Bptitle page

Bitter Pill:
A R E P O R T B Y
Families USA
June 2002
Bitter Pill: The Rising Prices of
Prescription Drugs for Older Americans
Families USA
This publication is available online at www.familiesusa.org R I S I N G D R U G P R I C E S
INTRODUCTION
Prescription drug expenditures are the fastest-growing component of
health care spending. Since 1995, national spending on prescription drugs has grown by over 10 percent every year, more than double the rate of growthfor spending on hospital care or physician and clinical services.1 Three trendshave been driving this rapid, sustained growth: The number of prescriptions perperson is increasing; newer, higher-cost prescriptions are replacing older, less-costly medications; and the prices of prescription drugs are rising. The lattertrend—rising prices—has become increasingly important. More than one-thirdof the increase in national prescription drug spending from 2000 to 2001 wasdirectly attributable to increases in drug prices.2 Rising prices affect all purchasers of prescription drugs—employers, in- surers, states (as purchasers of drugs for Medicaid beneficiaries and stateemployees), and consumers. In recent years, many of these purchasers havetaken steps to contain their prescription drug expenses.3 These steps haveincluded negotiating rebates or discounts from drug manufacturers, steeringconsumers away from higher-priced drugs, reducing drug coverage, andshifting more costs to consumers through higher copayments and deductibles.
Individual consumers, by contrast, have little recourse. Those who have insur-ance covering prescription drugs face higher copayments and, possibly, limitson which (or how many) prescriptions will be covered. Individuals who haveno coverage for prescription drugs, however, bear the brunt of these priceincreases. With no employer or insurer to negotiate better prices on theirbehalf, they are left to pay the full cost of their rising prescription drugcosts out-of-pocket.
Older Americans, in particular, are burdened by the increasing prices of prescription drugs. Seniors are the population most likely to need prescriptiondrugs, yet they are the least likely of all insured groups to have prescriptiondrug coverage. For several years, Families USA has monitored the prices of the50 prescription drugs most commonly used by older Americans. Our findings B I T T E R P I L L
have consistently shown that the prices of the 50 prescription drugs mostfrequently used by seniors have risen faster than inflation for each of theyears studied.4 This study, the latest in Families USA’s series of reports on prescription drug prices, has again found that the prices for the 50 prescription drugsmost commonly used by seniors have increased considerably faster than in-flation. This finding holds for last year (January 2001 to January 2002), forthe past five years, and for the past 10 years. Senior citizens generally liveon fixed incomes that are indexed to keep pace with inflation, but last year,the cost of the prescription drugs they purchased most frequently rose 7.8percent, nearly three times the rate of inflation.
FINDINGS
The prices of the 50 prescription drugs most frequently used by the elderlyrose by nearly three times the rate of inflation during calendar year 2001:On average, the prices of these top 50 drugs increased by 7.8 percent fromJanuary 2001 to January 2002, while the rate of inflation (excluding energy)in that period was 2.7 percent (see Table 1).
Drugs with Fastest-Growing Prices over the Past Year
!
From January 2001 to January 2002, of the 50 drugs most commonly usedby the elderly (see Table 1): ! One-fourth of these drugs (12 out of 50) did not increase in price.
! Nearly three-quarters of these drugs (36 of 50) rose one-and-one-half or ! More than one-third of these drugs (18 of 50) rose three or more times Among the 50 drugs most frequently used by seniors, the following drugssaw the steepest price increases over the one-year period from January2001 to January 2002 (see Table 1): ! metoprolol (50 mg), a beta blocker marketed by Teva, rose 20.3 percent (almost eight times the rate of inflation); R I S I N G D R U G P R I C E S
! Demadex, a diuretic marketed by Roche, rose 17.8 percent (nearly seven ! Premarin, an estrogen replacement marketed by Wyeth, rose 17.5 per- cent (nearly seven times the rate of inflation); ! Plavix, an anti-platelet agent marketed by Bristol-Myers Squibb, rose 16.8 percent (more than six times the rate of inflation); ! Zestril (both strengths), an ACE inhibitor marketed by AstraZeneca, rose 14.6 percent (more than five times the rate of inflation); ! Lipitor (10 mg), a cholesterol-lowering drug marketed by Parke-Davis, rose 13.5 percent (more than five times the rate of inflation); and ! Combivent, marketed by Boehringer Ingelheim and used to treat respira- tory problems, rose 13.4 percent (more than five times the rate ofinflation).
