Prescription Drugs and what Legislation Is Trying to Do - Essay Example

?Prescription Drugs and What Legislation Is Trying To Do Prescription drugs are those which are given by a physician or medical personnel to treat specific medical conditions. Prescription drugs are however only safe for those for whom the prescription drugs are prescribed as they are only recommended after the doctor has thoroughly examined them. The use of prescription drugs is on rise in the United States; Patel & Rushefsky (2006) noted a substantial increase in the use of prescription drugs from the early 1990s. According to the Department of Health and Human Services almost fifty percent of the American population takes at least one prescription drug while the use of three prescription medications was common among 16.5% of Americans. Mostly people took medications to keep their cholesterol levels and diabetes in control. The use of antidepressants also showed a marked increase and has tripled since 1988. An interesting point is that the use of prescription drugs is most common among elderly users. Observers quote that the increase in the use of prescribed drugs is largely due to the fact that people like to take the easy way out; instead of improving their eating habits and lifestyles, they prefer to take medications. Nowadays you will find a medicine for every problem, from pain in the toes to brain tumor, there is a pill for everything. The benefits of prescription are many, many long term diseases have been cured or prevented; the biggest benefit of prescribed drugs remains that it prevents other expenses such as hospitalization or a possible surgery. As stated by Petty (2007) the use of prescription medications has provided relief to many patients suffering from heart diseases, diabetes, arthritis, cancer and many other ailments. Life expectancy has greatly increased with the use of prescription medications and so has the quality of life. Why are prescription drugs so costly? For a nation which has become totally dependent on prescription drugs, the Americans are feeling the crunch of the costly prescription drugs. There are several factors which account for the expensive prescription drugs; the consumers however blame the pharmaceutical companies the most. Carlson (2006) argues that the pharmaceutical companies’ claim that the exorbitant prices of the drugs was due to the unreasonable regulations by the Food and Drug Administration in America. Carlson cited extensive marketing as one of the major causes of the high cost of the prescription drugs. According to Carlson the pharmaceutical companies spend a king’s ransom to aggressively market their products thereby influencing the physicians to prescribe their products. These marketing gimmicks also increase the demand by patients. Another reason for the high cost of prescription drugs is the expensive and extensive research carried out by the pharmaceutical companies. The drug companies claim that the expensive prescription medicines fund their research and if the cost of the medicines is reduced, it will cut down their research projects and they may not be able to produce life saving drugs for chronic diseases. Kimbuende, Ranji and Salganicoff (2010) further revealed that although there was a small increase (9%) in the population in United States, the use and of the prescription drugs increased by 39%. The studies also showed that there was a growing trend among doctors of prescribing newer and costly medicines instead of recommending older and cheaper although equally effective drugs. Also the prices of drugs have increased sharply and faster than the overall inflation. The patent laws which give the manufacturers monopoly for a limited time are also responsible for the sky rocketing prices of prescription drugs. The companies register any new drug and have its sole rights for the next twenty years after that it can be reproduced by other drug manufacturers and sold at lower prices. In order to keep the drug within the company many pharmaceutical companies release a slightly different versions of the drug thus extending their monopoly over the drug and making certain drugs beyond reach of the common man. Health Insurance and Prescription Drugs High cost of prescription plans has affected health insurance coverage as well as most of the Americans now cannot afford health insurance. A marked increase on drug spending has been noted over the past decade although prescription drugs make up for just one tenth of the health expenditures. The premiums of the health care have risen sharply in fact the rise in the premium rate is more than that of increments in salaries or inflation itself. The senior citizens are the worst affected by the high cost of prescription drugs. Welborn (2005) states that the elderly are the most vulnerable population with one third of them not having any prescription coverage. A large number of the senior citizens live on fixed incomes and after paying for essential utilities like rent, power, gas, food etc have little left for the costly prescription drugs. Elderly people need prescription drugs to combat ailments like diabetes, hypertension, stroke, cancer etc. Often due to high cost the elderly skip a dose which is even more harmful. However the high cost of prescription drugs does not affect the senior citizens alone, it is a problem faced by millions of uninsured or underinsured Americans. Whatever is the cause of the high prices of prescription drugs, it has sparked a heated debate and the politicians are now seriously concerned about this issue. People have in the meanwhile taken an alternative route and that is to purchase prescription drugs from across the border countries like Canada and Mexico. Canada is the preferred choice of many as the medication available is only a fraction of what people pay in America and also because of the high quality safety standards followed by the Canadian pharmacies making the drugs safe to use. Those who cannot cross the border are ordering online but the quality of the prescription drugs ordered online is questionable. Also the online purchasing has caused an increase in drug abuse as the online pharmacies do not ask for a prescription. Though FDA showed its concerns about online purchasing and tried to get the online pharmacies banned, there was little it can do to stop people from purchasing prescription drugs from other countries. The government is aware of the plight of the people and has made headway in implementing the Medicare Part D; a relief program for the seniors and the disabled while the Medicaid takes