’RE NEWER AND MIGHT BETTER
EFFECTIVE, BUT NOT NECESSARILY ALWAYS.
I THINK IT’S ALSO A QUESTION THAT WE’RE TRYING TO ASK ON A
NATIONAL LEVEL. BECAUSE WE DON’T HAVE I THINK,
VERY CONFUSING TO SOME OF US WHY DRUGS THAT HAVE BEEN
AROUND ARE SEEING PRICE INCREASES WHEN IT’S NOT
CLEARLY RELATED TO DEVELOPMENT.
>>Yunji: WHO IS OVERSEEING THIS?
WHO IS THE WATCHDOG ON THIS?>>WELL, CONSUMER.
WE ARE THE PUBLIC. THERE REALLY ISN’T MUCH
OVERSIGHT HERE. PART OF THE PROBLEM.
MEDICARE IS THE LARGEST PURCHASER OF PRESCRIPTION
DRUGS AND THEY DON’T EVEN HAVE AUTHORIZATION TO NEGOTIATE THE
PRICE. YOU HAVE A LOT OF POWER BY THE
PRESCRIPTION DRUGS MANUFACTURERS IN PARTICULAR
RIGHT NOW.>>Yunji: AS A PATIENT, IN A
SITUATIONER CAN’T NECESSARILY WALK AWAY?
I’M NOT GOING TO BUY BRAND X 5 BECAUSE I CAN BUY GRAND Y.
IF YOU NEED THIS MEDICATION, WHAT ARE THE OPTIONS?
>>YOU DON’T REALLY HAVE MANY OPTIONS.
PUTS OUR KUPUNA IN A DIFFICULT SITUATION IF THEY ARE INCOME
LIMITED. CHOOSING BETWEEN MEDICINE THEY
NEED TO STAY ALIVE AND STAY HEALTHY OR FOOD.
>>Yunji: HOW HAVE YOU SEEN THE DRUG PRICES CHANGED?
I KNOW THAT YOU’VE BEEN BATTING DIABETES FOR 40 YEARS
NOW. SO OBVIOUSLY, YOU’VE HAD A LOT
OF EXPERIENCE PURCHASING MEDICATION.
WHAT HAVE YOU SEEN OVER THOSE DECADE?
WELL, IN PREPARATION FOR COMING ON TODAY, I ACTUALLY
WENT BACK AND ASKED MY MOTHER, WHO IS A MEDICAL SCHOOL
PROFESSOR AMONG OTHER THINGS. AND SHE TOLD ME THAT IN 1980,
WHEN SHE WENT TO THE PHARMACY, TO BUY ME 100 UNIT VILE OF
INSULIN. COSTED EIGHT DOLLARS.
SINCE 2001, PRICE OF INSULIN HAS GONE UP 300%.
SYNTHETIC INSULIN CAME OUT, IT WAS CALLED HUMIL.
>>NO WE REMEMBER WE NEVER PAID MORE
THAN 18 TO $20 FOR A VIAL. SPIKE THAT HAPPENED AFTER 2001
INTRINSICALLY TIED TO REBATE DEALS FROM THE PHARMACY AND
REBATE COMPANIES HAVE TO EARN A PROFIT.
THIS IS IT A PROFIT BUSINESS. IT HAS TO DO WITH MAKING A
PROFIT. WHY THEY WILL NOT RELEASE
FINANCIALS TO THE MEDICARE OR THE FEDS.
>>Yunji: TRANSPARENCY 6 SHOWING WHAT SOMETHING IS
GOING TO COST. WHEN A DOCTOR IS PRESCRIBING
MEDICATIONS DO THEY KNOW WHAT IT’S GOING TO COST THEIR
PATIENTS?>>EXTREMELY DIFFICULT.
TALKED ABOUT, THIS IS AN OPEN MARKET.
VERY HARD FOR US. WHEN WE SEE PATIENTS AND WE
FOR INSTANCE, EVEN THERE’S MULTIPLE DRUGS WE COULD CHOOSE
ON MIGHT BE EFFECTIVE. WE HAVE TO FIGURE OUT WHICH
ONES IS COVERED. WHAT THE COPAYMENT WOULD BE
AND WE DON’T HAVE THAT INFORMATION OFTEN IN THE SAME
WAY THAT OUR PATIENT MAY NOT HAVE IT.
WHEN WE TALK ABOUT TRYING TO GOOD CONSUMERS, SMART
SHOPPERS, TRY DOING THE RIGHT THING FOR OUR PATIENTS, TRYING
TO DO THE RIGHT THINGS FOR THEMSELVES WE DON’T KNOW WHAT
THE COST OF THE DRUG WILL BE. WE DON’T KNOW WHETHER THERE’S
A CHEAPER COST BECAUSE A PLAN IS NEGOTIATED CHEAPER COST.
IT’S VERY HARD FOR US TO KNOW WHAT WE’RE DOING.
AS PART OF IT, DR. MATSUDA HAVE BEEN WORKING ON
PRESCRIPPING GUIDE, WEBSITE TO HELP PHYSICIANS TO HELP WHAT
IS COVERED AND WHAT THE COPAYMENT WILL BE.
MAIN MESSAGES HAVE TO BE SMART ABOUT THIS.
IT’S NOT EASY. THERE’S A LOT WORK TO PUT INTO
IT. WE HAVE TO FIGURE OUT HOW TO
FIND A BETTER WAY FOR THEM.>>Yunji: HOW DO WE AVOID
THAT STICKER SHOCK WHEN YOU’RE SUDDENLY AT THE COUNTER AT
LONG’S AND FIND OUT WHAT YOUR 7 PAYMENT IS RIGHT THEN?
IS THERE A WAY, A CONSUMER, TO FIND OUT AHEAD OF TIME SO YOU
CAN BE A SMART SHOPPER? A LOT OF ONUS IS ON PATIENT.
THAT SEEMS VERY DIFFICULT. DOCTOR IS SAYING HERE’S THE
DRUG YOU NEED. WHAT IS IT GOING TO COST ME?
DOCTOR MAY NOT EVEN KNOW.>>A LOT OF IT IS DISCUSSING
WITH YOUR INSURANCE COMPANY. USUALLY YOU CAN CALL THEM AND
ASK THEM FOR MEDICATION IF IT’S ON THEIR FORMULARY OR
PREFERRED DRUG THAT INSURANCE WILL COVER.
CHOOSING INSURANCE, IF YOU HAVE THE OPPORTUNITY, WORKING
YOU CAN SELECT INSURANCE YOU WANT TO BE ABLE TO CHOOSE
INSURANCE THAT WILL COVER MOST OF YOUR MEDICATIONS AND BE
AWARE OF WHAT THE COST WILL BE IF YOU’RE PAYING FOR A BRAND
OR GENERIC. MEDICARE PATIENTS, TIERING
SYSTEM. PAY A PRICE FOR GENERIC
MEDICATION, LOWER COST FOR A GENERIC MEDICATION THAT THE
INSURANCE WILL COVER. HIGHER COST FOR MEDICATION
GENERIC. GOOD TO SHOP AROUND.
LOOK FOR A INSURANCE COMPANY THAT WILL COVER MOST OF YOUR
MEDICATION. WHEN YOU DO GO TO THE
PHARMACY, EVEN THE PHARMACIST WON’T KNOW EXACTLY WHAT YOUR
COPAY IS UNTIL YOU ACTUALLY PROCESS THE PRESCRIPTION.
SO THAT IS WOULD BE GOOD TO HAVE AS WELL AS MORE
TRANSPARENCY SO THAT’S PATIENTS WILL ACTUALLY BE ABLE
TO FIGURE OUT WHAT THEIR COSTS WOULD BE BEFORE THEY GET THAT
STICKER SHOCK WHEN THEY GO TO 8 THE PHARMACY.
>>Yunji: IS THAT SOMETHING THAT NEEDS TO BE MANDATED
STATE LEVEL, FEDERAL LEVEL? HOW WOULD WE ACTUALLY GET
THAT?>>I THINK YOU PROBABLY WOULD
NEED MORE AT THE FEDERAL LEVEL.
BECAUSE ALL OF THE INSURANCE COMPANIES, MOST OF THEM, HAVE
FEDERAL TIES AND ARE AVAILABLE NATIONALLY.
HMSA IS WORK LOCAL INSURANCE COMPANY.
TIED WITH BLUE CROSS, BLUE SHIELD.
THERE IS A MEDICARE, RUNS NATIONAL MEDICARE PART D
BENEFIT FOR 40 MILLION PEOPLE. COMING OUT WITH SUGGESTIONS
THAT, FOR INSTANCE, ONE OF THE PHYSICIAN, TYPING IN THE
PRESCRIPTION TO SEND ELECTRONICALLY TO A PHARMACIST
START LOOKING AT MANDATE OR REQUIREMENT PRESCRIPPING
SYSTEM HAS THE COST INFORMATION.
I CAN HAVE THE CONVERSATION WITH YOU DIRECTLY, LOOK, THIS
IS HOW MUCH IT’S GOING TO COST IN TERMS OF 50 BUCKS OR FIVE
DOLLARS. IS THAT AFFORDABLE FOR YOU?
I THINK THAT’S ACTUALLY GOING TO BE REALLY IMPORTANT.
>>Yunji: WE WANT TO BRITT AUDIENCE.
GET YOUR QUESTIONS IN. TOM IN WAIKIKI HAS A QUESTION.
