At long last, relief for prescription costs is in sight

COMMENTARY

RICHMOND - For a couple of decades, my husband took 16 pills a day, some of them bottled by the Veterans Administration in Northampton and some by our pharmacist at Stop & Shop on Dan Fox Drive. We paid the whole bill each time because we didn't have prescription drug insurance. He needed them, and that was that. At least there was a tax deduction.

The reason for the split between two pharmacies - obviously a bit of a nuisance - was that his World War II service entitled him to a VA discount, and we wanted that on his most expensive pills. So the mailman brought those, and we went local for the less costly ones. The medications totaled hundreds of dollars a year, even with the VA's help. All the while, we felt that if the VA had a way to make drugs less expensive, why couldn't Medicare do that also? Well, now that Congress has passed President Biden's Inflation Reduction Act, Medicare will be able to negotiate with pharmaceutical companies on the prices of a large number of pills taken by seniors. But there were reasons why it wasn't easy to just do a discount on Medicare medications.

What we didn't know in the years we grumbled about one entity not doing what another one had managed to do for years was that the VA doesn't actually negotiate with drug companies - instead, according to a government source, the feds deny manufacturers access to the market place unless they accept lower prices. (Some critics have used the word extort to describe the process.)

On the downside, however, the VA has a limited list of drugs it will provide. It's quite possible that what the doctor wants a vet to take won't even be in the cupboard. One study

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group found that the VA covers only 106 of the 300 drugs most used by Medicare D enrollees.

The difference in operation is that the VA buys direct from the drug companies, while Medicare D (the medication coverage) reimburses pharmacies. And with Medicare, it's not just one entity paying - even if you try to ignore those over-the-top commercials on TV, you know a whole bunch of different insurers are involved.

Under the new law, which will be implemented in phases, both the Medicare patient and the government will save money. It's a lot of money: In 2021, the Government Accountability Office reported that the VA and Medicare covered prescriptions for about 52 million people in 2017 at a cost of $105 billion. (We Americans apparently have a lot of prescriptions: That $105 billion is was only a third of what Americans spent on pills, etc., that year.)

One of our common expressions when we get something we've been waiting for interminably is to say, "It's high time." Certainly it's high time this happened, after all the years we've read about what Canadians pay for prescriptions, but it is complicated. Rand Corporation's research found that U.S. prescription drug prices surpassed by 150 percent those in 32 countries, with the cheapest prices found in Turkey.

In the meantime, it's interesting how people deal with collections of prescribed pills. We have a heart-warming photo of my husband and our 3-year-old granddaughter at the table in a hotel in Florida, both faces concentrated and serious. He's facing pill bottles and counting out the next day's doses. She has paper and crayons and is coloring between the lines.

Years earlier, at breakfast in a different place in Florida, my husband took his pills, one by one, from the box labeled a.m. Our host, however, gathered all the pills of the day from containers on the table and downed them in one swoop, saying he had no patience with pills for morning, noon and bedtime. Doctors probably don't want to think about these things.

It's often been reported that some seniors have had to choose between medication and rent or food. So they will rejoice in one of the provisions that will take effect in 2025 with the new law - out-of-pocket prescription drug costs in Medicare will cap at $2,000. And in the years following, more drugs will be added to the list of those for which prices will be negotiated.

Few parts of this apparently will happen instantly, since steps are implemented in a succession of years. But government's foot on the brakes will continue to put long-awaited pressure on pharmaceutical companies. The burden for seniors has been a bitter pill for too long.

Ruth Bass is an award-winning journalist. Her website is www.ruthbass.com. The opinions expressed by columnists do not necessarily reflect the views of The Berkshire Eagle.

Now that Congress has passed President Biden's Inflation Reduction Act, Medicare will do be able to negotiate with pharmaceutical companies on the prices of a large number of pills taken by seniors. EAGLE FILE PHOTO