Today, more than 23 million older
Americans have transitioned into the
Medicare prescription drug benefit program.
Although most are pleased with
their prescription drug coverage, there
are still an estimated 3 million senior citizens
who fall into the so-called "doughnut
hole"the period when many
Medicare beneficiaries switch from making
copayments to paying for all of the
costs for their medicines.
Effective January 1, 2007, provisions in
the Medicare law will require the program
to pay 75% of drug costs up to
$2400 and 95% of drug costs over
$6250but beneficiaries will have to
foot the bill for all drug costs that fall in
between.
Fortunately, generic medicines can
provide a parachute for those seniors
who are in danger of falling into the
doughnut hole. Generics allow seniors to
continue to receive the same medicines
with the same results, but at a lower cost
than with their brand name counterparts.
Generics also can help to reduce
copayments, since they actually cost
seniorsand all consumersfrom 30%
to as much as 80% less than brands.
Access to generics is important for
seniors who are often on a fixed income
and are watching health care costs in
general, and drug costs in particular, take
an increasingly bigger bite out of their
wallets. In one recent survey, 26% of senior
citizens surveyed stated that they did
not fill a prescription, skipped doses, or
took smaller doses of medications due to
the high cost of drugs.
Last winter, Mark McClellan, MD, PhD,
then Centers for Medicare & Medicaid
Services administrator, stated that generic
medicines are a key part of lowering
Medicare prescription drug benefit costs.
The AARP is also urging its members to
use generic medicines to help delay
falling into the coverage gap. Not only will
generics assist seniors in leading healthier
lives, they also will lower overall costs
for the entire Medicare program, allowing
scarce health care dollars to be
stretched even further.
Yet, there is still more that can be done
to help lower prescription drug costs, not
only for Medicare recipients, but for the
entire health care system. That is why
the Generic Pharmaceutical Association
(GPhA) is actively encouraging Congress
to remove barriers that block seniorsand all Americansfrom receiving timely
access to generics.
Specifically, GPhA is asking Congress
to address the following issues:
•Mandate that the FDA create a
clear and efficient abbreviated
approval process for generic biopharmaceuticals.
There are everyday
medicines that do not have
affordable generic alternatives
because the FDA has not established
a review process. The result:
countless Americans are denied
access to these lifesaving medicines
because, without a generic
alternative, their costs are simply
out of reach. Congressman Henry
Waxman (D, Calif) and Senators
Chuck Schumer (D, NY) and Hillary
Rodham Clinton (D, NY) have introduced
legislation to create a pathway
to bring affordable generic biopharmaceuticals
to consumers.
•Restore the value of the 180-day
exclusivity period, which is being
threatened by so-called authorized
generics and by attacks on the ability
of generic companies to settle
patent challenges. Brand companies
are increasingly using tactics
to undermine the 180-day exclusivity
period, which Congress established
as an incentive to bring more
competition into the marketplace.
Less competition means higher
prices for consumers.
•Increase funding for the FDA's
Office of Generic Drugs to bring
affordable generic medicines to
consumers faster
•Pass the "Lower Priced Drugs Act,"
introduced by Senators Debbie
Stabenow (D, Mich) and Trent Lott
(R, Miss), which helps prevent the
filing of frivolous citizen petitions
that can needlessly delay generic
medicines from coming to market
Generic medicines can help keep senior
citizens from falling into the doughnut
hole, and they can help millions of other
Americans control their health care
costs. To ensure that the benefits of
generics are shared by all, Congress
needs to address the obstacles currently
facing the generic industry in bringing
these life-improving and lifesaving medicines
to consumers.