HillaryCare Comes Back

...The plan covers 22.5 million people who previously had no prescription drug coverage...

...In delaying access to new medicines, the VA is no different from the national health services of Canada and Great Britain...

...That doesn't seem to bother Speaker-to-be Nancy Pelosi...

...Yet Azilect, the newest drug to treat the symptoms of Parkinson's disease, approved in 2006, is not on the VA drug list, though every Medicare Part D plan has adopted it...

...Mike Ferguson, the New Jersey Republican serving on the House Energy and Commerce committee...

...In opposing the Medicare Part D reform in 2003, Democratic senator Patty Murray stated that she "was unhappy at the prospect that this plan could tell patients with MS, Parkinson's disease, and ALS that they can't get the drugs they need because their plan will not cover them...

...So among the first victims of the Democratic drug price-control scheme would be investors in the research Michael J. Fox also supports...

...Far from negotiating drug prices, the VA imposes them...

...Liberal and conservative opponents of the Bush program both predicted that angry seniors by this fall would be headed to the polls outraged at the cost, complexity, and inadequacy of their new drug benefit...

...Ferguson recently lost his mother to multiple myeloma, but not before Celegene's Revlimid allowed her three more years of life...

...Congressional Democrats should take note...

...Frank Lichtenberg, an economist at Columbia University's Graduate School of Business, found that the majority of the drugs on the VA formulary are more than eight years old—just 19 percent of prescription drugs approved since 2000 and 38 percent of those approved from 1990-2000 have made it onto the VA formulary...

...Celegene, which is likely to be bashed for the annual $61,000 price of Revlimid (a treatment for multiple myeloma and other cancers of the blood system), is investing heavily in a promising source of adult stem cells that have been used to replace dopa-mine neurons in people with Parkinson's...

...by Robert M. Goldberg Michael J. Fox made headlines for Democrats in the recent election campaign by promoting federal funding of embryonic stem cell research that the actor deems critical to finding a cure for Parkinson's Disease...

...The Democrats' Medicare plan would allow the government to negotiate prices directly with drug companies...

...Democrats and most policy experts predicted the new drug benefit would be confusing and unworkable, that seniors would fail to sign up, and Robert M. Goldberg is vice president of the Center for Medicine in the Public Interest...

...Incoming House Way and Means chairman Charles Rangel appears more interested in working with drug companies to expand their existing patient assistance programs, which help subsidize needy patients...

...If they won't, they are banned from selling medicines to Medicaid, Medicare, and the public health service...

...One exception is Rep...

...Federal law requires companies to sell to the VA at 24 percent below wholesale price...

...For all the talk about the supposed virtues of the VA price controls, nearly 2 million VA beneficiaries have signed up for Medicare Part D. That's because the new plans give them access to medicines they can't get under the VA...

...Patients must get drugs from VA pharmacies instead of retail outlets...

...Back then, a federal Breakthrough Drugs Committee was envisioned that would evaluate a drug's cost effectiveness...

...The VA demands even deeper discounts by creating a national formu-lary—a restrictive list of approved drugs for its patients...

...For him, the issue is passionately personal: "Price controls of any sort not only hurt seniors," he says...

...In response, venture capital investment in biotech dropped drastically and the market valuation of the biotech industry plunged 40 percent...

...The Medicare legislation creating the prescription drug benefit that took effect in 2006 (known as Part D) prohibited the government from negotiating directly with drug or biotech companies in order to guard against price controls...

...Patients who endure side effects from a formulary medicine—or who fail to respond to one—must submit themselves to an arduous and time-consuming bureaucratic process to gain access to any pharmaceuticals not on the list...

...Yet as former Medicare director Mark McClellan points out, the Stark proposal will perversely encourage higher prices...

...Unbeknownst to him, his message was part of a massive bait-and-switch...

...Instead, pharmacy benefit managers—the same service organizations most health plans use—would negotiate drug prices, pay pharmacy claims, etc., while offering competing versions of the Part D benefit to seniors...

