Archive | December, 2016

Facing Unaffordable Prices, Millions buy Medicine Outside U.S.


As drug prices have spiraled upward in the past decade, tens of millions of generally law-abiding Americans have committed an illegal act in response: They have bought prescriptions outside the U.S. and imported them.

One was Debra Miller, of Collinston, La., who traveled to Mexico four times a year for 10 years to get diabetes and blood pressure medicine. She quit in 2011 after the border patrol caught her returning to the U.S. with a three-month supply that had cost her $40. The former truck driver drew a stern warning not to do it again, but got to keep her pills.

“I didn’t know what I did wrong,” said Miller, 51, who now pays $120 a month at Walmart for her five medications while she waits to join Medicaid.

It’s no secret that some Americans regularly buy prescription drugs on the Internet or while traveling abroad. But the popularity of the approach is underscored by the results of a Kaiser Family Foundation poll conducted in November.

Eight percent of respondents said they or someone in their household had imported a drug at some point, a figure that would translate to about 19 million adults in the U.S. based on current Census population estimates.

Even the proportion found in the poll may be low, said Andrew Zullo, a clinical pharmacist and a doctoral student at the Brown University School of Public Health who has researched the subject. “People are uncomfortable talking about the cost of their own health care, and they don’t want to admit they are struggling to pay for their own meds,” he said. Some may also be reluctant to reveal they’ve broken the law.

Still, 8 percent is far higher than in surveys conducted by government interviewers, which suggested the number was about 2 percent in 2011 — though the government survey focused only on purchases in the previous 12 months. The Kaiser poll queried a nationally representative sample of 1,202 adults.

The Internet has made it easier for Americans to buy prescription drugs abroad, frequently from disreputable sources, according to Jaime Ruiz, a spokesman for U.S. Customs and Border Protection.

The Food and Drug Administration has cautioned that many online pharmacies aren’t what they seem to be. An international crackdown in 2014 found that many packages of medicines purportedly from Australia, Canada, New Zealand and the U.K. contained drugs from other countries, including India, China and Laos.

Zullo acknowledged that imported medications could be inferior or expired. Some could be counterfeits. But many medicines purchased from another country are the same as the ones patients buy in the U.S.

When purchased outside the country, many prescription medicines cost half or less of what they do in the U.S.

According to the FDA’s website, it is generally illegal for Americans to import drugs into the U.S. for personal use. The law isn’t rigorously enforced, in part because it is difficult to monitor the entry of medicine in suitcases and small packages. But in 2015 the FDA implemented a rule that would give government border inspectors expanded authority to destroy drugs imported for personal use at their point of entry.

In the poll, people who had imported medicines ranged from college students in their 20s to retirees in their 80s. They bought medications to treat chronic conditions — such as high blood pressure and thyroid problems — as well as acute problems such as sinus infections and acne.

Amanda Mazumder, a 27-year-old graphic designer in St. Paul, Minn., was stressed out by the murky legality of the situation when she tried buying birth control pills while in college five years ago. “That was the most difficult part, trying to be an honest citizen but also getting an affordable prescription,” she said. She couldn’t afford to pay $150 a month for her birth control, but found an online Canadian pharmacy that sold her a three-month supply for $60.

Bobby Grant, of Los Angeles, has relied on foreign pharmacies for seven years to get medicine for his partner’s severe asthma. Grant, 38, travels internationally for his job producing live shows. Each time he’s in Mexico or France, he buys 10-packs of inhalers and 20-packs of nebulizer solution for a fraction of what they would cost in the U.S.

His partner’s asthma would require inhalers costing $300 a month if she purchased them here. Grant estimates he saves at least $2,500 a year by buying the drugs overseas.

“I love her to death,” he said. “I’ll do whatever I can to take her stress away.”

This story was originally published by Kaiser Health News, a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

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Bronin Signs Contract with Dept of Interior


HARTFORD — Mayor Luke Bronin on Wednesday announced that he has signed a General Agreement with the U.S. Department of Interior, National Park Service regarding security measures at Coltsville Park.

In December 2014, Coltsville became a National Historical Park. The areas within Coltsville that received “National Historical Park” status include the following sites: Colt Armory, Church of the Good Shepard, Caldwell Colt Memorial Parish House, Colt Park, the Potsdam Cottages, Armsmear, and the James Colt House. The Public Law designating Coltsville as a National Historical Park also required that the NPS and the City enter into a written agreement regarding management of the land within the National Historical Park.

In September 2016,  Bronin submitted a resolution to the Common Council authorizing the City to enter into a General Agreement with the U.S. Department of Interior, NPS for the Coltsville National Historical Park, which fulfills the management of the land within the National Park requirement.

The Common Council approved the resolution on Oct. 24, 2016.

 

The five-year agreement signed by Bronin stipulates that both parties work together for the preservation and redevelopment of the National Historical Park and the neighborhood, develop a pattern of collaboration and communication, develop projects of mutual benefit leading to the conservation of historic resources, and creatively research funding opportunities for projects.

The NPS will be responsible for providing interpretation and education and managing special events to be held on the NPS-owned property.

In addition, the NPS and the City will cooperate in protecting and preserving the historical and cultural resources in Coltsville National Historical Park.

 

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Aetna-Humana antitrust Trial to Have a Different Twist


WASHINGTON —  As the first part of the antitrust trial on a proposed merger of health insurers Anthem and Cigna is wrapping up, a similar challenge to Aetna’s plan to merge with Humana is about to begin.