! The price of 10 more drugs increased by three or more times the rate of inflation. These drugs were: Paxil, used to treat depression; Prilosec, agastrointestinal agent; Prevacid, a gastrointestinal agent; Celebrex (bothstrengths), an anti-inflammatory; Claritin, an antihistamine; Pravachol,used to lower cholesterol; Glucophage, used to treat diabetes; Detrol,used to treat overactive bladder; and K-Dur 20, a potassium replacement.
Drugs with the Fastest-Growing Prices over the Past Five Years
!
Over the five-year period from January 1997 to January 2002, the prices ofthe prescription drugs most frequently used by older Americans rose, onaverage, 27.6 percent. This increase was more than twice the rate of infla-tion over that period, which was 12.4 percent (see Table 2).
Of the 50 drugs most frequently used by seniors, 42 have been on the mar-ket for the five-year period from January 1997 to January 2002 (see Table 2): ! More than three-quarters (32 of the 42) rose in price by more than one- and-one-half times the rate of inflation over the five-year period.
! Over two-thirds (29 of the 42) rose in price by two or more times the B I T T E R P I L L
! Almost one-fourth of these drugs (10 out of 42) rose in price by four or Of those 42 drugs, the drugs that saw the steepest price increases fromJanuary 1997 to January 2002 were (see Table 2): ! furosemide (20 mg and 40 mg), a loop diuretic marketed by Mylan, which rose by 136.4 percent and 135.2 percent, respectively (11 timesthe rate of inflation); ! Premarin, which rose by 67.5 percent (more than five times the rate of ! Synthroid (three strengths), a synthetic thyroid agent marketed by Abbott, which rose by over 67 percent (more than five times the rate of inflation); ! Glucophage, marketed by Bristol-Myers Squibb and used to treat diabe- tes, which rose by 62.2 percent (five times the rate of inflation); and ! Lanoxin (both strengths), marketed by GlaxoSmithKline and used to treat congestive heart failure, which rose by 58.1 percent (nearly five timesthe rate of inflation).
Generic Drugs Vs. Brand-Name Drugs
!
During the past year, 10 of the 50 drugs most frequently used by seniorswere generic drugs, while the remaining 40 were brand-name drugs. Pricesof generic drugs most frequently used by seniors rose by 1.8 percent fromJanuary 2001 to January 2002, a rate less than the rate of inflation. Duringthis period, prices for the 40 brand-name drugs most commonly used byseniors increased an average of 8.1 percent—three times the rate of infla-tion (see Figure 1 and Table 1). Thus, among the top 50 drugs used byseniors, prices for brand-name drugs rose four-and-one-half times the rateof prices for generic drugs in the past year.
! Of the 10 generic drugs, nine did not increase in price at all from Janu- ary 2001 to January 2002. The tenth drug, metoprolol (50mg), rose 20.3percent, more than seven-and-one-half times the rate of inflation duringthis period.
R I S I N G D R U G P R I C E S
Figure 1
Average Annual Cost of Brand-Name and
Generic Drugs,* 2001-2002
* Reflects prices for the 50 drugs most commonly used by seniors.
! By contrast, only three of the 40 brand-name drugs—Zocor, a choles- terol-lowering drug marketed by Merck; Norvasc, a calcium channelblocker marketed by Pfizer; and Alphagan, a glaucoma treatment mar-keted by Allergan—did not increase in price from January 2001 toJanuary 2002.
Of the 10 generic drugs, eight were on the market for the five-year periodfrom January 1997 to January 2002 (see Table 2). Of those eight drugs: ! three more rose slightly faster than the rate of inflation, and ! two (two different strengths of furosemide) rose approximately 11 times B I T T E R P I L L
High-Cost Drugs
!
Of the 50 drugs used most frequently by seniors, the average annual costper prescription as of January 2002 was $1,070 (see Table 3).5 Among these50 drugs, those with the highest annual cost were all brand-name drugs.
They include: ! Celebrex (200 mg), an anti-inflammatory analgesic marketed by Searle, ! Prilosec, a gastrointestinal agent marketed by AstraZeneca, had an an- ! Prevacid, a gastrointestinal agent marketed by TAP Pharmaceutical, had ! Zocor (20 mg), a cholesterol-lowering drug marketed by Merck, had an ! Plavix had an average annual cost of $1,440.
