From the Editor

According to the Senate Committee on Aging, 90% of our nation’s senior citizens take at least one prescription drug per month. Many, and I include myself, take multiple prescriptions. An AARP Public Policy Institute repost found that prices for widely used medications increased at six times the rate of general inflation. Not only have prices for brand-name medications increased, the price of generic medications is also increasing. Drug company price raises have resulted in an average cost per annum of prescription drugs that has increased to $11,000, or about 75% of the average annual Social Security benefit and half the median income of someone on Medicare. Since the majority of women aged 65 or older have incomes below or near the poverty line, frequently have chronic conditions that require long-term prescription medications, and live longer than their male counterparts, this is particularly problematic for older women.

The average annual cost for specialty drugs to treat illness such as cancer is in excess of $53,000—that’s 189 times the average cost for more-common generic drugs. Some Medicare plans require patients to pay a share of the cost that may be up to 50% rather than having a set co-pay. Medicare Advantage plans are more likely to require that patients pay a share of the cost.

The most common cause of price escalation in pharmaceuticals is not your local pharmacy but the prices set by manufacturers. According to Senator Claire McCaskill, “There’s a line at which huge price increases on prescription drugs go from rewarding innovation to price gouging. One pharmaceutical company executive, when asked why he instituted a particularly egregious price increase answered ‘because I can.’” At this juncture it seems obvious that many companies are taking advantage of the fact that patients depend on prescription medications for both maintaining quality of life and survival.

There is little question that a significant number of people on prescription medications daily face the choice of doing without basic necessities, food included, or going without medications necessary for disease management, pain management, or even survival—and no group is at greater risk than old women.

One option for people who meet the criteria for participation is clinical trials. In clinical trials, medication included in the trial is at no cost, and procedures conducted to measure treatment effectiveness are also at no cost. However, clinical trials are by definition experimental: The focus is on finding out whether a particular treatment is effective; there is no flexibility to try alternate treatments outside the scope of the trial while remaining in the trial, and eligibility for inclusion in clinical trials is stringent.

When diagnosed four years ago with advanced chronic lymphocetic leukemia, and unable to tolerate traditional chemotherapy, I entered a clinical trial at Moffitt Cancer Center in Tampa. I was fortunate that the treatment resulted in a partial, but significant, remission. There is, to date, no cure. However, the side effects from ongoing low-dose medication management were cumulative and began to have a significant impact on quality of life. I am no longer in the trial. However, it is possible that when the leukemia takes off again, there will be another clinical trial for which I’m eligible, or there will be a standard effective treatment that I can tolerate.

In the United States, the cost of health care is the number one cause of personal bankruptcy. I, like many others, am unwilling to become destitute if the price of whatever treatment I need in the future for survival would result in that outcome.