WHAT ROLE DOES POLITICAL SYSTEM HAVE IN THE PRICE OF
DRUGS N GREAT QUESTION. AARP LAUNCHED CAMPAIGN ON
PRESCRIPTION DRUGS AND TRYING TO BRING THE PRICE DOWN FOR
CONSUMERS. ISSUE HAS JUST REALLY BECOME
SO CRITICAL, PRICE IN AMERICA 9 IS HIGHER THAN ANY OTHER PLACE
IN THE WORLD. SO OFTEN, WE’RE PAYING TWICE
THE COST OF OTHER PEOPLE IN OTHER COUNTRIES.
THERE’S NO QUESTION WE HAVE TO TAKE ACTION.
FEDERAL EFFORT. PROBABLY FOUR DIFFERENT PRONGS
AT THE FEDERAL LEVEL AT THIS POINT.
STATE LEVEL, A LOT OF DIFFERENT EFFORTS.
LAST YEAR, 17 STATES THAT HAVE PASSED 26 BILLS INTO LAW.
FELL LEVEL, I THIS IS A CONVERSATION HAPPENING RIGHT
NOW AND ONE OF THE THINGS WE TALKED ABOUT WAS AUTHORIZING
MEDICARE SO THAT THEY CAN ACTUALLY NEGOTIATE WITH OTHER
COUNTRIES. FOR THEIR PRESCRIPTION DRUGS.
OR JUST NEGOTIATE, PERIOD. AND THAT’S ONE OF THE TALKS
THAT WE’RE HAVING RIGHT NOW. AND POTENTIALLY, PEOPLE CAN
MAKE A DIFFERENCE BY SPEAKING OUT.
LETTING THEIR CONGRESSIONAL MEMBERS KNOW, THESE ARE
CRITICAL ISSUES FOR THEM, WHETHER IT’S STATE LEVEL OR
THE FEDERAL LEVEL. NOW IS THE TIME.
BECAUSE THERE IS ACTUALLY JUST ACTIONS IN THE SENATE TODAY ON
SEVERAL BILLS. SO OTHER THING THAT WE’RE TRY
DOING IS REALLY CAP THE OUT OF POCKET COSTS FOR MEDICARE
FOLKS IN PARTICULAR. SO THE MEDICARE PART D COSTS
CAN BE VERY HIGH FOR SOME KUPUNA AND REALLY NEED TO
ADDRESS THOSE COSTS AND DIFFERENT WAYS THAT THE
FEDERAL GOVERNMENT CAN DO THAT.
SO THE OTHER THING THAT IS 10 REAL CHALLENGE IS THERE ARE
WAYS THAT CURRENT MANUFACTURERS PREVENT INJURY
GENERICS GETTING TO MARKET. PAY IT PLAY DEALS REQUIRE.
OTHER WAYS THAT THEY PREVENT THEM FROM COMING TO MARKET.
IS WE NEED TO ELIMINATE SOME OF THOSE LOOPHOLES AND THEN
FINAL ONE IS JUST TRANSPARENCY.
THERE’S MULTIPLE WAYS TO OPEN UP THE INFORMATION.
FOCUS ON THE MANUFACTURERS IN PARTICULAR.
FIND OUT WHY THEY’RE SETTING PRICES SO HIGH.
PARTICULARLY WHEN IT’S CHEAPER EVERYWHERE ELSE.
THE STATE LEVEL, ACTUALLY A COUPLE BILLS THAT WERE MOVING
THROUGH SESSION, AND KIND OF DIED AT THE VERY END.
I THINK THAT THIS YEAR MIGHT BE ANOTHER GOOD YEAR.
WE HAVE A CUP OF IDEAS. ONE OF THEM INCLUDES LETTING
THE STATE NEGOTIATE WITH OTHER COUNTRIES.
OTHER STATES HAVE ALREADY DONE THAT.
SO THAT IS ONE THAT WE’VE HEARD PEOPLE REALLY SUPPORT.
THERE’S OTHERS THAT DEAL WITH THE PHARMACY BENEFIT MANAGERS,
TRANSPARENCY ASPECT. OR JUST REQUIRING IF THERE’S A
DRAMATIC PRICE INCREASE, THERE WILL BE, INSURANCE COMPANIES
GET ADVANCED NOTICE. SO THE STATE LEVEL, PEOPLE ARE
STILL TALKING. I THINK THE IMPORTANT THING IS
THAT WE HAVE THE CONVERSATION, REALLY APPRECIATE COMING
FORWARD TO SPEAK UP BECAUSE PEOPLE DON’T NECESSARILY WANT
TO SHARE ALL OF THEIR PERSONAL PROBLEMS ABOUT MEDICATION BUT
NOW IS THE TIME TO TELL THEIR 11 STORY.
THAT’S GOING TO MAKE THE DIFFERENCE BECAUSE UNLESS OUR
LEADERS LEGISLATORS UNDERSTAND WHAT IS HAPPENING, AT THE
GROUND LEVEL, HOW PEOPLE ARE SUFFERING, HOW PEOPLE MIGHT BE
RATIONING THEIR INSULIN AND DYING, YOU’RE NOT GOING TO
UNDERSTAND. AARP IS ENCOURAGING PEOPLE TO
TELL THEIR STORIES OR LEARN MORE AT OUR WEBSITE.
AARP.ORG/RX. YOU’LL LEARN A LOT.
PLEASE ENCOURAGE PEOPLE TO TELL THEIR STORIES SO THAT WE
CAN LEARN, KEEP HAVING THIS CONVERSATION.
IT’S NOT A MISTAKE THAT INSULIN MADE IT IN THE PUBLIC
SPHERE TO SHORE UP THE DISCUSSION ABOUT OUTRAGES
PRICING WITH PRESCRIPTION MEDICATION.
YOU CAN’T SHOP AROUND FOR A BETTER INSULIN.
IF I DON’T HAVE INCHES LIPS FOR 24 HOURS, I DIE.
THAT’S IT. REALLY DOESN’T MATTER HOW MUCH
I HAVE TO PAY FOR IT. IF I WANT TO PRESERVE MY OWN
LIFE. PHARMACEUTICAL COMPANIES,
PORTION OF THE POPULATION WHO WILL DO ANYTHING THEY CAN DO
IT GET THE INSULIN TO AVOID COMPLICATIONS.
DEATH, KETOACIDOSIS, METABOLIC SHUTDOWN.
COMES WITHIN 24 HOURS.>>Yunji: WE READ ACCOUNTS OF
PEOPLE RATIONING INSULIN OR TRYING TO MAKE IT LAST LONGER.
TELL US ABOUT THAT.>>IRONICALLY, WHEN I THINK
ABOUT THAT, I THINK BACK, NOW I HAVE QUEST.
IT’S ONLY BEEN A COUPLE OF 12 YEARS.
BEFORE THAT, I HAD HMSA, TPO, BEST ININSURANCE MONEY COULD
BUY. WHEN I WENT TO THE PHARMACY TO
PICK UP 2 MONTH SUPPLY OF INSULIN, I HAD TO PAY 235
COPAY. NOW, $235 OUT OF YOUR MONTHLY
BUDGET TO KEEP YOURSELF ALIVE WHEN YOU’RE RAISING THREE
CHILDREN IN HAWAI’I, YOU UNDERSTAND.
THAT IS A HUGE CHUNK OF YOUR MONTHLY BUDGET YOU HAVE TO
SPEND TO AVOID ALL THE COMPLICATIONS COME WITH THIS
DISEASE. LEADING CAUSE OF DEATH IN
AMERICA. LEADING CAUSE OF BLINDNESS IN
THE WORLD. IT’S THE LEADING CAUSE OF
AMPUTATION IN THE WORLD. LEADING CAUSE OF KIDNEY
DISEASE IN THE WORLD. I COULD GO ON AND ON.
YOU HAVE TORE WHICH ABOUT HOW YOU CAN MAKE YOUR INSULIN LAST
AS LONG AS IT POSSIBLY CAN. RATIONING IS A REALLY
DANGEROUS EXTREME THING THAT I ONLY HAD DO A FEW TIMES.
INSULIN PENS, 200 UNITS INSULIN IN THE PEN.
DIAL THE DOSAGE UP. INJECT IT.
INJECT IT AS YOU GO. LITTLE BIT OF INSULIN LEFT IN
THE PEN BUT YOU CAN’T USE THE PEN ANY MORE.
I LIKE A LOT OF DIABETICS, TAKE A SYRINGE AND WITHDRAW
THE LEFTOVER INSULIN BECAUSE THAT’S A WHOLE OTHER DOSE.
ANOTHER FIFTH OF MY DAY THAT I CAN STAY ALIVE.
SAME THING WITH THE INSULIN PUMPS.
LAST FOR THREE DAYS, REMOVE 13 THEM.
EXCESS INSULIN LEFTOVER. NO HEALTH CARE PROFESSIONAL IS
GOING TO TELL YOU THAT YOU SHOULD EVER DO ANYTHING WITH
THAT EXCEPT THROW IT AWAY. I WOULD EXTRACT THE LEFTOVER
INSULIN LEFT OVER AND REINTRODUCE TO THE NEXT
INSULIN PUMP BECAUSE I DIDN’T KNOW IF MY INSULIN WAS GOING
TO LAST LONG ENOUGH FOR THE TIME PERIOD THAT THE HEALTH
INSURANCE COMPANY WOULD ALLOW ME TO THEN REUP MY
PRESCRIPTION AND PURCHASE MORE INSULIN.
