It took high-deductible health plans, which are supposed to make people smarter shoppers, to prompt public outrage over the skyrocketing cost of the allergy medicine injectors children needed for home and school. The fracas over drugmaker Mylan's Epipen prices nearly two years ago shows what's at stake. Kuhn and Clorinda Walley, the president of Good Days, say the investigations have cast a pall over donations and forced them to shut down funding for drug co-pays for several diseases. attorney in Massachusetts and the Health and Human Services (HHS) inspector general have been investigating this insurance co-payment assistance for more than three years. "If they really want to be charitable, they ought to give the drugs away for free to the poor and lower the prices for all." Kickback concerns "There ought to be something called a moral compass for those companies who make the decision to price at such a high level," says Kleutghen, who now takes $750 worth of drugs a day for his blood cancer, multiple myeloma, which is one of the costliest forms of cancer. His story and that of the other groups in investigators' and insurers' cross-hairs illustrate a little-understood twist on how Washington really works.ĭrugs could and should be cheaper for everyone, says Paul Kleutghen, a former pharmaceutical industry official who sold his last company to Novartis in 2003. Each $1 million industry donation that is used to help patients get high-priced drugs has the potential to generate up to $21 million for the drug company, according to a report last year from Citi Research, so "you cannot call that charity," Kleutghen says. The salary, he says, is justified because he was a CEO for 28 years and "we're really doing the work of the angels."Īs he prepares to retire April 30, Kuhn, 65, is in Washington this week lobbying for legislation that would protect co-pay and premium assistance from insurers who have been prohibiting its use in plans purchased on the Affordable Care Act (ACA) exchanges. Now, however, Kuhn is making about $600,000 a year at a group that brought in $86 million last year to help 28,000 people pay for their medicine. Kuhn, who has hemophilia and developed hepatitis C and HIV during a blood transfusion in the early 1980s, was struggling to pay for his own insurance at the time. “If I end up paying for this, I’d have to liquidate all my assets within five years,” said Rodgers, 80, who relies on Social Security and a modest income from non-profit charity work.Īnother group, Patient Services, was started by former pastor Dana Kuhn in 1989 to pay patients' insurance premiums. The groups Good Days has had his share of two drugs that have kept him alive and cost more than $200,000 a year. Supporters include Leonard Rodgers, a Tempe, Ariz., patient with an incurable blood cancer. "Patients shouldn't have to live month to month at the mercy of the drug companies." "These groups are a marketing arm of pharma, and the fact that patients are caught in the middle of all this is disgusting," Mitchell says. The money to pay for the groups’ support of patients comes almost entirely from the drug companies themselves or other charities they fund. Co-payments are the part of drug bills that insurers require consumers to pay to make them aware of the true cost of medication and encourage them to seek cheaper alternatives such as generic medications. The investigations, noted by several drugmakers in their regulatory filings, are slowing contributions to at least two of these assistance groups, charities that sometimes pay top executives salaries of $300,000 or more.Ĭritics of these groups, such as Patients for Affordable Drugs founder David Mitchell, say they drive up the cost of health care by masking the price of drugs and forcing higher costs on the insurance companies that pass them along to consumers and employers. Watch Video: Non-profit helps man with $19,000 a month drug prescriptionĬo-payment assistance groups, created to help patients with the increasingly higher price of drugs to treat medical conditions, are under investigation by federal authorities for possibly skewing the cost of health care to favor drug companies.
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