By contrast, the 10 generic drugs were significantly less expensive, with anaverage annual cost of treatment of $375 as of January 2002 (see Table 3).
The average annual price for the 40 brand-name drugs was nearly threetimes that for generics—$1,106 as of January 2002 (see Figure 1). Prices forthe generic drugs were as follows: ! furosemide (40 mg), marketed by Mylan, had an annual cost of $59; ! atenolol (25 mg), a beta blocker marketed by Geneva, had an annual cost ! albuterol, a respiratory agent marketed by Warrick, had an annual cost ! metoprolol, marketed by both Teva and Mylan, had an annual cost of $405; ! isosorbide mononitrate (60 mg), marketed by Warrick and used to treat ! APAP/propoxyphene, marketed by Mylan and used as a pain reliever, had R I S I N G D R U G P R I C E S
Frequent Price Changes
!
Of the 42 drugs that were on the market for the five-year period from Janu-ary 1997 to January 2002, 32 drugs had a price increase on at least fiveoccasions during this period (see Table 3). During those years, the follow-ing drugs increased in price at least nine times: ! Claritin, an antihistamine marketed by Schering-Plough, increased in ! Synthroid (all strengths reported) increased 11 times; ! K-Dur 20, a potassium replacement marketed by Schering-Plough, in- Long-Standing Drugs
!
Of the 50 drugs most frequently used by seniors, 20 have been on the mar-ket for the full 10-year period from January 1992 to January 2002. Prices forthe vast majority of these 20 drugs increased considerably faster than therate of inflation. This is surprising since these drugs have been on the mar-ket an average of 22 years (Tables 1 and 4).
! More than one-half (12 of 20) rose at least two times the rate of inflation; ! Nearly one-half (nine of 20) rose at least three times the rate of inflation; and ! One-quarter (five of 20) rose at least four times the rate of inflation.
Of the 20 drugs on the market for the 10-year period between January 1992and January 2002, those with the most significant increases in price were: ! furosemide (20 mg), which increased 338.7 percent (more than 11 times ! furosemide (40 mg), which increased 244.6 percent (more than eight ! Premarin, which increased 128.3 percent (more than four times the rate B I T T E R P I L L
! Lanoxin (both strengths), which increased 125.9 percent (more than four ! Synthroid (all three strengths), which increased roughly 112 percent (nearly four times the rate of inflation); and ! K-Dur 20, which increased 96.8 percent (more than three times the rate NOTES TO TABLES
Drug names that are capitalized are brand names. The drugs that are not capitalized aregeneric, with the exception of APAP/propoxphene, which is a generic.
The following are abbreviations used in the tables and the explanations of each: microgram, which is 1/1-millionth of a gram milliequivalent, an alternate form of measurement International Unit, a measurement of biological activity International Units per actuation (spray) R I S I N G D R U G P R I C E S
Table 1
Annual Percent Change in Price of the Top 50 Drugs (by Number of Claims) Used by the Elderlya
Rank by Drug Name
Strength
Marketer
Approval
Multiple
Top 50 Drugs, Average Weighted by Salesc
CPI All Items less Energy, Annual Percent Change
a Based on price as of January 15 for each year reported. Drugs are listed in descending order of number of prescriptions.
b Generic or co-marketed versions of this drug are available.
c The weighted average was calculated based on 2000 expenditures for each drug in the Pennsylvania PACE program.
Source: Compiled by PRIME Institute, University of Minnesota, for Families USA from data published by the Pennsylvania Pharmaceutical Assistance Contract
for the Elderly (PACE) and data found in Price-Chek PC published by Medi-Span (Facts and Comparisons, Indianapolis), May 2002.
B I T T E R P I L L
Table 2
Cumulative Price Change of the Top 50 Drugs (by Number of Claims) Used by the Elderlya
Drug Name
Strength
Therapeutic
Cumulative
Multiple
Category
1997-2002
1997-2002
Top 50 Drugs, Average Weighted by Salesc
CPI - All Items less Energy, Annual Percent Change
nm Not marketed during part or all of the period indicated.
a Based on price as of January 15 for each year reported. Drugs are listed in descending order of number of prescriptions.
b Generic or co-marketed versions of this drug are available.
c The weighted average was calculated based on 2000 expenditures for each drug in the Pennsylvania PACE program.
