Free prescription drugs available to those in need

By David Schwab; and Ed Silverman
Newhouse News Service

	Fred Hassan
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The catch is that many consumers don't know it.

At a time when rising drug prices are causing more commotion than ever, big pharmaceutical companies are giving away billions of dollars' worth of free medicines to Americans who lack health coverage and have limited incomes.

But critics, including watchdog groups and some doctors, say companies don't do enough to publicize these programs, and patients often must go to great lengths to find out about programs that vary from company to company. Even some in the industry — notably Schering-Plough Chief Executive Fred Hassan — acknowledge the system needs an overhaul.

"The people who would benefit the most are the least likely to be aware of them," said Daniel Rosan, program director at the Interfaith Center for Corporate Responsibility in New York, a shareholder group that has been lobbying drug companies for years to increase giveaways and cut drug prices.

A survey of the nation's 15 largest drug makers by The Star-Ledger newspaper of Newark, N.J., found they gave away medicines valued at $3.2 billion last year. The companies contend these donations function well as a program of last resort for patients.

"We do promote them actively," said Rick Luftglass, Pfizer's director of U.S. philanthropy. "The fact that we reached 1.2 million patients does bear out the fact we are getting the word out. ... We enroll as many eligible patients as we can."

Pfizer, the world's biggest drug maker, gave away $500 million worth of drugs last year. Schering-Plough, with a fraction of Pfizer's sales, and serious business problems, gave away more than $200 million.

These figures are wholesale prices, which are lower than retail prices. They don't include giveaways overseas, such as free AIDS medicines in Africa, nor do they include medicines provided at reduced fees under discount-card programs for seniors on Medicare.

Included in the giveaways are the top 20 selling drugs, from cholesterol and blood-pressure medicines to those for arthritis pain, depression and heartburn.

Typically, participation in the programs is limited to people who earn no more than twice the federal poverty level, which is about $36,000 for a family of four.
 
The number of patients getting free medicines rose 30 percent last year, to more than 6 million, according to the Pharmaceutical Research and Manufacturers of America, the industry trade group. Bristol-Myers Squibb, for instance, said the number of its participants has doubled to nearly 1 million in the past two years.

Drug makers say their programs are supposed to ensure patients don't go without prescription medicines because they can't afford them.

Companies rely on the Internet, their sales representatives and doctors to spread the word. Critics say that isn't enough for those not savvy enough to use the Web or for those who don't have a regular doctor.

"The companies should devote the same energy to the patient-assistance programs as they devote to the launch of a new product," said Rosan, whose organization includes 275 religious groups plus pension funds and endowments with a combined portfolio of about $110 billion.

"I didn't see any ads for patient-assistance programs when I watched the Super Bowl," he said.

Television ads won't work, industry representatives counter.

"We find it's the patient interaction with physicians and really the grass-roots efforts where they are getting care that is the best way to reach these patients," Pfizer's Luftglass said.

Despite the huge numbers, the billion-dollar giveaways still represent a tiny fraction of the $216 billion in prescription drug sales last year. Sixty-five million Americans lack prescription drug coverage, including about one-third of those on Medicare.

"The outreach and publicity targeted at the population that could use the medicines is slim to none," said Ron Pollack, executive director of FamiliesUSA, an advocacy group. "The only people who know about the programs tend to be either desperate or tenacious."

Michael Christian, president of Patient Advocate Solutions, estimates about 25 percent of doctors are aware of how to seek free medicines.

"People don't know about this and want to," Christian said. "There's a tremendous lack of awareness."

Critics such as Rosan and Pollack contend the drug industry's efforts to use their sales representatives to inform doctors isn't enough to help patients who don't have their own regular doctors or who are reluctant to admit to them that they can't afford medicine.

While the industry's trade group has put all the forms on an automated Web site, that is of little use for many needy or elderly patients, they say.

Critics also say the patchwork of programs is cumbersome and a burden on patients and overworked doctors.

"I am a bit dismayed by it. There are so many different programs and they have different eligibility criteria. It's created a headache sometimes in a very busy office," said Edward Langston, a family physician in Lafayette, Ind., and a trustee of the American Medical Association. The AMA said the industry needs to do more to publicize the programs and eliminate unnecessary paperwork.

Schering-Plough's Hassan recently proposed the creation of a national foundation to administer the programs run by individual drug makers.

Copyright © 2004 The Seattle Times Company