DIABETES, AMOUNT OF THE INSULIN YOU TAKE FROM
DAY-TO-DAY, CAN CHANGE. IF I TOOK MORE, OR A LOT LESS,
THEN I WOULD HAVE EXCESS OR NOT ENOUGH INSULIN.
HAVING TO MAKE THOSE CHANGES WHEN YOU HAVE BIG PHARMA,
BENEFIT MANAGERS HEALTH INSURANCE COMPANIES,
PHYSICIANS, ALL, HANDS IN THE POT, IMMEDIACY OF THE NEED FOR
INSULIN BECOMES ALL THE MORE REAL WHEN ALL OF THE OTHER
PEOPLE HAVE TO MAKE DECISIONS JUST SO YOU CAN GET WHAT YOU
NEED TO LIVE THAT DAY.>>Yunji: WHEN YOU HEAR
SOMEONE MAKING CHOICES LIKE THAT, PRETTY COMPELLING.
>>RIGHT. I’LL HAVE TO SECOND WHAT HE
HE’S SAYING. HEAR THIS ALL THE TIME.
THERE’S TWO PARTS OF THIS. ALONG WITH INSULIN, I HEAR
THIS FOR OTHER THINGS. SIMPLE AS ASTHMA INHALERS FOR
ASTHMA. INHALERS COST $400.
THEY’RE NOT COVERED. OR EVEN IF THEY ARE COVERED,
CAN COST 25 TO FIFTY DOLLARS 14 EACH MONTH.
FOR JUST A SINGLE MEDICATION. ONE SENSE, THERE IS SOMETHING
I REALLY, REALLY WANT PEOPLE TO KNOW, WHICH IS I WANT TO
HEAR THOSE STORIES. I WOULD MUCH RATHER HAVE
SOMEBODY TELL ME, I CAN’T AFFORD MY MEDICATION.
OR WHAT CAN YOU DO TO HELP? AND TO SPEND THE TIME TO TRY
TO WORK THAT OUT. KNOWING THAT IT’S HARD DO IT.
LOOKING FOR WAYS TO FIND COVERED MEDICATION TO DO THE
PRIOR AUTHORIZATIONS REQUIREMENTS TO GET SOMETHING
COVERED. OR HAVING THOSE REALLY FRANK
DISCUSSIONS. WE GET THAT MEDICATION IS NOT
AFFORDABLE, IT’S NOT HELPING ANYBODY.
>>Yunji: WE HAVE A BUNCH OF COMMENTS AND QUESTIONS COMING
IN. CONNIE FROM THE BIG ISLAND
SAYING. MEDICATION I’M USE SOMETHING
SO EXPENSIVE. EXPERIMENTING WITH NOT USING
IT. PRICE CREATES A MISTRUST OF
THE MEDICAL COMMUNITY. UNDERMINING BASIC TENET OF
CARE. THAT TO WHAT YOU’RE SAYING.
AS A PATIENT, DON’T WANT TO TELL YOUR DOCTOR, I DON’T
THINK I CAN AFFORD THAT.>>RIGHT.
MESSAGE TO DOCTORS IS, WE REALLY HAVE TO BE AWARE OF IT.
THROW IN TEN PEOPLE HAVE TROUBLE PAYING FOR
MEDICATIONS. THREE IN TEN.
GO FROM SKIPPING MEDICATIONS TRYING TO NOT TAKE IT OR NOT
TAKING IT ALL TOGETHER, NOT 15 EVEN SUBSTITUTING ANYTHING
ELSE. I WANT TO GAIN THAT TRUST
BACK. I DON’T WANT TO BE SEEING — I
DON’T PHYSICIAN WANT TO BE SEEN AS WE SENT A
PRESCRIPTION. DON’T CARE ABOUT THE COST.
WE DON’T KNOW. PEOPLE ARE FEELING THAT THE
BURDEN A LITTLE TOO MUCH ON THEM WHEN THEY HAVE TO TRY TO
FIGURE OUT WHERE TO CUT THE COSTS TO BE ABLE TO FILL THE
PRESCRIPTION. CAN THEY GO TO THEIR DOCTOR
FOR HELP. ON BOTH SIDES, COME AND TELL
YOUR PHARMACIST PICK UP THE PRESCRIPTION.
SCR THEM CALL YOUR DOCTOR. ON THE DOCTOR’S SIDE, JUST ASK
FIRST. SAY, I GAVE YOU THAT
PRESCRIPTION. ARE YOU BEING ABLE TO AFFORD
YOUR MEDICATION? IS THIS A PROBLEM?
BECAUSE I’M THERE. I’M PART OF YOUR TEAM.
I’M THERE TO ADVOCATE FOR YOU. I’M THERE TO HELP AND DO
WHATEVER I CAN.>>MIKE IN WAIKIKI HAS A
QUESTION DR. MASUDA YOU WOULD BE GREAT TO ANSWER THIS.
WHAT IS HAPPENING WITH COMPOUND MEDICATIONS WHICH
DOCTORS MIX AND PRESCRIBE IN THEIR MOST OFFICE?
HIGHER PRICE THAN SIMILAR DRUGS FROM THE PHARMACY.
>>USUALLY, COMPOUND MEDICATIONS COME FROM
COMPOUNDING PHARMACY. FEW LEFT AT LEAST ON OAHU, I
THINK THERE’S TWO COMPOUNDING PHARMACIES.
THOSE ARE MEDICATIONS. 16 USUALLY, THAT YOU KPT GET
AVAILABLE THAT IS MADE FROM A MANUFACTURER ALREADY.
UNFORTUNATELY, MOST INSURANCE COMPANIES JUST BECAUSE SAFETY
ISSUES, AND WHAT THIS KNOW IS EFFICACIOUS WILL USUALLY
PRESCRIBE WHAT THE F D.A. APPROVES AND MANUFACTURER
CAN MAKE. THERE ARE STILL SOME
MEDICATIONS THAT CAN BE COMPOUNDED.
THAT THE INSURANCES WILL COVER.
BUT VERY FAR AND FEW BETWEEN THESE DAYS.
>>JESSICA, ONE PERSON HERE REMAINING ANONYMOUS, WANTS TO
KNOW IS AFFORDABLE CARE ACT MAKING A DIFFERENCE IN THE
PRICE OF MEDICATION?>>DIRECTLY, IT’S NOT
ADJUSTING THE PRESCRIPTION DRUG ISSUE.
WE REALLY HAVE TO LOOK AT THE TRANSPARENCY, WHAT IS
HAPPENING REALLY EXPOSE THE DIFFERENT LEVELS.
IT’S DIFFERENT LEVELS WHEN WE TALK ABOUT TRANSPARENCY.
LEVEL AT THE PHARMACIST, SAY THAT YOUR COPAY IS GOING TO BE
HIGHER THAN THE ACTUAL GENERIC YOU COULD BUY.
SOME STATES ARE NOW SAYING, LET’S REQUIRE THAT YOU REVEAL
THAT INFORMATION. SO THERE’S A LOT OF DIFFERENT
THINGS THAT HAVE NOT EVER BEEN ADDRESSED.
OR TALKED ABOUT. SO THAT’S ONE REASON WE’VE GOT
TO HAVE THIS CONVERSATION RIGHT NOW.
LET ME JUST THROW OUT ANOTHER NUMBER THAT AARP FOUND JUST
RECENTLY. SO THE AVERAGE KUPUNA MIGHT
TAKE ABOUT 4.5 PRESCRIPTION 17 DRUGS A YEAR.
COST IS ABOUT $26,000 A YEAR. SO AT THE SAME TIME, MEDICARE
THAT MEDIUM MEDICARE BENEFIT, $24,150.
WE’RE PUTTING PROFITS OVER PEOPLE.
SO SOMETHING HAS TO CHANGE. WE HAVE TO ADDRESS THIS
AGREED. THAT’S WHAT IT IS.
PLAIN, SIMPLE. ADD A LITTLE BIT TO THAT.
THINGS LIKE LEGISLATION IN THE PAST WHICH HAVE TRADITIONALLY
LOOKED AT HOW DO WE GET PEOPLE DRUG COVERAGE?
SO FOR INSTANCE, MEDICARE PART D, CREATED IN 2006, MANY
PEOPLE SENIORS DIDN’T HAVE DRUG COVERAGE.
NOW, 45 MILLION PEOPLE DO. JUST THROUGH MEDICARE PART D
THE PROBLEM, USED TO HAVE DRUG COVERAGE OR NOT.
COMPLETELY CHANGED. WE’RE SEEING PEOPLE WHO HAVE
DRUG COVERAGE AND THEN DRUGS ARE COVERED.
BUT THE DRUG COVERAGE HAS CHANGED IN THE SENSE PEOPLE
ARE BEING ASKED TO PAY MORE OF THE SHARE OF THE COST.
PEOPLE HAVE DEDUCTIBLES. FIRST TIME THEY BUY A
PRESCRIPTION, UNDERMEDICARE PART D, FIRST $415 IS OUT OF
POCKET UNTIL YOU’RE PAYING THAT COMPLETELY OUT OF POCKET
YOURSELF. AND EVEN IF WE’RE NOT UNDER
MEDICARE, IF I HAVE INSURANCE THROUGH COMMERCIAL PLAN,
THROUGH MY EMPLOYER, I CAN HAVE DEDUCTIBLES AS WELL.
