U.S. Senator Al Franken visited Gordy's Warming House Thursday not for the ice cream or the coffee, but rather to meet with a group of Northland residents who are on the front lines of the battle against the high cost of pharmaceuticals in the United States.
Stories about people cutting pills in half or not taking medication, or choosing between medication and food, were referenced several times over the nearly hour-long meeting between Franken and his constituents.
Ely's Teri Haapala identified herself to Franken as "a pharmaceutical consumer when she can afford it."
"I want you to be able to leave that last part off," the senator told her. He then explained that he reintroduced the "Prescription Drug and Health Improvement Act" to help people just like her. The goal of the bill is to reduce barriers that currently prevent Medicare from negotiating with drug companies to lower prices, something that the Department of Veterans Affairs, Medicaid and other government programs can already do, he said.
The bill — which is cosponsored by 15 Democrats, including fellow Minnesota Sen. Amy Klobuchar — would also make it illegal for drug companies whose drug patent lapses to pay generic drug makers not to sell their cheaper drug, a "pay for delay" tactic that Franken called "egregious and anticompetitive." It would also remove the loophole allowing pharmaceutical companies to deduct the cost of advertising from their expenses.
"Pharma spends more in marketing than they do in actual research and development," Franken said.
The plan would also require drug companies to disclose how much they spend on research, manufacturing and marketing, along with any research grants from the federal government.
"It's especially galling that so many drugs that are developed with taxpayer dollars are unaffordable now for so many Americans now," Franken said in a speech March 31 on the Senate floor.
Pharmacist Megan Undeberg — who works in medication therapy management for Raiter Clinic and Community Memorial Hospital — talked at length about "the donut hole," the coverage gap that exists with most Medicare prescription drug plans. After a person and his or her drug plan have spent a certain amount of money for covered prescription drugs, they hit the donut hole. Once inside, they have to pay all costs out-of-pocket for the drugs up to a certain limit, before "catastrophic coverage" kicks in and they can exit the donut hole and only pay a small coinsurance amount or copayment for the rest of the year.
Undeberg said a patient may have to go a month paying full price for insulin — unaffordable for many — before they rack up enough costs to regain coverage. If they get medicine free, they're in the donut hole longer. Asthma medicine is also very expensive.
People sometimes go broke, she said, or they get very sick.
"We have people not eating, not paying bills, living without lights or phone," she said.
Esko's Jill Beyer told of how she scrambled to call doctors and hospitals to ask for free insulin samples — the price has more than doubled over the last five years — when a woman she helps hit "the donut hole" and couldn't afford to pay full price until she got her monthly check.
More help is just a phone call away, said Brenda Shafer-Pellinen, who works with the Area Agency on Aging and Senior LinkAge Line (800-333-2433).
"Unfortunately a lot of people don't know they qualify or they won't ask," said Shafer-Pellinen, explaining that she and her coworkers can help individuals with health insurance counseling or connect them to various county, state and federal resources.
Thrifty White pharmacist Nat Willgohs said he'd like to see cheaper prices rather than the rebates and coupons some pharmaceutical companies offer, to make the drugs affordable for people. He said his employees spend a lot of time trying to help people find a way they can afford the medicine they need.
Beyer said in addition to trying to find samples of medicine for people who are in that situation, she looks for programs to help in other ways — Ruby's Pantry for food, Lakes and Pines to help with heating bills, for example — so they can better afford their life-saving medicine.
"Do people end up in the emergency room?" Franken asked.
"Or dead," said Undeberg. "Or the life they had is compromised, and then the costs of ER, and the ambulance, hit them too."
Franken left before he could hear all the stories, moving on to Duluth and two more appointments the same day. But his statement to the Senate is one that the people he met at Gordy's would wholeheartedly agree with: "It's morally wrong that some people are denied access to lifesaving drugs because they can't afford them," he said. "And it's something we can fix."