While both are the result of lawsuits to block the mergers filed by the U.S. Justice Department on the same day in July, the trials will be much different.

The first phase of the Anthem-Cigna trial, expected to wrap up Friday, centers on whether the $54 billion merger of those two insurers would dramatically decrease competition for “national accounts,” or plans for large, multi-state corporations.

The Justice Department also argues the merger would fail because there is friction between the companies’ CEOs and because Cigna in July stopped cooperating with Anthem on various deal-related issues.

“How do you work on integration without talking to the person you’re integrating with?” asked U.S. District Judge Amy Berman Jackson, who is presiding over the trial.

If Jackson does not rule in favor of the Justice Department, the second phase of the Anthem-Cigna trial is scheduled for Dec. 12 and will focus on whether the merger will decrease competition in dozens of local markets.

In another room in the same federal courthouse, the $37 billion Aetna-Humana merger trial is set to begin on Monday.

U.S. District Judge John D. Bates will preside over that trial. The Justice Department will argue that Aetna’s merger with Humana will dry up competition across the nation in the Medicare Advantage market.

The Justice Department says the combined companies would cover 980,000 of the 1.6 million seniors in the nation covered under Medicare Advantage plans. Aetna and Humana will argue that traditional Medicare will provide plenty of competition to their policies.

“The two cases are very different,“ said Deep Banerjee, an insurance analyst with Standard & Poor’s Global Ratings.

Banerjee said Aetna and Humana may have an edge over the other insurers. He agrees with Aetna and Humana that “the Medicare market should be looked at as a whole,” and traditional Medicare considered as competition to Medicare Advantage.

The insurers also have another card they can play, one that Anthem and Cigna do not: They have offered to divest themselves of Medicare Advantage plans in areas of high concentration.

“The divestiture may be a valuable and attractive issue for the judge to use to rule for the insurers,” said Professor Tim Greaney, co-director of the Center for Health Law Studies at Saint Louis University School of Law.

Cigna headquarters in Bloomfield

Cigna Corp.

Cigna headquarters in Bloomfield

Aetna said it has an agreement to sell Medicare Advantage business covering 290,000 people to rival insurer Molina if its planned merger is allowed to be completed.

But Molina specializes in Medicaid, the government insurance for the poor, instead of Medicare Advantage, a type of health plan offered by private companies that contract with Medicare to provide coverage for the elderly.

The Justice Department is expected to argue that it would be difficult for Aetna and Humana to divest themselves of enough Medicare Advantage customers to keep that market competitive, especially in 364 counties across the nation where a merger would result in what it says is an acute lack of competition.

Aetna, meanwhile, is expected to try to knock down another Justice Department complaint – that a merger would hurt competition in Affordable Care Act exchanges – by saying it is quitting most exchanges and leaving many counties in states where it still has a presence in the exchanges.

Failed remedies

The Justice Department argued in the Anthem-Cigna case that a merger would result in higher prices, lower quality, reduced consumer choice and less innovation. It’s expected to make a similar argument in the Aetna-Humana case next week.

“Because of the offer of divestiture, the Aetna-Humana merger may have a better chance,” Greaney said. “But I think the Justice Department has a very strong argument on the merits in both cases.”

Meanwhile, David Balto, a former attorney with the Justice Department’s Antitrust Division who opposes both mergers, said the Aetna-Humana tie-up will result in more concentration than an Anthem-Cigna marriage.

“I think the competitive concerns are even greater,” Balto said. “I think the Justice Department has an even stronger case against Aetna and Humana.”

The reason, Balto said, is that the Justice Department can point to previous cases where insurers made divestitures but premiums rose sharply anyway.

He said divestitures were made in  1999 when Aetna and Prudential merged and in 2008 when United and Sierra merged and prices increased by 7 percent and 13.7 percent, respectively.

Balto said the biggest failure was the 2012 Humana-Arcadian merger, where one of the three companies that acquired business divested as part of the merger “exited the market, another company partially exited the market, and premiums increased by 44 percent.”

First reported in CTMirror, our media partner.

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Asian Host First Culture Night


HARTFORD — The Asian American Student Association at Trinity College hosted the first Intercollegiate Asian American Culture Night in the Admissions Grand Room.

In addition to the Trinity students who hosted the event in November, the conference welcomed Asian culture clubs from the University of Connecticut, Eastern Connecticut State University, Connecticut College, and Wesleyan University.

Members of the Trinity College Asian American Student Association executive board with Trinity College President Joanne Berger-Sweeney

Members of the Trinity College Asian American Student Association executive board with Trinity College President Joanne Berger-Sweeney

Each club brought food to share with the group, and offered introductions and presentations as the students got to know one another. “The energy was very high, and the enthusiasm for future events such as this was very apparent,” said Ethan Yang, the first-year representative for Trinity’s AASA and one of the conference organizers. “During the open microphone session, many people passionately discussed issues relating to the Asian American identity, including conflicts with tradition, acceptance, fitting in, and being criticized for not looking Asian.”

The event organizers believe that this was the first step toward forming a coalition to unite Asian American culture clubs from colleges across Connecticut. The organization aims to encourage further collaboration and communication amongst its member clubs.

“My co-host Hamna Tariq and I had the privilege of hosting one of the most successful and productive AASA events ever,” Yang said. “Overall, this event was an unprecedented and historic step that has created momentum that will surely change the state of Connecticut for the collegiate Asian American, and hopefully all cultures.”

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