 |
Claritin Brouhaha
As many readers probably already know, the patent protecting the potent allergy drug Claritin expired this past December. The FDA granted permission for Claritin's developer, Schering-Plough, to sell it in the United States without a prescription as an over-the-counter medication. As an OTC product, the price will drop 75 per cent. For allergy sufferers who have previously paid $4 per pill for the required once-a-day dose, their monthly cost will drop to $30: a savings of $90 each and every month. Schering-Plough is gambling that it will make up at least some of the lost revenues by increasing the total volume of sales now that patients have unfettered access to this medication. According to new reports, these changes were made in response to a request from the health insurance industry. [Go to http://abcnews.go.com/wire/Living/ap20021211_626.html for the AP article on this topic.]
So, consumers now have unrestricted access to an antihistamine that has proven to be safe, effective, and largely free of serious side effects for many people. The cost per dose has dropped substantially, and the company who privately funded research to develop the medication will see its revenues drop precipitously in the short run, with a chance that income will recover somewhat over time. Sounds like a win for the American people, doesn't it? And maybe similar "cost containment" strategies can be applied to other aspects of the health care industry?
Then why should there be consternation? Primarily because the health insurance giants have announced their intention to immediately drop coverage for prescription drugs that compete with Claritin. The initial outcome will be to substantially bolster the bottom line of the insurers. According to Dr. William Berger, president of the American College of Allergy, Asthma, and Immunology, this policy change will trap patients and physicians in the crossfire between the health insurance and pharmaceutical industries. "Neither have any say in the decision-making process even though it directly affects how doctors practice medicine and how patients live their lives."
Ironically, this will also increase the out-of-pocket costs for those who have high quality health insurance policies that include prescription drug coverage. Rather than spending an average of $8 per month in co-pay for alternative medications, patients will be forced to immediately switch to Claritin and to pay the full cost now that it is an OTC drug. So, those patients will be paying more for a medication that may, or may not, be as effective for their condition. Of course, they could continue with their current prescription medication if they don't do well with Claritin, but only if they pay the full costs, which will be approximately 10 times what they paid prior to this chain of events.
It will be very interesting to watch these controversies play out over the next year or so. Most industry observers view this initiative as a trial balloon sent up by the insurance industry, and predict that these trends will accelerate if the Claritin transition ultimately proves to be successful. Drug price containment strategies can also be applied to other aspects of health care, so this public health experiment may ultimately affect P&O coverage.
My concern is that the only sure winners in this situation are the insurance companies, who are projected to save 3 billion dollars a year on Claritin alone. Those pharmaceutical companies who tried to compete with Claritin will see the market for their medications collapse when they are declared "non-covered services", saving the insurance industry even more billions each year.
But, when a market suddenly collapses, this effectively discourages future competition since drug companies must invest profits to develop alternative medications. Schering-Plough will obviously take a major hit in the short run since prescription Claritin reportedly accounts for one third of their total annual income, although sales should increase somewhat when the insurance industry drops coverage for competitor products.
Those Americans without insurance or prescription drug coverage will undoubtedly benefit by the reduction in the cost when Claritin becomes an OTC medication, but the biggest losers of all will be those people who have faithfully paid for premium health insurance policies that include prescription drug coverage. These changes mean that they now have less coverage, regardless of what their physician prescribes, and more out-of-pocket expenses. Since it is virtually certain that the insurance companies will not be passing on their savings to the consumers in the form of steep reductions in the costs for a policy, the net effect is to punish those citizens who pay for private health insurance: they will continue paying high prices for reduced coverage.
The lesson is that, as we are starting to realize from the Managed Care experiment, it is very difficult to truly reduce the costs of quality health care. It is far easier to shift costs from one sector to another or to defer necessary costs, and both strategies benefit the insurance industry in the short run without improving the situation for patients. It will be fascinating to see what the long-term assessment is about the shift of Claritin to a name brand OTC medication, and how this affects health care coverage in the future.
|
|
Algorithms for O&P
John,
I thought you might have some insight or be able to refer me to some algorithms specific to prosthetic and orthotic treatment plans. Specifically,
-have you seen any sort of algorithm for diabetic feet at risk for amputation,
- ne... read more
|
Re: Algorithms for O&P
Hi Karl- Two great questions: requiring far more space than this email forum will permit. I'll add both to my list of potential topics for future Corners or publications. Short answers: the literature on the at-risk diabetic foot is pret... read more
|
|
|
Caracteristicas del sistema Hidraulico MAUCH SNS y del sistema C - Leg.
Ciudad de México 20 de Marzo, 2003.
Estimado John Michael, CPO, FAAOP, FISPO:
Un estudiante en prótesis y ortésis desea conocer las características de los sistemas de rodilla hidraulico MAUCH SNS y del sistema de rodilla C - Leg. ¿Existen... read more
|
Re: Caracteristicas del sistema Hidraulico MAUCH SNS y del sistema C - Leg.
The similarities and differences between the C-Leg and the Mauch SNS are too complicated for a complete review here, but I will highlight the major distinctions. As you know, the SNS offers yielding hydraulic stance control and hydraulic s... read more
|
|
|
X Aniversario del Centro de Rehabilitación Integral en Queretaro, Mexico.
Ciudad de México 5 de Marzo, 2003.
Estimado John Michael, CPO, FAAOP, FISPO: le agradecemos nos permita anunciar que el Centro de Rehabilitación Integral para Minusvalidos del Aparato Locomotor en la ciudad mexicana de Queretaro, celebra e... read more
|
Re: X Aniversario del Centro de Rehabilitación Integral en Queretaro, Mexico.
Congratulations to the Queretaro Center on their tenth anniversary! --John Michael CPO
|
|
|
|
|