Source: Compiled by PRIME Institute, University of Minnesota, for Families USA from data published by the Pennsylvania Pharmaceutical Assistance
Contract for the Elderly (PACE) and data found in Price-Chek PC published by Medi-Span (Facts and Comparisons, Indianapolis), May 2002.
R I S I N G D R U G P R I C E S
Table 3
Wholesale Cost Per Year of Therapy for Top 50 Drugs (by Number of Claims)
Used by the Elderlya
Drug Name
Strength
Number of
Approval
Price Changes
Cost/Year
1997-2002
Top 50 Drugs, Average Weighted by Salesc
a Based on price as of January 15 for each year reported. Drugs are listed in descending order of number of prescriptions.
b Generic or co-marketed versions of this drug are available.
c The weighted average was calculated based on 2000 expenditures for each drug in the Pennsylvania PACE program.
Source: Compiled by PRIME Institute, University of Minnesota, for Families USA from data published by the Pennsylvania
Pharmaceutical Assistance Contract for the Elderly (PACE) and data found in Price-Chek PC published by Medi-Span (Facts and
Comparisons, Indianapolis), May 2002.
B I T T E R P I L L
Table 4
Cumulative Price Change of the Top 50 Drugs (by Number of Claims) Used by the Elderlya
Strength
Therapeutic
Cumulative
Multiple
Category
1992-2002
1992-2002
Top 50 Drugs, Average Weighted by Sales c
CPI - All Items less energy, Annual Percent change
nm Not marketed during part or all of the period indicated.
a Based on price as of January 15 for each year reported. Drugs are listed in descending order of number of prescriptions.
b Generic or co-marketed versions of this drug are available.
c The weighted average was calculated based on 2000 expenditures for each drug in the Pennsylvania PACE program.
Source: Compiled by PRIME Institute, University of Minnesota, for Families USA from data published by the Pennsylvania Pharmaceutical Assistance
Contract for the Elderly (PACE) and data found in Price-Chek PC published by Medi-Span (Facts and Comparisons, Indianapolis), May 2002.
R I S I N G D R U G P R I C E S
METHODOLOGY
This report used data from the Pennsylvania Pharmaceutical AssistanceContract for the Elderly (PACE) program. PACE is the largest outpatientprescription drug program for older Americans in the United States. In 2000,248,820 persons were enrolled in the PACE program, and the program filled8,979,931 prescriptions. Because of its large size and abundance of claimsdata, the PACE database is commonly used to estimate the elderly’s pre-scription drug use and expenditures.
Using PACE claims for 2000, we developed a list of the 50 top-selling prescription drugs used by older Americans and ranked them by number ofprescriptions issued. Price histories for the 50 top-selling drugs in the PACEprogram were obtained from Price-Chek PC, a database published by Medi-Span/Facts and Comparisons. The price indicator used in this report was theaverage wholesale price (AWP), the price that drug marketers suggest thatdrug wholesalers charge pharmacies.
It is sometimes suggested that AWP is not an accurate measure of drug prices paid by consumers because so many of those consumers enjoy dis-counts that have been negotiated by managed care organizations or otherbulk purchasers of pharmaceuticals. Most older Americans, however, cannotnegotiate such discounts with marketers.
Another commonly used measure of drug prices is the wholesale acqui- sition cost (WAC), the price that wholesalers pay marketers. Although datagiven in this report were calculated using the AWP, calculations using theWAC showed similar trends.
This report used weighted averages in calculating annual price in- creases for the entire list of top-selling prescription drugs. That is, beforeaveraging, the price of each drug was multiplied by a factor that representsthe drug’s percentage of total sales of all drugs on the list for a given year.
This adjustment was made to ensure that the price trends reported accu-rately reflect the cost of drugs older people use most often.