SO WHEN PEOPLE, EVEN WHEN THE DRUG IS COVERED, WE’RE PAYING
MORE OF THE SHARE OF THE COST. SO IT’S NOT JUST WHETHER WE
HAVE INSURANCE OR NOT, IT’S 18 JUST NOT WHETHER THE DRUG IS
COVERED. WE HAVE TO ASK POLICY MAKERS
TO REALLY LOOK AT, INSTEAD OF JUST EXPANDING COVERAGE, WE
KNOW THAT AS LONG AS THE PRICES OF DRUGS WITH ARE GOING
UP, SOMEBODY IS PAYING FOR IT. IF IT’S CONSUMERS OR UP,
TAXPAYORS, MEDICARE, HEALTH PLANS, I THINK THAT’S REALLY
IMPORTANT FOR PEOPLE TO UNDERSTAND NOW.
WHEN THEY’RE TALKING TO LEGISLATORS.
>>I WANT TO EMPHASIZE THAT POINT.
EVEN IF YOU DON’T TAKE PRESCRIPTION DRUGS, THIS IS AN
IMPORTANT ISSUE BECAUSE YOU’RE PAYING PREMIUMS THAT ARE
HIGHER AND PAYING TAXES BECAUSE WE ALL SUPPORT THIS
MEDICARE SYSTEM. SO IT MATTERS.
WE’RE TALKING ABOUT BILLIONS OF DOLLARS EVERY YEAR.
>>WE TALKED A LITTLE BIT AT THE BEGINNING OF SHOW, ALLUDED
TO THE IDEA OF PERHAPS ORDERING THESE DRUGS BY MAIL.
GOING TO ANOTHER COUNTRY. IS THAT A VIABLE OPTION, DO
YOU THINK, TO DO THESE MAIL ORDERS?
I KNOW FOR A LONG TIME, A LOT OF POP UP ADS, ORDER YOUR
DRUGS FROM CANADA. IS THAT A SAFEWAY TO TRY TO
LOWER YOUR COST?>>WELL, I WOULD PROBABLY SAY
NO, BECAUSE YOU CAN’T NECESSARILY VERIFY WHERE THEY
GET THEIR MEDICATIONS FROM. BUT IT WILL BE LESS EXPENSIVE
FOR YOU. SO YOU JUST WANT TO MAKE SURE
YOU DO YOUR RESEARCH AS WELL AND MAKE SURE THIS WAS
LEGITIMATE PHARMACY AND THEY 19 OBTAIN THEIR MEDICATIONS FROM
LEGITIMATE MANUFACTURERS BECAUSE YOU HAVE NO WAY OF
TRACKING EXACTLY WHERE THEY GET THEIR MEDICATIONS FROM.
BUT THERE ARE OPTIONS. SOME INSURANCE COMPANIES, IF
YOU DO MAIL ORDER THROUGH U.S. PHARMACY, THAT CAN MAIL THE
PRESCRIPTIONS TO YOU IF YOU GET A 3 MONTH SUPPLY,
SOMETIMES THEY PROVIDE A DISCOUNT FOR THE COST.
FOR YOUR MEDICATIONS AS WELL.>>Yunji: I’M NOT SURE WHERE
HE IS WRITING IN FROM. QUESTION THAT A LOT OF PEOPLE
WOULD ASK. WHY IS THERE A PRICE
DIFFERENCE OR RETAILERS LIKE CVS, WALGREEN’S, WAL-MART,
COSTCO, SAM’S CLUB SAME DRUGS AT THE RETAILERS?
WHY DO I PAY ONE PRICE ONE PART OF TOWN AND ANOTHER IF I
GO ACROSS TOWN?>>THAT’S REALLY IMPORTANT TO
KNOW. WHEN WE TALK ABOUT SMART
SHOPPING, IF A DRUG IS NOT COVERED BY INSURANCE, THEN ALL
BETS ARE OFF. YOU REALLY HAVE TO DO THE
SHOPPING. YOU HAVE TO JUST LIKE ANYTHING
ELSE YOU SHOP FOR, IF IT’S NOT COVER BY INSURANCE, PAYING
100% OF THE COST OUT OF POCKET.
MIGHT BE DIFFERENT AT LONG’S AND DIFFERENT AT SAFE WAYS
WAL-MART AND WALL GREENS. WEBSITE CALLED WEB RX.
LOOK AT PRICES DIFFERENT PHARMACIST.
USE THAT SOMETIMES TO GET A QUICK IDEA.
WEB RX. IT’S ALSO IMPORTANT TO NOTE
THAT IF A DRUG IS COVERED BY 20 INSURANCE, IT SHOULDN’T MAKE A
DIFFERENCE WHICH PHARMACY YOU’RE FILLING IT AT.
IF THAT PHARMACY IS WHAT WE CALL WITHIN THE NETWORK, IT
MEANS YOUR HEALTH PLAN HAS CONTRACTED WITH CERTAIN NUMBER
OF PHARMACIES WITHIN, WHERE YOU LIVE, AND THEY WILL, THE
PRICES IS ACTUALLY NEGOTIATED BY THE HEALTH PLAN.
AND IT DOESN’T MATTER WHETHER YOU FILL AT A LONG’S OR
WALGREEN’S, AS LONG AS IT’S PART OF THAT NETWORK.
BIGGEST PROBLEM IS IF IT’S NOT COVERED BY I INSURANCE, PAYING
FULL COST, YOU SHOULD DEFINITELY SHOP AROUND.
IF IT’S COVERED, IT SHOULDN’T MAKE A DIFFERENCE AS LONG AS
THAT PHARMACY IS WITHIN YOUR NETWORK.
>>Yunji: YOU’VE HAD EXPERIENCE ON QUEST AND
PRIVATE INSURANCE. TELL US ABOUT THE DIFFERENCE
OF THOSE TWO EXPERIENCES.>>WELL, AS I STATED BEFORE, I
WAS SHOCKED AT HOW MUCH PPO, HMSA POLICY WOULD HAVE ME PAY
FOR MY PRESCRIPTION MEDICATIONS.
ESPECIALLY INSULIN. SWITCHING OVER TO QUEST, THERE
IS NO COPAY WHEN YOU GO IN TO PICK UP YOUR PRESCRIPTIONS.
HOWEVER, I DID HAVE THE EXPERIENCE WHERE WHEN I
STARTED, MY ENDOCRINOLOGIST PRESCRIBED A NAME BRAND
INSULIN, MADE BY NOVO NORDISK, TAKING FOR HOW MANY YEARS NOW,
30 YEARS. HE PRESCRIBED IT IN THE PEN
INJECTION. WENT OFF THE PUMP FOR A WHILE.
DECIDED TO START ME ON THE PEN.
CONTINUOUS GLUCOSE MONITOR 21 WITH PEN INSULIN INJECTIONS.
I WENT TO THE PHARMACY TO PICK UP MY FIRST PRESCRIPTION.
AND IT WAS SOME INSULIN I NEVER HEARD OF.
NOW, I JUST WANT TO MAKE THE POINT THAT INSULIN IS NOT
COUGH MEDICINE. IT’S NOT EVEN A STATIN.
IT’S SOMETHING WHERE THEY USE BIOLOGICAL MEANS AND
BIOLOGICAL MATERIALS TO PRODUCE BATCHES OF INSULIN.
IT’S AN ENZYME. IT’S NOT LIKE YOU CAN’T MESS
IT UP. THAT’S THE FIRST THING.
SO IT’S NOT LIKE EVERY BATCH OF INSULIN IS EXACTLY THE
SAME. SO YOU COMPILE ON TOP OF THAT
THAT MY BRAND WAS CHANGED AND MY DOCTOR TOLD ME LATER QUEST
CHANGED EVERYBODY’S WITHOUT TELLING THEM.
SO I SHOWED UP. SAW THIS NEW MEDICATION.
I DIDN’T KNOW ANYTHING ABOUT IT.
EXCEPT THAT IT’S INSULIN I WAS TO TAKE T IT WASN’T AS
EFFICACIOUS FOR ME. I HAD SOME PROBLEMS WITH IT.
HAD A LOT OF LAG TIME BETWEEN WHEN I TOOK IT AND WHEN I
NEEDED IT TO ACT ON THE CARBOHYDRATES THAT I WAS
INTAKING. SO I HAD TO GO BACK TO MY
DOCTOR, DISCUSS THIS WITH THEM.
AS OUR PHYSICIAN PANEL MEMBER MENTIONED, HE WORKED WITH ME
TO GET A REQUEST TO MY QUEST INSURER TO CHANGE THAT.
THAT TOOK TWO WEEKS. SO I WAS TAKING INSULIN THAT
WASN’T REALLY HELPING ME AS MUCH AS INSULIN SHOULD FOR 2
WEEKS. 22 ULTIMATELY, DIABETES IS A
DISEASE OF THE SMALL BLOOD VESSELS.
THE SUGAR IN YOUR SYSTEM, IF IT’S NOT MET UP WITH BY
INSULIN. DOES DAMAGE TO THE SMALL BLOOD
VESSELS BEHIND THE EYES, AND THE KIDNEYS AND THE FEET AND
THE EXTREMITIES. AND SO THAT DAMAGE TAKES PLACE
OVER A LONG PERIOD OF TIME. ANY DELETERIOUS EFFECT YOUR
BLOOD SUGAR CAUSING IT TO GO HIGH, IS DOING LONGTERM DAMAGE
TO YOUR ORGANS. LITTLE THINGS, AND THE
DISCUSSION THAT WE’RE HAVING THAT EXEMPLIFIES THE POINT
HERE. WHICH IS YOU DON’T SHOP AROUND
FOR INSULIN. THAT SHOULDN’T BE A REALITY.
