Esther Beaudoin has struggled with arthritis since she was young, and she’s had two back surgeries just in the last two years. She also has thyroid problems and high blood pressure. To keep going, she needs 10 to 12 prescription drugs, from Synthroid, to Plavex, to Nexium.
A widow on Social Security, Beaudoin, 70, of East Providence, has little money to begin with, and every month, her medications were costing her over $2,000.
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Then her daughter Kim saw an ad for RxforRI, a program sponsored by the nation’s pharmaceutical companies to help eligible consumers get free and reduced-price drugs.
Beaudoin called, expecting it to be a waste of time.
“I was absolutely surprised,” she said. One by one, an attendant took down the names of her medications and found programs that would provide most of them for free. To help with the cost of her painkillers, the woman told her how to get a Medicare drug discount card.
It took some work – Beaudoin had to fill out several forms, and wait for approval – but since last year, most of her medications have come in the mail, free of charge.
“I’ve saved loads and loads of money,” she said.
Beaudoin, who RxforRI promoters estimate is saving about $5,400 per year, is one of over 32,000 Rhode Islanders who have called the program’s toll-free number or used its Web site, RxforRI.org, to connect with drugmakers’ patient assistance programs in the last year.
It’s unclear how many actually got prescription drugs; over 18,000 were told they appeared to be eligible for at least one program and given the applications, according to Mark Grayson, a spokesman for the Pharmaceutical Research and Manufacturers of America (PhRMA), but nobody’s keeping track of how many of those people end up getting medicines.
What PhRMA does know is that last year, when RxforRI and a handful of similar programs were launched across the United States, use of patient assistance programs hit a new record: 22.1 million prescriptions with a wholesale value over $4.17 billion, up from 18 million prescriptions valued at $3.4 billion in 2003. (For perspective, U.S. pharmaceutical sales in 2004 were $251 billion, according to NDCHealth Corp., up 10 percent from 2003.)
So pleased are PhRMA member companies with the response to RxforRI and similar programs, that last month they took them to a national level as the Partnership for Prescription Assistance, the largest-ever private program to help the uninsured with prescription drugs. As with RxforRI, the PPA includes a wide range of non-industry partners, such as doctors’ groups, patient advocates, and community organizations.
In its first month, the national program helped another 180,000 people, PhRMA has said. To further heighten awareness of the effort, PhRMA is now sponsoring a national “Help Is Here Express” bus tour; the bus will be here this week, just as RxforRI celebrates its anniversary.
PhRMA and its members are spending “tens of millions of dollars” on these initiatives, Grayson said, not including the value of the drugs themselves – and the companies have set no cap on how many free prescriptions they’ll give out. But there’s no question that in the current climate, every Esther Beaudoin they can help is a big public relations asset.
Drugmakers have long faced public criticism of the high cost of their products – a month’s supply of cholesterol-reducing Lipitor, for example, costs over $80 – and for their resistance to the creation of generic versions of their drugs. The industry successfully fended off the establishment of price controls when the Medicare prescription drug benefit was passed, but consumers and some states, including Rhode Island, have fought back by embracing the reimportation of drugs from Canada.
Drugmakers have found their own ways of curbing Canadian imports, especially by cutting off the supply to pharmacies known to be selling to Americans, but also by speaking extensively about the potential dangers of imported drugs.
And while many U.S. residents are still buying from Canada, some of the wind does seem to have come out of the importation movement’s sails: Illinois’ drug-import program, I-SaveRx, now available in five states, processed only 6,300 orders in its first six months, the Associated Press reported last month. Two other state-run Web-based importation programs, the AP said, filled around 13,000 prescriptions between early 2004 and last month.
Locally, the outlook for importation is even more dismal. While Secretary of State Matt Brown’s informational RIRx Web site has gotten over 350,000 hits in the last year, according to spokesman Paul Tencher, RIMeds.com, an importation site and toll-free order line set up by CanaRx with Brown’s support, has enrolled just over 50 people since February.
Tencher did note that the service had gotten almost 1,500 requests for information, and he stressed the impact it had made on those who used it: “It’s 50 more people who can afford their prescription drugs who couldn’t before.”
RxforRI, too, has its limitations. Lisa Smolski, executive director of the Rhode Island Free Clinic, where the program was unveiled last year, said most of her agency’s clients don’t have the knowledge and confidence to go through the cumbersome application process.
The clinic does tap into the individual drugmakers’ programs directly, however, and Smolski said she considers RxforRI a good resource and has recommended it to many non-clients.
Officials at the Providence Community Health Centers and Thundermist Health Centers gave similar assessments, saying they have other programs of their own – and Thundermist has a resident prescription drug specialist – that can meet most of their patients’ needs.
Dr. Michael Fine, meanwhile, a partner in Hillside Family Medicine, in Pawtucket, who has appeared in TV advertisements for RxforRI, said 50 to 100 people in his practice are getting drugs through the program at any given time – but about as many get drugs from Canada.
The eight-doctor practice has a staffer who helps patients tap into programs such as RxforRI, Fine said, and yet the application process is still daunting. “My guess is that there are many more people who could use it,” he said. “It’s a little cumbersome.”
Given the strictures of the U.S. health care system, however, it would be hard to make a program like RxforRI much easier to use, Fine said. So while he likes and promotes RxforRI, he said Americans need a much better, broader solution to the problem of drug affordability.
“I think what works best is group purchasing,” he said, citing Rhode Island’s plan to buy influenza vaccine for the entire state as a good example of how it could be done. “That kind of thing is a perfect opportunity for a public-private partnership.”
Until a better solution comes along, Fine said, he’s using all means available to save his patients money, and prescribing lower-cost generic drugs to the extent he can.
Generics themselves, however, can’t help all patients, as Gerri Forster, 64, an RxforRI user in Coventry, learned firsthand. She retired from Fleet Bank after 30 years upon being diagnosed with breast cancer, and she’s been fighting the disease for three years, on a fixed income.
Forster takes Neurontin, a painkiller, and like many breast cancer patients, she was put on tamoxifen, which is available in generic form. But when she ran out of pills and went for a refill, she was shocked to find the tamoxifen alone was $56.
“I started to cry,” she recalled in an interview. “I just said, ‘I don’t have the money.’”
Forster heard about RxforRI from a staffer at the Coventry Senior Center, and signed up. “I thought it was a gift from God,” she said. Now she’s also getting Arimidex, a cancer drug she was placed on after the tamoxifen hurt her so much that she had to have a hysterectomy.
Forster said she saves about $400 a month through RxforRI, and she’s spreading the word. In her building alone, she has signed up 10 or 12 people. “I love the program,” she said.