B I T T E R P I L L
DISCUSSION
Seniors, who often live on fixed incomes, are especially hard hit by increases indrug prices. America’s seniors rely disproportionately on prescription drugs:Although they represent just 13 percent of the population, they consume morethan one-third of all prescriptions.6 Not only do seniors use more prescriptions,they also rely on more costly medications: Drug expenditures for seniors consti-tute 42 percent of total drug expenditures.7 Despite their greater need, seniorsare also the most likely population with health insurance to find themselveswithout coverage for prescription drugs. More than 10 million Medicare benefi-ciaries lack such coverage, and millions more have inadequate and unreliablecoverage.8 In the last year, prices for the 50 drugs most commonly used by seniors rose, on average, by nearly three times the rate of inflation. This is not a one-year phenomenon. Of these top 50 drugs, 42 have been on the market at leastfive years and, over that five-year period, have increased in price, on average, bymore than twice the rate of inflation. Three of these drugs—Synthroid, Lanoxin,and Premarin—have been on the market since the 1960s, yet over the last fiveyears these drugs have increased in price by roughly five times the rate of infla-tion (see Table 2).
Most of the drugs with the fastest-growing prices are drugs used to man- age chronic health conditions. There were 18 drugs whose prices increased byat least three times the rate of inflation in the last year. Of these, nearly all arefor the treatment of common chronic conditions such as diabetes, hyperten-sion, heart disease, and arthritis. Older Americans with chronic conditionsdepend on these drugs to maintain their well-being. Seven million Americansage 65 and older have diabetes.9 Millions more suffer from high blood pressure,heart disease, and high blood cholesterol.10 Older people with chronic diseaseslike diabetes and hypertension frequently take more than one drug to treat justthat one condition, and many older people are living with two or more of theseconditions simultaneously. While a senior may be able to compensate for a dra-matic increase in price for one medication by making adjustments to other areasof household spending, few can afford simultaneous increases for multiple drugs.
R I S I N G D R U G P R I C E S
The Role of Advertising
The highest-cost drugs on the list of the 50 drugs most commonly used by
seniors are also among the most commonly prescribed. In fact, the five
highest-priced drugs are all among the 12 most commonly prescribed, and
these five high-priced drugs alone account for nearly 20 percent of the
prescriptions written for these 50 drugs. Not only are these drugs high-
priced, but they are also among the drugs whose prices are rising most
rapidly. Prices for Prilosec, Prevacid, Celebrex, and Plavix all rose by three to
six times the rate of inflation in the past year.
Not coincidentally, these high-priced drugs are among the most heavily advertised. Direct-to-consumer advertising plays a major role in increasingthe demand for many high-priced drugs, sometimes steering consumers tohigher-priced drugs when a lower-cost alternative may be equally appropri-ate. Marketing and advertising efforts of the drug companies have proven tobe quite lucrative. In 2000, AstraZeneca, the maker of Prilosec, spent $107.5million just in direct-to-consumer advertising of Prilosec (this figure doesnot include other promotional activities such as marketing efforts targetedto physicians and medical students). In 2001, AstraZeneca had sales of $5.68billion for Prilosec alone. Direct-to-consumer advertising is common amongother high-priced drugs as well. In 2000, Searle, the marketer of Celebrex, spent$78 million on direct-to-consumer advertising of Celebrex; the firm had $3.1 bil-lion in sales of Celebrex in 2001.11 Brand-Name Monopolies
Generic drugs offer seniors a lower-cost alternative to higher-cost, brand-
name drugs. The average yearly cost of the 50 drugs most commonly used
by seniors was $1,070. For brand-name drugs, the average was $1,106,
compared to $375 for generics. The most expensive generic drug on the list,
APAP/propoxyphene, had an annual cost of $444; the lowest, the 20 mg
strength of furosemide, cost $52 a year. The lower cost of generics and the
slower growth in their prices argue for a greater emphasis on getting more
high-quality generics to the market.
B I T T E R P I L L
When a generic drug enters a market where only a brand-name drug is available, price competition results, offering consumers the potential forgreat savings. According to the Congressional Budget Office, generic drugsare about half the price of brand-name drugs in the first year after the ge-neric enters the market.12 Not surprisingly, the brand-name companies go togreat lengths to prevent generic drugs from entering the market. A drugcompany can extend its monopoly in a number of ways, including marketingwhat is essentially a “new and improved” version of an existing drug; claim-ing the generic company has infringed on a patent, halting the entry of thegeneric for up to 30 months; and by entering into deals with generic manu-facturers to delay their marketing of the generic.