REALLY NO, ONE SHOULD HAVE TO PAY FOR INSULIN.
THAT’S THE REALITY. 40,000 AMERICANS EVERY YEAR
SINCE THE YEAR 2000 ARE DIAGNOSED WITH TYPE 1 DIABETES
ALONE. 30 MILLION AMERICANS HAVE
DIABETES. 7 MILLION CURRENTLY TAKE
INSULIN TO STAY ALIVE EVERY DAY.
THIS IS A DRUG THAT SHOULD NOT HAVE A PRICE ATTACHED TO IT.
IF IT DOES, IT SHOULD BE THE SAME SMALL PRICE FOR EVERYONE
WOULD HAS TO TAKE IT. BECAUSE WHEN DISASTERS HIT,
WHEN THINGS ARE IN SHORT SUPPLY, DIABETICS ARE THE
FIRST TO DIE.>>Yunji: A LOT OF THOSE
DIABETICS ARE SENIORS WE KNOW. WHAT KIND OF CHOICES ARE YOU
HEARING THAT THEY HAVE TO MACON THIS?
WHAT CAN THEY DO? 23 HE’S RIGHT.
CERTAINLY HARD TO SHOP AROUND FOR INSULIN.
WHAT DO YOU SUGGEST FOR THEM?>>GO TO AARP.ORG.
TELL YOUR STORY. IT’S A REAL CHALLENGE RIGHT
NOW. I’M HEARING A LOT OF DIFFERENT
PEOPLE STARTING TO SPEAK UP. SO YOU KNOW, TALK TO YOUR
DOCTOR. TALK TO YOUR PHARMACIST.
DON’T BE SHY. I WANT TO ENCOURAGE PEOPLE TO
TAKE PART IN OUR DEMOCRATIC SYSTEM.
LET YOUR LEGISLATORS KNOW, CRITICAL ISSUE AND THEY HAVE
TO TAKE ACTION RIGHT NOW. BECAUSE WE’RE PAYING THE
PRICE. NOT JUST PERSONALLY, FOR
PEOPLE WHO TAKE PRESCRIPTION DRUGS, BUT ALL OF US PAYING
THE PRICE. WHY ARE WE AS A COUNTRY PAYING
HIGHEST PRICES IN THE WORLD? WE KNOW THERE’S A PROBLEM.
WE HAVE TO STOP ALLOWING THE PROFIT OVER PEOPLE.
>>Yunji: CALLER IS A PHYSICIAN AND PATIENT.
IS THE PANEL AWARE THAT GENERIC DRUGS ARE NOT
CHEMICALLY EQUIVALENT AND IT IS IMPOSSIBLE TO BE FDA
BECAUSE THEY CANNOT POLICE THEM?
WHAT CAN BE DONE? MICHAEL IN HONOLULU.
>>I KNOW THAT I’VE HAD THE EXPERIENCE OF GOING TO THE
PHARMACY, GETTING PRESCRIBED ONE THING, BUT THEN GENERIC IS
GIVEN TO ME AS A MATTER OF COURSE.
CHEAPER. WHAT KIND OF CONTROL DO YOU
HAVE OVER THAT? 24 GETTING THE BRAND NAME AS
OPPOSED TO THE GENERIC? IS THIS TRUE, FDA CANNOT
POLICE GENERIC?>>FDA HAS TESTING FOR
GENERICS AND DOES TESTING TO TEST IF IT’S EQUIVALENT TO THE
BRAND NAME MEDICATIONS. THEY HAVE A RESOURCE THAT
PHARMACISTS CAN USE THAT SHOW WHETHER OR NOT IT’S EQUIVALENT
ENOUGH TO RELEASE MEDICATION AND THEY HAVE LAWS WHERE
PHARMACISTS CAN SWITCH FROM A BRAND MEDICATION TO A GENERIC
IF IT IS DEEMED EQUIVALENT TO THE BRAND MEDICATION.
SO THAT IS COST OF SAVINGS MEASURE FOR THE PATIENT.
BUT IF IT’S NOT WORKING, AS WELL FOR YOU, YOU CAN TALK
WITH YOUR PHARMACIST OR PHYSICIAN AND THEY CAN REQUEST
FOR A BRAND NAME DRUG. LIST THAT ON THE PRESCRIPTION
AS BRAND NAME DRUG ONLY. SOMETIMES YOUR INSURANCE MAY
NOT COVER THE BRAND NAME AND THEY WOULD HAVE TO WORK WITH
THE PHYSICIAN TO SUBMIT A REQUEST TO GET THE BRAND
ANYMORE MEDICATION.>>FEW QUESTIONS FOR DOCTORS.
MORE OF A COMMENT. PART OF THE PROBLEM IS DOCTORS
ARE OVERPRESCRIBING SO PEOPLE ARE OVERMEDICATING.
DOCTORS ARE GUESSING WHEN THEY PRESCRIBE.
UNCLE DON’S OPINION. ARE DOCTORS ALLOWED TO RECEIVE
COMPENSATION FROM DRUG COMPANIES?
>>ACTUALLY, GREAT QUESTION. WE DON’T — I WON’T SAY WE,
VAST MAJORITY OF DOCTORS ACTUALLY DON’T RECEIVE DIRECT
COMPENSATION. FOR INSTANCE, IF I PRESCRIBE
CHOLESTEROL DRUG, I DON’T GET 25 A PROFIT WHAT’S PRESCRIBED.
HAVING SAID THAT, THERE ARE, MEDICATIONS THAT ARE, FOR
INSTANCE, CANCER MEDICATIONS OR INJECTION INFUSION
MEDICATIONS, THAT PHYSICIANS HAVE TO DO WITHIN THE OFFICE
ITSELF. SORT OF, PRIMARY CARE, SORT OF
A DIFFERENT BALLGAME. THERE HAS BEEN DISCUSSION
ABOUT THOSE SPECIALTY MEDICATIONS THAT NEED TO BE
ADMINISTERED ESPECIALLY BY A PHYSICIAN IN THE OFFICE.
HOW THOSE ARE PRICED. AND WHETHER PHYSICIANS GET A
FEE FOR ADMINISTERING THEM. BUT ON TOP OF ALL OF THAT,
ACTUALLY IS A WEBSITE WHERE YOU CAN LOOK UP WHETHER YOUR
PARTICULAR DOCTOR HAS RECEIVED ANY SORT OF FUNDING FROM THE
PHARMACEUTICAL COMPANY, FROM SOMETHING AS SIMPLE AS WHETHER
THEY HAD A FREE MEAL PAID FOR, ARE THEY ON THE SPEAKER’S
BUREAU, DO THEY RECEIVE A FEE FOR THAT, OR DO THEY GET, ARE
THEY DOING RESEARCH FUNDED BY IT?
OPEN PAVEMENTS.GOV. I BELIEVE THAT WEBSITE.
TYPE IN YOUR DOCTOR’S NAME AND LOOK FOR T I CHECK MY NAME
REGULARLY. CLINIC ACTUALLY, I KNOW I
HAVEN’T DONE ANYTHING. BUT I SERVE ON THE NATIONAL
TASK FORCE. I HAVE TO CHECK IT.
ACTUALLY, OUR CLINIC HAS A POLICY OF NOT GETTING FREE
MEALS FROM PHARMACEUTICAL COMPANY.
WE APPRECIATE THE EDUCATION BUT WE DON’T FEEL LIKE IT HAS
TO BE LINKED TO ANYTHING THAT IS A FINANCIAL DOLLAR ATTACHED
TO IT. 26>>Yunji: IT’S DIFFICULT FOR
MANY DOCTORS TO MAKE THAT CHOICE THOUGH.
ISN’T IT? SEEMS LIKE SOME STRUGGLE
BECAUSE, YOU KNOW, IT’S A BIGGER QUESTION OF WHETHER
SOMETHING COMES ON MARKET. NEW DRUGS DEVELOPED ALL THE
TIME. AS PHYSICIANS WE WANT TO STAY
ON TOP OF THINGS AND HOW THINGS WORK.
HOW WE DO THAT AS A NATION TO UNDERSTAND HOW NEW DRUGS WORK,
WHETHER IT’S WORTH THE COST, DIFFERENT FROM OLDER LESS
EXPENSIVE DRUG THAT MIGHT WORK JUST AS WELL, THAT’S A VERY
SEPARATE, VERY GOOD QUESTION ABOUT HOW WE KEEP ON TOP OF IT
BOTH AS PHYSICIANS AND PATIENTS AS WELL.
FASCINATING TO KNOW WHETHER YOUR DOCTOR HAS HAD ANY OF
THESE BENEFITS. KEEPING TRACK OF A LAWMAKER.
I DON’T KNOW THAT ANY OF US WOULD TAKE THE TIME DO THAT
AND THEN, AS A PATIENT, WOULD YOU DO THAT?
WOULD YOU LIKE TO RESEARCH YOUR DOCTOR?
>>I HAVE IN THE PAST. MY FATHER WAS INVESTIGATOR FOR
THE FOOD AND DRUG ADMINISTRATION.