...Another 9 million poor seniors have their entire drug costs covered, with fewer restrictions on choice than under the state or Medicaid programs on which they previously relied...

...Genzyme, whose drugs are always a target of Democratic anti-pharmaceutical show trials, just bought the rights to a Parkinson's clinical trial program of Avi-gen...

...It is not on the VA drug plan...

...Unwilling to recognize the good news, Democrats have consistently pointed to the government-negotiated drug prices offered by the Department of Veterans Affairs as a model for what they would do with Medicare Part D. Ron Pollack, executive director of the liberal advocacy group Families USA (which supported a market-based approach to Medicare drug coverage when Democrats and President Clinton advanced it in 2000), has asserted, "Medicare is overwhelmingly the largest purchaser [of prescription drugs], and it's ridiculous for Medicare not to get the best deal of all institutional purchasers...

...Tysabri, a new drug for multiple sclerosis, is available under every Medicare plan...

...The political appeal of this proposal is self-evident...

...None of the drugs regarded as priority medicines since 2000 by the Food and Drug Administration are on it either...

...So far, Republicans have been largely silent about the success of the new Medicare drug benefit, or about the harm likely to be caused by the Democratic proposals to dismantle it...

...That's because the Democrats also promised Medicare reforms that would have the effect of denying seniors access to new Parkinson drugs and of undermining investment in stem cell research—indeed, in all kinds of pharmaceutical research...

...Speculative biotech research will be unsustainable under Democratic price pressure...

...Demand cost-effectiveness studies, and the drugs will be offered to Medicare last while the case is made to the private sector first...

...In fact, as the Washington Post reported (after the election), polls show 80 percent of those covered are satisfied with the plan...

...However, both the Congressional Budget Office and Medicare analysts estimate that the government could do no better than a private company in negotiating prices...

...That includes Merck, which just invested over $1 billion in a company run by Nobel Prize winners that developed a technique to suppress tumor growth common to stem cell therapy, and Eli Lilly, which is investing in a company called Suven that focuses on Alzheimer's, schizophrenia, depression, vascular dementia, and Parkinson's disease...

...Today, drug companies have over 1,000 partnerships with biotech firms...

...Lichtenberg estimates that "the use of older drugs in the VA system may have reduced life expectancy by 2.04 months" per person...

...Medicare officials believe the plan's average per-person subsidy will drop 15 percent next year to under $80 per month, even as the out-of-pocket costs of seniors continue to drop...

...She is readying a proposal to force Medicare to ratchet down prices for every drug now and in the future using the VA approach...

...This, they argue, could cut prices enough for the government to pay for 100 percent of the prescription drug costs of every senior in America...

...It is hard to imagine how such research could be sustained in a system that would cut drug companies' revenues and sales in half...

...Companies that don't meet that additional discount don't make the list...

...Indeed, the VA price controls take a toll on the health of seniors who depend on the veterans' system for their care...

...If making the lives of seniors shorter and sicker isn't bad enough, the Democrats' price control plan threatens to devastate pharmaceutical and biotechnology innovation just as the failed Clinton drug-pricing scheme of 1993 would have...

...That's one reason lots of drugs are available to Medicare patients now, but not to folks in the VA system...

...You set a top price for Medicare or the VA, or demand a deeper discount than the private sector, and watch the drug prices increase and discounts disappear...

...They hurt our children and grandchildren who suffer with Parkinson's, cancer and juvenile diabetes...

...that those who did would receive scant coverage as drug companies jacked up prices to cash in on sweetheart deals absent any government jawboning...

...Under the lash of competition, the cost of the program has been lower than expected—by a whopping $26 billion in 2006...

...Because they aren't proposing market-like negotiations but a combination of price controls and restrictions on what drugs seniors can use...

...So why do Democrats insist they can...

...In a word: HillaryCare...

...Some prudent Democrats have begun to hedge their bets...

...Incoming Senate Finance Committee chairman Max Baucus, who supported the Medicare drug benefit, has agreed to hold hearings on government price negotiations but is cool to the idea...