One example of what these delays mean for consumers is the case of Prilosec, the number one drug prescribed for seniors. The original patentfor Prilosec expired in October 2001. However, the marketer, AstraZeneca,delayed market entry of a generic by filing nearly a dozen lawsuits and byclaiming that Prilosec is unique when administered with applesauce. Thisforced the generic manufacturer to do time-consuming research on how thegeneric works when sprinkled on applesauce before it could receive ap-proval to go to market.13 Every day that brand-name manufacturers canavoid competition from generics, they stand to make millions of dollars. In2001, AstraZeneca had Prilosec sales of more than $16 million a day; thatyear, the company raised the price of Prilosec by more than four times therate of inflation. Based on 2001 sales, the eight-month delay since the expi-ration of the patent means an estimated $3.8 billion in sales for AstraZenecafrom this one drug, depriving consumers of the savings from a generic alter-native.14 Legislative changes are needed to ensure that consumers haveunimpeded access to generic drugs.
R I S I N G D R U G P R I C E S
CONCLUSION
As this study confirms, the prices of the top-50 prescription drugs used by older Americans continue to rise faster than inflation, year after year.
However, the older Americans who depend on these drugs do not have in-comes that are rising nearly as rapidly and their coverage for prescriptiondrugs is steadily eroding. The gap between the cost of the medications theyneed and what they can afford is growing wider as drug prices rise fasterthan inflation. Part of the solution to this mounting problem is the enact-ment of a meaningful drug benefit within the Medicare program. Withoutany moderation in prescription drug prices, however, the future of prescrip-tion drug coverage for Medicare beneficiaries (as well as Medicaid, insurers,employers, and all others) will be in jeopardy, and consumers will be forcedto bear the brunt of continuing increases in prescription drug prices.
B I T T E R P I L L
ENDNOTES
1 The Kaiser Family Foundation and Sonderegger Research Center, Prescription Drug Trends: A Chartbook Update (Washing-ton: Henry J. Kaiser Family Foundation, November 2001).
2 National Institute for Health Care Management Research and Educational Foundation, Prescription Drug Expenditures in2001: Another Year of Escalating Costs (Washington: National Institute for Health Care Management, May 2002).
3 Kaiser Family Foundation and Health Research and Educational Trust, Employer Health Benefits: 2001 Annual Survey(Menlo Park, CA: Henry J. Kaiser Family Foundation, September 2001); Amanda McCloskey, Failing America ’s Seniors:Private Health Plans Provide Inadequate Prescription Drug Coverage (Washington: Families USA, May 2002); AmandaMcCloskey, “Prescription Drugs,” Preserving Medicaid in Tough Times: An Action Kit for State Advocates (Washington:Families USA, May 2002).
4 Amanda McCloskey, Enough to Make You Sick: Prescription Drug Prices for the Elderly (Washington: Families USA, June2001); Amanda McCloskey, Still Rising: Drug Price Increases for Seniors 1999-2000 (Washington: Families USA, April 2000);Kathleen Haddad, Hard to Swallow: Rising Drug Prices for America’s Seniors (Washington: Families USA, November 1999).
5 All averages are weighted to reflect volume of sales.
6 Amanda McCloskey, Cost Overdose: Growth in Drug Spending for the Elderly, 1992-2010 (Washington: Families USA, July2000).
7 Ibid.
8 The Kaiser Family Foundation, Medicare and Prescription Drugs (Washington: The Henry J. Kaiser Family Foundation, May2001).
9 Centers for Disease Control and Prevention, National Diabetes Fact Sheet: General Information and National Estimates onDiabetes in the United States, 2000 (Atlanta: U.S. Department of Health and Human Services, Centers for Disease Controland Prevention, 2002).
10 American Heart Association, 2002 Heart and Stroke Statistical Update (Dallas: American Heart Association, 2001).
11 Data on spending for direct-to-consumer advertising taken from Steve Findlay, Prescription Drugs and Mass MediaAdvertising: 1999-2000 (Washington: National Institute for Health Care Management, November 2001). Sales figures aretaken from the 2001 annual reports of the firms that market these medications.
12 Congressional Budget Office, How Increased Competition from Generic Drugs Has Affected Prices and Returns in thePharmaceutical Industry (Washington: Congressional Budget Office, July 1998).
13 Rachel Zimmerman and Susannah Rodgers, “FDA Approves Generic Version of Prilosec,” The Wall Street Journal,November 19, 2001.