SO I HAPPEN TO KNOW THAT IN THE LAST TEN OR 15 YEARS, NEW
LAWS WERE INTRODUCED REGULATING WHAT TYPE OF GIFTS
AND HOW THE GIFTS CAN BE GIVEN BY THESE PHARMACEUTICAL
COMPANIES TO TRY MAKE IT NOT SUCH A DIRTY PROFIT DRIVEN
BUSINESS. BUT CLEARLY, THOSE REGULATIONS
HAVEN’T HELPED THE UNDERLYING PROBLEM.
>>Yunji: THERE’S SOME 27 INTERESTING QUESTIONS, I THINK
THIS IS PROBABLY FOR YOU, JESSICA.
I DON’T THINK THIS IS THE CASE.
ONE QUESTION, ONE CALLER ASKING, IS THE UNITED STATES
THE ONLY COUNTRY THAT HAS FOR PROFIT PRESCRIPTIONS?
WE TALK ABOUT COUNTRIES, DRUG MAKERS SELLING PRESCRIPTIONS
IN OTHER COUNTRIES, MEDICAL COMPANIES ARE MAKING MONEY.
>>ABSOLUTELY. YEAH.
THEY’RE MAKING MONEY EVERYWHERE.
>>MAKING LESS.>>THEY’RE MAKING A LOT OF
MONEY IN THE UNITED STATES. I THINK THAT IS ONE OF THE
QUESTIONS THAT AMERICANS SHOULD HAVE FOR CONGRESS.
OUR GOVERNMENT. OFFICIALS.
GOT TO CHANGE THIS.>>ON THAT POINT, ANDREW,
PERHAPS FOR YOU DOCTOR, ARE THE U.S. DRUG CONSUMERS
SUBSIDIZING OTHER COUNTRIES THAT NEGOTIATE LOWER PRICES
WITH DRUG COMPANIES FOR THE SAME DRUGS?
IN OTHER WORDS, IF THE CONSUMERS IN CANADA ARE PAYING
LESS, IS THAT ON THE BACKS OF US?
>>COMMON REFRAIN I HERE IN THIS POLITICAL CLIMATE.
>>Yunji: IS THAT THE CASE?>>I DON’T THINK IT’S DIRECTLY
THE CASE. WHAT HAPPENS IS A LOT OF NEW
DRUGS THAT GET PRODUCED AND RELEASED, A LOT OF IT IS
THROUGH THE U.S. AND BIGGEST MARKET IS U.S.
WE HAVE FREE MARKET HERE. SO THE OTHER COUNTRIES KIND OF
BENEFIT FROM THAT BECAUSE VERY 28 THAT INNOVATION AND ALLOW FOR
THAT INNOVATION. SO ONCE THE DRUGS ARE APPROVED
HERE, THEY WILL BE ABLE TO GET THEM CHEAPER.
IF THEY GET GO TO OTHER COUNTRIES, THEY MIGHT BE ABLE
TO USE THE SAME DRUG AND GET IT FROM THE MANUFACTURER AT A
LOWER PRICE BECAUSE THEY DON’T MAYBE KIND OF WANT TO FOLLOW
UP ON THAT. I THINK MOST OF US HERE WOULD
SAY, WE WANT PHARMACEUTICAL COMPANIES TO DO RESEARCH,
PRODUCE BETTER DRUGS, NOBODY IS ARGUING WITH THAT.
WHAT WE WANT IS ALSO FOR THOSE DRUGS TO BE AFFORDABLE.
IT SHOULDN’T FIND ON WHETHER YOU’RE A DIABETIC WITH MONEY
OR DIABETIC WITHOUT MONEY OR CANCER PATIENT WITH MONEY OR
CANCER PATIENT WITHOUT MONEY. IT SHOULDN’T DEPEND ON WHETHER
YOU LIVE IN CANADA OR U.S. OR SOME OTHER COUNTRY.
THE MAJOR PHARMACEUTICAL COMPANIES, SOME ARE UNITED
STATES AND OTHER COUNTRIES LIKE ISRAEL AND EUROPE, HAVING
SAID THAT, FOR THE UNITED STATES, OUR GOVERNMENT FUNDS A
LOT OF RESEARCH AND SO THERE HAS BEEN A QUESTION OF WHEN WE
FUND RESEARCH TO HELP PHARMACEUTICAL COMPANIES
DEVELOP DRUGS OR THAT HELPED PHARMACEUTICAL BENEFIT FROM
THE RESEARCH, WHAT DO WE GET BACK FROM IT?
AS A COUNTRY, WHY ARE HE PAYING THE MOST PRICES?
THAT SORT OF NEGOTIATION, WE CAN UNDERSTAND IF IT’S AT A
COUNTRY LEVEL. IT SHOULD NOT BE AT THE
PATIENT LEVEL. IT SHOULD NOT BE AT THE
PHYSICIAN LEVEL, TRYING TO 29 NEGOTIATE THOSE PRICES.
WE’RE STARTING TO QUESTION SHOULD IT EVEN BE AT THE
HEALTH PLAN LEVEL DEPENDING ON WHETHER YOU HAPPEN TO SIGN UP
FOR ONE PLAN OR ANOTHER. STATES ARE STARTING TO SAY,
SHOULD WE GET INTO THIS GAME OF NEGOTIATING ON A STATE
LEVEL? WE AT MEDICARE AREN’T EVEN
NEGOTIATING AT THE MEDICARE LEVEL.
BUT THE MEDICAID, FOR LOW INCOME PEOPLE, WE ARE.
FOR THE VA, VETERANS, ASSOCIATION, WE ARE.
I THINK IT’S VERY IMPORTANT TO HAVE THOSE DISCUSSIONS.
I’M NOT EVEN LEGISLATOR OR — BUT CAN I SAY WHEN I SEE MY
PATIENTS COME IN, IF THEY CAN’T AFFORD SOMETHING, AND
I’M SPENDING A LOT OF TIME FIGHTING FOR THAT, I’LL BE
HONEST, I THINK IT’S TIME PHYSICIANS, MANY PHYSICIANS
ARE STARTING TO SPEAK UP AS WELL.
WE NEED TO KEEP THIS–>>IF YOU DON’T WANT TO
NECESSARILY HAVE YOUR DOCTOR, I MEAN, I WOULD LOVE THE IDEA
OF BEING ABLE TO LOOK UP THE DRUG, SEE THE PRICE, AND THEN
HAVE THAT DISCUSSION. ON THE OTHER SIDE, I DON’T
NECESSARILY WANT THAT TO BE PART OF THE CONVERSATION WHEN
IT COMES TO MY PRESCRIPTIONS FOR MY HEALTH CARE.
WHAT I WANTED TO SAY, QUESTION, USED TO BE A FEW
YEARS AGO, YOU COULDN’T EVEN FIND OUT WHAT DOCTORS WERE
GETTING. IT WASN’T EVEN OPEN OR
TRANSPARENT. THERE WAS LEGISLATION PASSED
TO SAY, IT SHOULD BE OPEN AND 30 TRANSPARENT.
SO THAT NOW, PHARMACEUTICAL COMPANIES HAVE TO REPORT ON A
DOCTOR LEVEL WHO IS GETTING WHAT.
I’M NOT SAYING YOU NEED TO GO AND DO RESEARCH ON YOUR
DOCTOR, BUT I AM SAYING IT IS GOOD POLICY THAT
PHARMACEUTICAL COMPANIES HAVE TO BE OPEN, TRANSPARENT ABOUT
WHERE THAT MONEY IS GOING. I THINK AS A PHYSICIAN, HEALTH
CARE PROVIDER, WE HAVE TO BE TRANSPARENT WITH OURSELVES.
WHAT WE WANT TO BE EDUCATED, DOESN’T NEED TO COME WITH A
FREE MEAL. WHAT WE WANT TO GO EDUCATE
OTHER PEOPLE DO, WE NEED A CONSULTING FEE?
>>I JUST LIKE TO SAY THAT I RECENTLY NOTICED THAT THE
UNITED STATES CONGRESS, HOUSE OF REPRESENTATIVES, HELD
HEARINGS, ON THE VERY SUBJECT OF THE RISE IN INSULIN COSTS
AFTER ALL OF THE THINGS IN THE MEDIA, YOUNG MAN WHO LOST HIS
INSURANCE PLAN ANDYED, RATIONING INSULIN.
MY HOPE FROM A NATIONAL PERSPECTIVE, IS THAT WE COULD
GET TO ONE LITTLE PIECE OF LEGISLATION THAT WOULD ADDRESS
THIS ONE LITTLE SLICE OF THE HEALTH CARE PRESCRIPTION DRUG
CONUNDRUM AND THAT, WITH INSULIN AS THE POSTER CHILD
FOR THE REASONS I’VE ALREADY STATE, WOULD THEN TRIGGER SOME
TYPE OF FORWARD THINKING AND ADDRESSING ALL PRESCRIPTION
MEDICATIONS AND HOW IT FACTORS INTO OUR HEALTH INSURANCE
MARKET, AFFORDABLE CARE ACT, WHATEVER WE’RE GOING TO DO TO
MAKE IT MORE AFFORDABLE. BUT THEN OTHER THING I THOUGHT
ABOUT IS IF I WERE WATCHING 31 THE SHOW RIGHT NOW, I WOULD
WANT TO CALL IN AND ASK A QUESTION TO OUR PHARMACY
MEMBER BECAUSE I REMEMBER WHEN I HAD HMSA, PPO, AND I HAD A
INSULIN PUMP THAT WAS WIRELESSLY CONNECTED TO MY
GLUCOMETER, SO I PEDIATRIC MY FINGER, PUT A DROP OF BROOD ON
THE TRIP STRIP. ME MY BLOOD SUGAR.
