30 Apr 2004

Government's website shows Canads still much cheaper then the NEW DRUG DISCOUNT CARDS.

WASHINGTON, April 29 -- The government on Thursday activated a Web site documenting wide variation in prices for scores of prescription drugs at thousands of pharmacies around the country.

In many cases, the prices offered to Medicare beneficiaries, with the help of new drug discount cards, appear similar to the prices available to any consumer using online pharmacies.

Indeed, consumer advocates and Democratic members of Congress said the prices available with the new Medicare cards were often higher than those charged by online pharmacies or Canadian drugstores, or paid by federal and state agencies.

When the Web site began working at 1:35 p.m., Medicare officials released a blizzard of detailed data not previously available to the public. By entering a ZIP code and the names of specific drugs, consumers can learn the prices charged at local pharmacies or through the mail.

Some disparities appeared startling. The Web site, www.Medicare.gov , indicates that a beneficiary can buy a month's supply of Zocor, in 20 milligram tablets, for $101.92 with one discount card, and for $257.96 with another card, at the same Costco pharmacy in Las Vegas. Zocor is used to reduce cholesterol.

The Web site is intended to help Medicare beneficiaries choose a drug discount card, but anyone can use the site. People who are not comfortable using the Internet can call a toll-free telephone number, 800-MEDICARE (633-4227), to obtain the same type of information, which will be sent to them in leaflets listing prices for the drugs they use.

A Medicare beneficiary would find that the prices for 30 10-milligram tablets of Lipitor, another cholesterol-lowering agent, range from $67.07 to $78.53 at retail pharmacies in downtown Washington.

Prices were in the same range at drugstores in other places, for example, Waterloo, Iowa; Itta Bena, Miss.; and Los Angeles. The charge for a 90-day supply of Lipitor bought by mail ranged from $183.71 with a Walgreen's discount card to $207.45 with an RxSavings card distributed by Reader's Digest.

By contrast, a consumer who ordered from drugstore.com, without a Medicare discount card, would pay $62.99 for 30 tablets of the same drug and $183.97 for a 90-day supply, plus a few dollars for shipping and handling.

The Web site automatically displays the total cost, under different discount cards, for any combination of drugs that a beneficiary might request. At pharmacies in the South Bronx, for example, the cost for a 30-day supply of three commonly prescribed drugs, Celebrex, Fosamax and Norvasc, ranges from $161.19 to $209.14. Federal officials and consumer advocates said they hoped that public knowledge of such disparities would drive down prices.

Drug card sponsors may "try to match each other's discounts," said Bonnie Burns, a policy specialist at California Health Advocates.

For many sponsors, the Web site says: "Currently no information available. Please check back later."

Tommy G. Thompson, the secretary of health and human services, said in December that the cards would enable beneficiaries to save "10 percent to 25 percent on their total drug spending, with discounts up to 25 percent or more on individual drugs."

But after analyzing the data on Thursday, Representative Henry A. Waxman, Democrat of California, said, "The prices available with the new Medicare cards are far higher than the prices available in Canada and the prices negotiated by the federal government on the Federal Supply Schedule, and are no lower than the prices currently available to individuals who do not have the cards."

Medicare beneficiaries can sign up starting next week and can use the cards from June of this year until January 2006, when Medicare's new prescription drug benefit begins.

The Bush administration estimates that 7.3 million elderly and disabled people will sign up for the cards, and it predicts that 4.7 million of them will have incomes low enough to qualify for extra assistance, a $600 credit.

Individuals may be eligible for the credit if their annual incomes are no more than $12,569. Couples may qualify if their income does not exceed $16,862. All Medicare beneficiaries, except those who have Medicaid drug coverage, can obtain cards.

The cards, like other features of the new Medicare law, have provoked furious political debate.

The House Republican Conference is urging Republican lawmakers to publicize the drug cards and to help constituents sign up. For example, it said, House Republicans should invite drug card sponsors to public meetings with Medicare beneficiaries, and lawmakers should consider making "stump speeches" at these "drug card fairs."

Moreover, it said, members of Congress should highlight the benefits by sending mail to low-income elderly people, by recording radio announcements and by submitting opinion articles to newspapers.

But Democrats were skeptical. "Even with the discount cards, drugs will be more expensive in the United States than in Canada and Europe," said Representative Rahm Emanuel, Democrat of Illinois.

Representative Sherrod Brown, Democrat of Ohio, said that drug price increases would erode the value of the discounts. "When a drug company inflates the price of a drug by 33 percent," Mr. Brown said, "a 10 or 15 percent discount is not a price break. It's an insult."

By ROBERT PEAR and MILT FREUDENHEIM
NYTimes, April 30, 2004

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