14 AstraZeneca, Annual Report and Form 20-F 2001 (2002).
R I S I N G D R U G P R I C E S
This report was written by:
Director of Health Policy Analysis, Families USA The following Families USA staff contributed to the
preparation of this report:
Peggy Denker, Director of PublicationsNancy Magill, Production Coordinator Christopher Fellabaum, Research Assistant Special Thanks to:
Stephen W. Schondelmeyer, Pharm.D., Ph.D., PRIME Institute, the University of Minnesota, for developing the data used in this report Cover Design by:
Please visit our Web site at:
www.familiesusa.org
Families USA
Families USA is a national, nonprofit organization dedicated to the achievement of high-quality,affordable health and long-term care for all Americans. You can help promote Families USA’s goals bybecoming a member of Families USA today.
" Yes, I want to add my voice in support of affordable, high-quality health care for all.
________ $50 ________ $100 ________ $250 ________ Other " Please send me information about Families USA’s grassroots advocacy networks.
" Enclosed is $70 for a one-year subscription to Families USA Publication Service (includes a 20% discount on all previously published materials).* " Please send me the publications listed below (20% discount for subscribers to Publication Service).* Pub Code Title
Quantity
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Name: ________________________________________________________________________________
Organization: _________________________________________________________________________
Street Address: ________________________________________________________________________
City, State, Zip Code: ___________________________________________________________________
Telephone (Day): __________________ (Evening) ___________________ (Fax) ____________________
* DC residents/organizations, add 5.75% sales tax or provide exempt certificate.
Total Amount Enclosed : ________________________________________________________________
Contributions to Families USA are tax-deductible. Please make your check payable to Families USA.
Families USA receives no financing from the health or insurance industries. We rely on funding from individuals and private foundations. Families USA • 1334 G Street, NW, 3rd Floor • Washington, DC 20005 • 202-628-3030
PUBLICATIONS AVAILABLE FROM FAMILIES USA*
Publication
Families USA Publications Service. Annual subscription to reports,
issue briefs, and fact sheets published by Families USA.
Failing America’s Seniors: Private Health Plans Provide Inadequate Drug
Coverage. A Special Report (5/02)
A 10-Foot Rope for a 40-Foot Hole: Tax Credits for the Uninsured - 2002 Update
Collusion and Other Anticompetitive Practices: A Survey of Class Action
Law Suits Against Drug Manufacturers (4/02)
Assessing the Bush Administration’s Proposed Medicare Drug Discount
Card Program. A Special Report. (3/02)
Health Action 2002 Tool Kit (1/02)
Prescription Drug Costs and Coverage: An Action Kit for State Advocates (12/01)
A 10-Foot Rope for a 40-Foot Hole: Tax Credits for the Uninsured (9/01)
Consumer Health Assistance Programs: Report on a National Survey (6/01)
Designing a Consumer Health Assistance Program (6/01)
Healthy Pay for Health Plan Executives. A Special Report (6/01)
Off the Charts: Pay, Profits and Spending in Drug Companies (7/01)
Enough To Make You Sick: Prescription Drug Prices for the Elderly (6/01)
Getting Less Care: The Uninsured with Chronic Health Conditions (2/01)
Expanding Coverage for Low-Income Parents: An Action Kit for State Advocates
Health Action 2001 Tool Kit (1/01)
A Guide to Monitoring Medicaid Managed Care (9/00)
Cost Overdose: Growth in Drug Spending for the Elderly, 1992-2000 (7/00)
Go Directly to Work, Do Not Collect Health Insurance: Low-Income Parents
Losing Medicaid (6/00)
Uninsured in Michigan: Working Parents Lose Health Insurance (5/00)
Still Rising: Drug Price Increases for Seniors 1999-2000 (4/00)
Clouds Over the Sunshine State: Florida’s Working Parents
Lose Health Insurance (4/00)
Welfare Action Kit for Advocates (1/00)
* For a complete list of Families USA publications, visit our Web site at (www.familiesusa.org) or send a self-addressed stamped envelope (55¢ postage) to Families USA Publications, 1334 G Street, NW, Washington, DC20005.
Families USA • 1334 G Street, NW, 3rd Floor • Washington, DC 20005 • 202-628-3030

Source: http://lobby.la.psu.edu/_107th/101_Medicare_Rx_Coverage/Organizational_Statements/FamiliesUSA/FamilesUSA_Bitter_Pill.pdf