ASK ME, HOW MUCH INSULIN DO YOU WANT ME TO GIVE YOU BASED
ON BLOOD SUGAR. PRICE OF THOSE TEST STRIPS RUN
THERE WITH INSULIN. OVER A DOLLAR A STRIP.
IF YOU BUY 100 STRIPS AND YOU NEED TO BE UNDER GOOD CONTROL
AND STUDIES HAVE SHOWN, DIABETICS TEST THEIR BLOOD
SUGAR MORE TIMES ARE UNDER BETTER CONTROL.
SHOWN OVER AND OVER AGAIN. SO IF YOU TAKE IT UPON
YOURSELF TO PRICK YOUR FINGER FIVE TO TEN TIMES A DAY, OVER
A DOLLAR A STRIP. DO THE MATH.
WHEN I WENT TO THE PHARMACY IN HAWAI’I, FOR THE FIRST TIME,
11 YEARS AGO, AND I HAD MY HMSA PPO, I WENT UP TO BUY MY
HUGE PRESCRIPTION OF STRIPS BECAUSE I TESTED MY BLOOD
SUGAR A LOT. CHARGE, COPAY WAS ZERO.
HMSA DOESN’T CHARGE THEIR DIABETIC PATIENTS FOR TEST
STRIPS. THEY’RE FREE.
IF YOU HAVE HMSA PPO. WELL, IF YOU DON’T HAVE THE
TEST STRIPS, YOU CAN’T TELL YOUR INSULIN PUMP OR DIAL UP
YOUR INJECTION AND TAKE THE INSULIN YOU NEED BECAUSE IT’S
BASED ON YOUR BLOOD SUGAR LEVEL.
THAT’S WHY THEY MADE THE TEST 32 STRIPS FREE.
SO THAT PEOPLE WOULDN’T HAVE TO GUESS AND PEOPLE COULD HAVE
BETTER CONTROLLED DIABETES. WELL, THE NEXT STEP FOR HMSA
IN THE STATE OF HAWAIʻI IS TO MAKE INSULIN FREE.
NO CHARGE. AND THEN WE WON’T EVEN HAVE TO
DISCUSS THE PROBLEM ABOUT PEOPLE HAVING TO RATION
INSULIN. RATIONING STRIPS OR RATIONING
INSULIN, REALLY RATIONING FOOD.
AND I THINK EVERYONE IN THIS SOCIETY AGREES.
THERE’S ENOUGH FOOD TO GO AROUND IF YOU KNOW WHERE TO
GET IT.>>Yunji: WHAT ABOUT THAT
TACTIC ABOUT ADDRESSING SPECIFIC ISSUE, SPECIFIC
DISEASE LIKE DIABETES AS OPPOSED TO TAKING ON THE WHOLE
PRESCRIPTION DRUGS AS A WHOLE? THE CONCERN THEN IS THAT
CERTAIN DRUGS JUST DON’T GET TO BE INCLUDED BUT WE ARE
TALKING ABOUT MILLIONS OF AMERICANS.
>>GREAT IDEA. I WANT TO EMPHASIZE THERE ARE
EFFORTS RIGHT NOW, LIKE THE SENATE JUST TODAY PASSED
THROUGH IMPORTANT COMMITTEE CREATE THAT.
SO THAT IS ONE PIECE OF LEGISLATION THAT COULD REALLY
MAKE A DIFFERENCE HERE. BUT THE DEVIL IS IN THE
DETAILS. THAT’S WHY IT’S CRITICAL FOR
US TO RAISE THESE ISSUES RIGHT NOW TO SPEAK TO OUR
LEGISLATORS, AT THE FEDERAL LEVEL, AND STATE LEVEL.
BECAUSE WE HAVE TO TAKE ACTION IN BOTH AREAS.
SO I THINK THAT’S A REALLY 33 INTERESTING PROPOSITION.
AND GIVEN WHAT WE KNOW ABOUT INSULIN, AND THE PRICE OF
INSULIN, I THINK IT’S A GREAT CONVERSATION.
STATISTICS WE HAVE ARE FROM 2015, ONE YEAR, THE PRICE WENT
UP 20%. THERE’S NO REASON.
PEOPLE NEED IT. AND THEY KNOW PEOPLE NEED IT.
GOING TO PAY FOR IT. WE’VE GOT TO START ASKING
THOSE TOUGH QUESTIONS AND NOT JUST TAKING IT.
GOT TO INSIST THAT OUR LEADERS TAKE ACTION.
>>Yunji: BOB IN HAWAIʻI KAI WOULD LIKE TO KNOW, WHAT WOULD
BE THE EFFECT ON PRICE, WHAT WOULD BE THE EFFECT ON PRICE
OF DRUGS FROM A SINGLE PAYOR SYSTEM AS ADVOCATED BY BERNIE
SANDERS AND SOME OTHERS IN THE DEMOCRATIC PARTY RIGHT NOW?
LOVE TO OPEN THAT UP TO ANY OF YOU.
HARD TO KNOW LIKE YOU SAID, DEVIL IS IN THE DETAILS.
WHAT THAT SINGLE PAYOR SYSTEM WOULD LOOK LIKE.
IS THAT SOMETHING THAT WOULD HELP?
>>IT COULD POSSIBLY HELP. IN OTHER COUNTRIES HAVE SINGLE
PAYOR SYSTEMS, COST OF MEDICATIONS IS QUITE A BIT
LOWER. WHAT IT WILL DO THOUGH IS
LIMIT THE TYPES OF MEDICATIONS PEOPLE CAN GET.
SO ABILITY TO CHOOSE OR SELECT BETWEEN DIFFERENT MEDICATIONS
WILL BE NARROWED DOWN AND EVERYBODY WOULD HAVE THE SAME
ACCESS TO THE SAME TYPES OF MEDICATIONS.
>>HOW DO WE KNOW THAT?>>BECAUSE THAT’S WHAT GOES ON
IN OTHER COUNTRIES THAT HAVE 34 THESE TYPES OF MEDICATIONS.
TYPES OF SOCIALIZED MEDICINE. ONE-PAYOR SYSTEM, GOING TO
ONLY CONTRACT WITH CERTAIN MANUFACTURERS TO GET THE BEST
COST FOR THE MEDICATION. SO IT WILL LIMIT THE AMOUNT
THAT THE TYPES OF MEDICATIONS THAT YOU ARE GOING TO GET.
YOU’RE NOT GOING TO — UNLESS YOU WANT TO PAY FOR DIFFERENT
TYPES OF MEDICATION. PROBABLY HAVE TO FEATURE WHERE
YOU CAN PAY OUT OF POCKET. WHICH IS THE SAME CASE NOW.
IF YOUR INSURANCE DOESN’T COVER MEDICATION, YOU’RE STILL
ABLE TO GET THE MEDICATION YOU JUST HAVE TO PAY OUT OF POCKET
FOR THAT.>>OR POTENTIALLY, IN MY CASE,
HAVE YOUR PHYSICIAN LOBBY THE SINGLE PAYEE TO GIVE YOU THE
MEDICATION THAT MAY BE MORE EXPENSIVE BUT MORE EFFICACIOUS
FOR YOUR PARTICULAR CASE.>>YES, DEFINITELY, IF YOU’RE
HAVING PROBLEMS WITH THE MEDICATION, YOU CAN ALWAYS
REQUEST WHAT’S CALLED PRIOR AUTHORIZATION TO SEE IF THERE
IS ALTERNATIVES THAT YOU CAN SELECT.
>>I’M SURE THAT TYPE OF OPTION WOULD BE AVAILABLE
BERNIE SANDERS PLAN.>>WE DON’T KNOW.
EXACTLY. WHICH IS MY INITIAL QUESTION.
HOW DO YOU KNOW?>>YOU DON’T KNOW AT ALL.
>>THINK POINT IS OTHER COUNTRIES THAT HAVE NATIONAL
HEALTH INSURANCE AND WE’RE NOT THE ONLY COUNTRIES STRUGGLING
WITH THIS AS WELL.>>WHOLE DRUG RACKET IS
NOTHING MORE, DENNIS IN HONOLULU.
WHOLE DRUG RACKET IS NOTHING 35 MORE THAN CRIMINAL EXTORTION.
INDUSTRY NEEDS HEAVY PROFIT REGULATION.
ALL DRUG ADVERTISING SHOULD BE ELIMINATED.
WE HAVEN’T TALKED ABOUT THAT PIECE.
THAT IS THE TREMENDOUS AMOUNT OF MONEY THAT DRUG MAKERS ARE
SPENDING ON ALL THOSE ADS THAT WE SEE IN MAGAZINES AN ON
TELEVISION. HOW MUCH OF THAT INFLUENCE
COST OF MEDICATION?>>WELL, I DON’T THINK WE KNOW
EXACTLY. WHAT I KNOW, THEY’RE SPENDING
MORE ON MARKETING AND ADVERTISING THAN RESEARCH WE
HAVE GENERAL NUMBERS. THERE’S A PROBLEM BECAUSE
THEY’RE SPENDING A LOT OF MONEY MARKETING, A LOT OF —
DIFFERENT TYPES OF DRUGS AS WELL.
