"Free Enterprise" Help for
drug industry is surely celebrating California voters' decision
to reject both of the special election's drug discount measures
this week. It poured $80 million into this state election,
and its trade association noted that a major motivation
was to "preserve the free enterprise system"-presumably
one in which companies are free to decide how much and in
what ways to help low-income people who cannot afford the
retail price of their medications.
the drug industry now ready to invest another $80 million
in our state-this time on activities that help vulnerable
Californians instead of campaign consultants? Here are a
few steps these companies can take to truly help uninsured
and underinsured patients.
and improve their charitable programs, instead of merely
promoting them. Medicine for People in Need (Medpin),
a project of the nonprofit Public Health Institute, operated
a three-year program that distributed $170 million worth
of medications to uninsured Californians. This program
was transparent, predictable, and consistent-the very
features that nonprofits have for years requested from
the drug companies' charitable programs. The industry
should build on lessons learned from this effort to make
its charitable programs more accessible and valuable to
needy patients and their health care providers.
report verifiable data that provides specific information
on how companies' charitable programs actually help people.
This is especially important for California, because evidence
suggests that our uninsured residents are less likely
than other states' to be helped by companies' free-drug
to the realities of the new Medicare drug coverage.
Many drug companies are preparing to end or curtail their
charitable programs for Medicare patients. Unless these
companies work with independent nonprofits to ensure that
their programs complement Medicare's new prescription
drug coverage, many elderly, blind, and disabled patients
will be seriously disadvantaged when Medicare drug coverage
evidence-based assessments of newly approved drugs.
Ironically, many low-income patients with chronic conditions
are treated with high-priced new drugs, courtesy of the
industry's charitable programs and the free samples distributed
to providers. This may work well as long as the samples
and charity lasts, but once a company's marketing campaign
ends (along with its free samples) and its voluntary charity
is curtailed, what happens to those patients? Drug companies
should support efforts by Medicaid agencies and health
care providers to stabilize low-income patients from the
outset on medicines selected through an evidence-based
process to be the best and most cost-effective.
Drug companies must
answer to different and sometimes competing priorities, including a responsibility
to shareholder profits and a moral commitment to sustain charitable programs.
The industry is both a beneficiary of government's patent protections and
a critic of increasing government's role in facilitating discounts for lower-income
groups. It's uncertain where a free-enterprise approach to expanded discounts
fits into that mix. But with the distraction of the two ballot initiatives
now behind us, our public officials should now work effectively with health
care groups and the drug industry to craft a program that truly helps Californians