care of the low income group people. One in every five Americans is covered by the Medicaid which offers better discounts on prescription drugs as the discounts are set by the government. The Medicare Part D Up till 2002 the government played a minor role in the purchase of prescription drugs as its contribution was restricted to twenty two percent only. Ever since the issue of purchasing prescription drugs has become explosive, several reforms have been introduced under the Medicare Modernization Act thereby raising the government’s contribution to around forty percent in the first two years. The government passed the Medicare Plan for the benefit of senior citizens and the disabled which offered health coverage at a low premium and brought the prescription drugs within reach. The Medicare Prescription Program was created in 2003 and became effective from 2006. Anyone having a Medicare was eligible for this plan irrespective of the cost, health history or the earnings; the coverage was provided by the private insurance companies. Under the Medicare Part D, the person covered by Medicare paid only a portion of the cost of prescription drugs. The Medicare Prescription Program offered two types of plans; the Medicare Advantage Prescription Plans (MA-PD) which offered to cover the prescription drugs and any other services approved by the Medicare; however you could avail the services of select pharmacies and doctors. The other plan was the Stand along Prescription Drug Plan or the PDP which only provided some relief from the high cost of prescription drugs. This plan was mainly for those people who wanted prescription drug coverage together with a Medicare supplement while paying the traditional charges for services. In most States this coverage was offered on free standing basis although other factors like deductibles, co-pays, monthly premiums and formularies varied. The Medicare Part D Controversy The “coverage gap” commonly known as the “donut hole” was the most controversial part of the Medicare Part D. The coverage gap or the donut hole came as a rude shock to many who on reaching the maximum amount found that they now had to pay the total cost of the drugs themselves. Actually the person first had to make a down payment of $310 for the drug cost. This is known as deductible. The insurance company then paid seventy five percent of the cost of drugs while the person was responsible for paying only twenty five; this share was termed as co-payment. . However once the cost accumulated to $2840, the person was said to reach the donut hole and was responsible for paying the entire amount of the drug cost. The person remained in the donut hole until a specific amount of $3610 was spent. The Affordable Care Act Law 2011 The Obama government made some changes in the Medicare Part D under the Affordable Care Act Law which brought a welcome financial relief to many especially for those who were on a fixed income. As stated by Thomas & Carson (2011) the Affordable Care Act depicts a strong involvement of the government in the health care sector. Under this Act more children were now entitled to health coverage while those up to twenty six years of age could be covered by their parents’ health insurance. However the elderly seemed to benefit a lot form this Act. According to this Act, after reaching the coverage gap, the person did not have to pay the full amount but was entitled to a fifty percent discount on the purchase of brand name prescription medicines. The limit of the coverage gap was fixed at $4,550 and included the deductible, the co-insurance and the co-payments paid. After reaching the $4,550 out of pocket expenses, the insurance plan was once again responsible for paying for a major portion of the drug costs till the year ends. This is called catastrophic coverage. The price of the monthly premiums is not included in the above mentioned price calculations. The Medicare also intended to offer additional benefits like discounts on the charges of both brand name drugs as well as generic drugs. The government hopes that by 2020 these reforms will close the donut holes (coverage gaps) and instead of making full payment, the person will be responsible for twenty five percent of the payments for generic medicines and fifty percent for brand name drugs. The changes proposed in the Affordable Care Act will be effective from 2014. The reduction proposed in the catastrophic coverage which will effectively bring down the out of pocket costs. To compensate for the high price of prescription drugs for catastrophic disease, the charges paid for medical care and prescriptions by the individual are lowered. The government is also encouraging the use of generic drugs as they are relatively cheaper than brand name drugs. Conclusion The use of prescription drugs is quite high in the United States but what is more alarming is that the patients have to pay through their nose to purchase prescription drugs. People of all ages are adversely affected by the increasing prices of the prescription drugs which seem to rise at a rate much faster than salaries or the general inflation but the elderly are most vulnerable to the rising prices as most of them live on limited income. To provide relief to the people, the Obama Government passed the Affordable Act which can be considered as a Health Insurance Reform Legislation. This Act has given new hope to the nation; under this Act Americans irrespective of their age were entitled to better health coverage. This Act was particularly beneficial to the senior citizens as it provided a fifty percent discount on brand name medications to those in the donut hole (coverage gap). With these reforms the present government is committed to lessen the financial burden of the individuals. References Carlson, E. A. (2006). Times of Triumph, Times of Doubt: Science and the Battle for Public Trust. New York: Cold Spring Harbor Laboratory Press. Kimbuende, E., Ranji, U., & Salganicoff, A. (2010). Prescription Drug Costs. Kaiser Family Foundation. Retrieved from http://www.kaiseredu.org/Issue-Modules/Prescription-Drug-Costs/Background-Brief.aspx Patel, K. & Rushefsky, M. E. (2006). Health Care Politics and Policy in America. Ed 3. New York: M.E. Sharpe Inc. Petty, B. G. (2007). Prescription Drugs. Maryland: Johns Hopkins Health Thomas, W. L. & Carson, R. B. (2011). The American Economy: How it Works and How it Doesn’t. New York: M.E. Sharpe Inc. Welborn, D. (2005). Everything You Need to Know about Buying Prescription Drugs in the U.S., Canada and Mexico. Florida: Frederick Fell Publishers. Read More