SO IT DEPENDS ON WHAT YOUR DOCTOR IS PRESCRIBING, AND
WHAT YOUR MEDICAL CONDITION IS.
BUT SOME OF THE BRAND DRUGS ARE EXTREMELY EXPENSIVE.
PEOPLE NEED TO TAKE THEM.>>Yunji: WE ONLY HAVE A FEW
MINUTES LEFT. I WANT TO SORT OF DIAL IT
DOWN. WE WERE SORT OF AT THE
30,000-FOOT LEVEL. AS A PATIENT WHO IS NAVIGATING
THIS, IF YOU ARE PRESCRIBED NEW MEDICATION OR HAVING THAT
CONVERSATION YOUR DOCTOR, WHAT DO YOU ADVISE?
HOW DO WE INCLUDE THIS SO THAT IF YOU’RE NOT SHOCKED WHEN YOU
GET TO LONG’S OR WHEREVER YOU MAY FILL YOUR PRESCRIPTION.
>>I THINK THE FIRST THING, AGAIN, I’LL GO BACK TO, MAIN
MESSAGE AT THE BEGINNING. 36 COMMUNICATION.
EVERY RIGHT TO TELL YOUR HEALTH CARE PROVIDE, FAMILY
DOCTOR OR PRIVATE CARE DOCTOR OR SPECIALIST, TO EVEN JUST
START THE CONVERSATION, DO YOU KNOW HOW MUCH IT WILL COST?
THEN IF IT’S TOO MUCH, OR EVEN IF IT’S JUST COSTING QUITE A
BIT, SAY I CAN FORWARD IT OR THIS HARD ON ME.
JUST GET THAT CONVERSATION GOING.
THEN FROM THE PHYSICIAN’S SIDE, CHECK IN WITH YOUR
PATIENT. SEE HOW IT IS.
WE UNDERSTAND IT’S HARD TO FIGURE OUT WHAT’S COVERED.
HARD TO FIGURE OUT THE COST. WAY WORSE WHEN IT BEATS NOT
TAKING THE MEDICATION OR TRYING TO CUT BACK ON IT.
THAT AND TALK TO YOUR LEGISLATORS.
OR YOUR PHARMACIST.>>Yunji: WHEN YOU ARE AT THE
PHARMACY COUNTER, THERE MIGHT ABE FEELING THAT YOU’RE KIND
OF YOU’RE TOO LATE. ARE YOU?
>>TOO LATE FOR? NO, I THINK YOU GET THE COST
OF YOUR MEDICATION, YOU REALIZE THAT’S TOO EXPENSIVE,
ASK TO SPEAK TO THE PHARMACIST.
SEE IF THERE’S ALTERNATIVES THAT MIGHT BE AT LOWER COST.
THEY CAN CONTACT YOUR PHYSICIAN AND SEE IF THEY
WOULD BE WILLING TO MAKE A CHANGE OR EVEN JUST WRITING
DOWN THE NAMES OF THE MEDICATIONS AND YOU CAN AS A
PERSON CAN CONTACT YOUR DOCTORS TO SEE IF THERE IS
ALTERNATIVES. OF COURSE, IN HIS CASE,
INSULIN WORK DIFFERENTLY. 37 BUT THERE ARE SOME THAT YOU
CAN GET ACTUALLY OVER THE COUNTER IS THAT ARE AT LOWER
COST AT DIFFERENT PHARMACIES AS WELL.
SO PHARMACISTS CAN HELP WITH PROVIDING SOME ALTERNATIVES AS
WELL THAT MIGHT BE CHEAPER.>>I’M GOING TO SECOND THAT.
NEVER REALLY TOO LATE. PHARMACISTS, I’VE SPENT MORE
TIME THAN I WOULD LIKE SOMETIMES, PHARMACISTS AND
PHYSICIANS, WE WORK REALLY STRONGLY AS A TEAM.
WE GET THAT THEY ARE FIRST LINE WHEN YOU GO AND GET YOUR
MEDICATIONS ON HOW TO USE THEM AND HOW MUCH IT COST.
WE WANT THAT FEEDBACK. WE DON’T LIKE HAVING TO DOWELL
AT EXTRA WORK TO TRY TO FIGURE IT OUT.
JUST COMPLETELY INVALUABLE PART OF THE TEAM TO HELP THE
PEOPLE WE TAKE CARE OF. IT IS NOT TOO LATE.
>>Yunji: I KNOW THAT YOU ARE ENCOURAGING PEOPLE TO SHARE
THEIR STORIES.>>AARP.ORG/RX.
>>Steve: I WANT TO GIVE YOU THE LAST WORD TONIGHT.
WHY IS THIS SO IMPORTANT?>>REALLY IMPORTANT TO ME.
I WANT TO GO BACK TO THE.>>Guy: WHO RANG IN WITH
WAIKIKI ABOUT THE CRIMINAL EXTORTION.
WHAT’S IMPORTANT TO ME IS THAT EVERYONE SEE THE TRUE BIG
PICTURE. THIS IS A FOR PROFIT
SITUATION. THE FACT MADE BY JESSICA THAT
COMPANIES ARE SPENDING MORE ON ADVERTISING THAN THEY ARE ON
RESEARCH AND DEVELOPMENT MAKES PERFECT SENSE IN THE CASE OF
DIABETES. 38 I REPRESENT 40,000 PEOPLE
EVERY YEAR WHO WILL BE PAYING OUTRAGEOUS PRICES FOR INSULIN.
AND THEY HAVE NO CHOICE ABOUT YOU TO PAY THOSE PRICES TO
PRESERVE THEIR LIFE. SO WHY WOULD I EVER CONDUCT
RESEARCH TO CURE THAT DISEASE? IT IS SO MUCH PROFIT AND
GUARANTEED 40,000 AT LEAST EVERY YEAR HAS TO BUY THAT
INSULIN. AND THIS INSULIN WHOSE PRICE
HAS GONE UP 300%, SINCE 2001, IS A CASH COW FOR LACK OF,
THEY USED TO USE COWS. IT’S A CASH COW FOR LACK OF A
BETTER TERM. REMEMBER, THE INVENTERS OF
INSULIN DIDN’T EVEN WANT TO PATENT IT BECAUSE THEY THOUGHT
THAT NO ONE SHOULD EVER PROFIT OFF OF INSULIN AND THE TWO
SCIENTISTS OF THE THREE WHO DID AGREE TO MAKE THE PATENT,
SOLD IT FOR 1 CANADIAN DOLLAR. YEAH, THEY WERE CANADIAN.
WHERE THEY GET THEIR INSULIN FOR REALLY CHEAP.
>>Yunji: THANK YOU FOR JOINING US AGAIN.
EMPHASIZE WE DID INVITE REPRESENTATIVES OF THE
PHARMACEUTICAL COMPANIES TO JOIN US TONIGHT.
BUT THEY DECLINED THAT INVITATION.
THANK YOU FOR JOINING US TONIGHT.
WE ALSO THANK OUR GUESTS. JESSICA WOOLEY, ADVOCACY
DIRECTOR FOR AARP HAWAI’I CAMLYN MASUDA, DOCTOR OF
PHARMACY. CHIEN-WEN TSENG FAMILY
PHYSICIAN. AND
EMILE SLOBODA, DIABETIC PATIENT.
INSIGHTS WILL TAKE A BREAK 39 NEXT THURSDAY FOR THE JULY 4TH
HOLIDAY BUT WILL BE BACK THE FOLLOWING WEEK FOR A
DISCUSSION ON INDIGENOUS AGRICULTURE AND HOW IT CAN
CONTRIBUTE TO FOOD SUSTAINABILITY. JOIN US THEN.
I’M YUNJI DE NIES FOR INSIGHTS ON PBS HAWAI`I – A HUI HOU!


One thought on “INSIGHTS ON PBS HAWAIʻI: High Cost of Prescription Drugs | Program

  1. The patient here was the one who spoke the truth about the issues. The Pharmacy Benefit Managers (PBMs – Optum RX CVS Caremark and Express Scripts) are a major part of the issues. AARP receives a lot of money from United Healthcare who owns Optum RX, a PBM. PBMs can get greater compensation for higher cost drug. This benefits both the manufacturer and the PBM. Both do not want the rebates/discounts to end but the PBM has no obligation to pass these onto the patient.

    It is time for PBMs and drug manufacturers both to be held accountable.

    Also, sometimes it is cheaper to pay cash vs use insurance. If a physician can access patient insurance information, they may, sometimes, unfortunately, direct the patient to the insurance company's PBM owned mail-order/retail. Due to PBMs not passing on their negotiated discounts to the patient at the pharmacy counter/mail-order, this can actually cause the patient with a high deductible health plan to pay 100% of the costs as seen here in this news report by PBS why a patient paid $285 copay for a $40 drug. https://www.pbs.org/newshour/health/why-a-patient-paid-a-285-copay-for-a-40-drug

    Mail-order is risky. In America, we shouldn't have to go to Canada to get meds. We shouldn't have to use Good RX when we pay outrageous cost already for insurance coverage. We should be able to get our medications at an affordable price from the hands of our trusted pharmacists, not the PBM owned retail and life-threatening mailorder. PBMs are causing the greatest decline in our pharmaceutical care far and beyond just drug prices. PBMs have created a drug access issue.

    PBMs are greedy. Mail-order is far from what is the best options for the patients.

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