ALBANY - David Edkin can no longer afford the $900 monthly cost of his pain medication for debilitating rheumatoid arthritis. So for the last two years he's soaked his swollen, uncooperative hands in hot water to get them moving.
“I've pretty much exhausted all of my money and stuff since I've been out of work,” said the 51-year-old former auto mechanic from Rochester. “So I've pretty much been selling all of my tools off to survive.”
For 400,000 New Yorkers like him, a new discount pharmaceutical card could cut down on his daily pain.
The card included in this year's health budget will allow him - and others between ages 50 and 64 - to buy medications at a discount. New Yorkers who are the right age and make a living wage but can't afford insurance may qualify for the same discount pharmaceutical cards, which will offer an average of 30 percent off name brand drugs and 60 percent off generics.
For example, Lipitor is a common cholesterol medication that has no generic equivalent. In Albany, the most inexpensive 30 day supply of Lipitor was $120.62. If Pfizer, the company that makes the drug, agrees to participate in the discount program, it could cost as little as $84.43.
The state is leveraging its massive buying power to get the cards, which will also be available for the disabled. Those who are 65 and older can already get comprehensive drug coverage through the state's Elderly Pharmaceutical Insurance Coverage program. The cards will help some of those who have fallen through the cracks.
“This is a group (whose) income levels frequently don't have insurance or they don't have insurance that covers that pharmaceutical part of their cost,” state Health Commissioner Dr. Richard Daines said.
Other states are also using their consumer power to provide discount pharmacy cards, most often for the elderly.
At least 28 states had some type of pharmaceutical discount program in 2007, with many eliminating or expanding age requirements and some diminishing or eliminating the income requirements for eligibility.
Maine was the first state to take the expansion step, offering a pharmaceutical program aimed at adults 18-65 - but children and the disabled without insurance were also eligible, according to the National Conference of State Legislatures.
Oregon, Arizona, Washington state and Wisconsin have no age or income requirements to enroll in programs for drug discounts.
In the first year, New York state health officials expect 15,000 people to sign up. Officials estimate that 400,000 New Yorkers are eligible for the program, which will be available next April.
“A lot of people between the ages of 50 and 64, they don't qualify for Medicare yet and they don't qualify for other programs,” said Kristin Legere, spokeswoman for the AARP. “That's a pretty large group of people.”
Still, some people, like 46-year-old Geraldine Blake, just miss the qualifications. She's too young to get the discount card and her part-time work as a school bus driver disqualifies her for Medicaid, so she often skips medications or takes expired drugs for her diabetes and relentless nerve pain.
“I cry at night,” she said. “I put up with a lot, and I don't go to bed.”
The plan will cost the state $2.5 million the first year in administrative expenses and for financing prescriptions until rebates come back, Daines said.
The cost of pharmaceuticals can be one of the greatest health care burdens for Americans, and eventually Daines would like to see a pharmaceutical benefit for all New Yorkers.
“It's a goal when we get it modeled (if) it saves us money more than we are now,” he said. “We want access to the drugs and we want savings. Not every bulk buying agreement results in savings for every party.”
“The good news is that some low income New Yorkers will be getting help with their prescription drug prices,” said Assembly Health Committee Chairman Richard Gottfried. “The bad news is it's much more limited than it should be, which not only means that a lot of people won't be able to get the card at all, but a lot of people won't be able to get as much of a discount. If the card covers more people the state can leverage bigger discounts.”
On the Net
Pharmaceutical assistance for those 65 and older: http://www.health.state.ny.us/health-care/epic/
For help finding the best program to help pay for medications: https://www.pparx.org/Intro.php
To compare prescription prices in your area: http://rx.nyhealth.gov/pdpw/
For 400,000 New Yorkers like him, a new discount pharmaceutical card could cut down on his daily pain.
The card included in this year's health budget will allow him - and others between ages 50 and 64 - to buy medications at a discount. New Yorkers who are the right age and make a living wage but can't afford insurance may qualify for the same discount pharmaceutical cards, which will offer an average of 30 percent off name brand drugs and 60 percent off generics.
For example, Lipitor is a common cholesterol medication that has no generic equivalent. In Albany, the most inexpensive 30 day supply of Lipitor was $120.62. If Pfizer, the company that makes the drug, agrees to participate in the discount program, it could cost as little as $84.43.
The state is leveraging its massive buying power to get the cards, which will also be available for the disabled. Those who are 65 and older can already get comprehensive drug coverage through the state's Elderly Pharmaceutical Insurance Coverage program. The cards will help some of those who have fallen through the cracks.
“This is a group (whose) income levels frequently don't have insurance or they don't have insurance that covers that pharmaceutical part of their cost,” state Health Commissioner Dr. Richard Daines said.
Other states are also using their consumer power to provide discount pharmacy cards, most often for the elderly.
At least 28 states had some type of pharmaceutical discount program in 2007, with many eliminating or expanding age requirements and some diminishing or eliminating the income requirements for eligibility.
Maine was the first state to take the expansion step, offering a pharmaceutical program aimed at adults 18-65 - but children and the disabled without insurance were also eligible, according to the National Conference of State Legislatures.
Oregon, Arizona, Washington state and Wisconsin have no age or income requirements to enroll in programs for drug discounts.
In the first year, New York state health officials expect 15,000 people to sign up. Officials estimate that 400,000 New Yorkers are eligible for the program, which will be available next April.
“A lot of people between the ages of 50 and 64, they don't qualify for Medicare yet and they don't qualify for other programs,” said Kristin Legere, spokeswoman for the AARP. “That's a pretty large group of people.”
Still, some people, like 46-year-old Geraldine Blake, just miss the qualifications. She's too young to get the discount card and her part-time work as a school bus driver disqualifies her for Medicaid, so she often skips medications or takes expired drugs for her diabetes and relentless nerve pain.
“I cry at night,” she said. “I put up with a lot, and I don't go to bed.”
The plan will cost the state $2.5 million the first year in administrative expenses and for financing prescriptions until rebates come back, Daines said.
The cost of pharmaceuticals can be one of the greatest health care burdens for Americans, and eventually Daines would like to see a pharmaceutical benefit for all New Yorkers.
“It's a goal when we get it modeled (if) it saves us money more than we are now,” he said. “We want access to the drugs and we want savings. Not every bulk buying agreement results in savings for every party.”
“The good news is that some low income New Yorkers will be getting help with their prescription drug prices,” said Assembly Health Committee Chairman Richard Gottfried. “The bad news is it's much more limited than it should be, which not only means that a lot of people won't be able to get the card at all, but a lot of people won't be able to get as much of a discount. If the card covers more people the state can leverage bigger discounts.”
On the Net
Pharmaceutical assistance for those 65 and older: http://www.health.state.ny.us/health-care/epic/
For help finding the best program to help pay for medications: https://www.pparx.org/Intro.php
To compare prescription prices in your area: http://rx.nyhealth.gov/pdpw/
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