No Such Thing as Free Drugs?

May 21, 2009

The headlines are out: "Pfizer to Give Free Viagara to Unemployed," writes the New York Post, and "Recession Giveaway!" begins aWall Street Journal blog entry. Even UrbanDaddy, a free daily email for city dwellers, tempts its subscribers with "Free Viagra Courtesy of Pfizer."

While the release of this news inspires a spate of media humor, industry speculation about Pfizer’s Medicines Assistance for Those who are in Need (MAINTAIN) program is no joking matter. The program, set to be fully operational on July 1, 2009, may give rise to bigger questions about limited access to certain drugs, the cost for healthcare today, and what happens once the program ends.

For people who have recently lost their job, more than 70 Pfizer primary care drugs will be available free for up to 12 months, or until the user becomes re-insured (whichever comes first)—but only if certain requirements are met:

—Loss of employment since January 1, 2009
—Prescribed and taking a Pfizer medicine for at least three months prior to becoming unemployed and enrolling in the program
—Lack of prescription drug coverage
—Can attest to financial hardship

Rich Segal, professor and chair of the department of pharmaceutical outcomes and policy at the University of Florida, believes that the issue at hand goes beyond just the uninsured. "If you are unfortunate and take four or five medications, the amount paid out-of-pocket is not only affecting the uninsured, but also the underinsured who have reasonably decent health plans," said Segal. "These programs are nice, but it doesn’t solve the bigger problem, which is out-of-pocket costs for Americans due to the complex relationships between pharma companies and managed care organizations." Segal also pointed out that for many people (particularly the underinsured) the high cost of prescription drugs is a significant issue that limits access to many medications.

Dow Jones Newswires notes that companies including Merck, Abbott, Amgen, and Wyeth have all expanded patient-assistance programs in recent weeks. Mahmud Hassan, director, pharmaceutical management MBA program at the Rutgers Business School and the Blanche and Irwin Lerner Center for Pharmaceutical Management Studies, says that while it’s a "good gesture" for these companies to address the recession through such initiatives, there may be unintended consequences, such as pressure to maintain the programs after the recession is over and a price increase for drugs not covered by the program, as well as the price of drugs for the insured.

"Several Big Pharma companies have already taken steps to address the issue of recession by reducing the income threshold and eliminating or reducing co-payments," said Hassan. "Obviously, it is a good gesture for companies to initiate a drug assistance program and/or make it less restrictive for during recession. But once the recession is over, it will be hard to discontinue the program for those who remain uninsured/underinsured."

MAINTAIN was rolled out in "record time" (talks began in early April; the announcement was released mid-May), and Ray Kerins, vice president, worldwide communications and head of global media relations for Pfizer, says the company is not speculating what will be done or not one year from now, but makes clear that everybody who needs assistance can get it.

"We think this makes sense. We ran the numbers. But we won’t talk about the numbers because it’s not about that," said Kerins. "We have decades of experience running programs like this—the focus and benefit is the patient, and we are going out of our way to make sure that folks are aware of the program."

As for the speculation of an increase in drug price, Kerins disagreed: "When it comes to Pfizer and any price increase: take 2001 to 2006, our meds went up on average 3 percent per year. However, also understand the average copayment went up 14 percent," he said. "Everyone has got to do their part when it comes to looking at folks who need access to medicine. We have done it before, we understand the benefits and need for it, and we are now dealing with it in these tough economic times."