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Competition and prescription drugs

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Last week, the Biden administration announced it would encourage Medicare to bargain with drug companies on the cost of 10 expensive medicines. While others cheered or vilified Biden, I was checking to see if Flovent was on the list.

No, the top three drugs subject to negotiation were Eliquis, Jardiance, and Xarelto. I hadn’t heard of them or any of the others. But I know something about Flovent (also called Flixotide or Fluticasone). This column doesn’t usually complain about my health, but bear with me. I’ll make this fit into local and national issues.

I use a Flovent inhaler for asthma. It’s a mild problem and should have a minor medicine. The problem is that my first one-month Flovent prescription cost $284 at Albertsons. Fortunately, Medicare paid $10 of that.

This is a rip-off. Here’s how I know. After the first dose, I ordered Flovent from a Canadian company that sells the same drug for $50 and has it shipped from New Zealand. Probably a good part of that cost is shipping. Even $50 seems steep. To my eye, the only way the little device should cost more than $5 is if it was a cannabis inhaler.

Is buying prescription drugs from foreign companies even legal? From what I can gather, I may technically be a criminal, although so many people buy drugs from Canada or Mexico that they can’t bust us all – and they don’t actually bust any of us.

But, you ask, why buy from New Zealand by way of Canada when you could drive 90 miles to Palomas? Yes, we are fortunate to be within driving distance of medical, pharmacy, dental, and optical services that are a lot cheaper than American ones, and may in some cases be just as good. People in Kansas don’t have that privilege, although some RVs in the border parking lot have licenses from distant states.

I haven’t yet driven to Palomas, because I can’t figure out whether they have the drug I need or not. But the next time I need rugs or tequila, I’ll check it out. But why is Flovent more than five times as expensive here as in New Zealand? I don’t buy the pharmaceutical companies’ story that they need to keep costs high to research new drugs.

A recent story in the Washington Post claimed that drug companies use patent tricks to keep inhaler costs high, even though the devices and their contents haven’t changed or been improved in many years.

But enough of my trivial problems. My story only illustrates how bad it is for people with worse problems who need more expensive drugs.

If you are a diabetic using insulin, you may be laughing at my pathetic Flovent complaint. Things got so bad that recently, over the protests of Republicans and pharmaceutical companies, the Inflation Reduction Act capped the cost of insulin for Medicare enrollees at $35 a month.

The 10 drugs on Biden’s negotiation list are used to treat blood clots, diabetes, heart trouble, autoimmune diseases, and cancer. I’m betting that some readers know exactly what these drugs are and why they are necessary. But those users may not know the real cost because Medicare pays it.

Seniors using these medicines would raise hell if Medicare didn’t pay. Apparently, they have more pull with Congress than Flovent users. But it cost Medicare $29 billion last year for just the top three. And what about the ones that didn’t make the top 10? No wonder Medicare is projected to run out of money in a few years.

By the way, the Biden announcement shattered some of my stereotypes. Democrats seemed to be in favor of Medicare competing on drug prices, but Republicans are against it. Isn’t that backward? Why would Republicans oppose competition? Aren’t Democrats supposed to be the secret socialists who want price controls?

And can Medicare really negotiate drug prices? What if the pharmaceutical companies refuse to bargain? That seems to be what happened with asthma inhalers. Medicare pays very little for them. Perhaps the pharmaceutical companies will choose to leave Medicare patients out in the cold. Maybe they hope to make up the loss by raising prices for people not on Medicare – although many of those will have to do without.

So, what will you do if you see a pharmaceutical company CEO sitting on Bullard Street with a hand-written sign: “Can’t afford drug research. Please help.” Will you put a quarter in the can? Or will you, like me, walk on by?

We have one of the best medical systems in the world for wealthy people, but other developed countries don’t have the same problems with outrageously priced prescription drugs. I’m ready for change.

The views expressed here are those of the author and do not necessarily reflect those of the Southwest Word Fiesta™ or its steering committee.

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Bruce McKinney

Bruce McKinney is a Silver City business owner, close observer of local government and occasional troublemaker. In his column, which appears every other Wednesday, he tries to address big questions from a local perspective. Send comments and ideas to
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