News in brief - Sept. 27, 2004

Patients mum about skipping drugs because of their cost - "Partial-birth abortion" ban again ruled unconstitutional - Advocates for breast cancer patients back drug reimportation - Medicare drug project enrollment falls below expectations - AIDS group sues drugmaker over prices

Patients mum about skipping drugs because of their cost

Much of the country is talking about the high cost of prescription drugs, but that conversation is often missing in the doctor's office. A survey of 660 patients who missed medications or stopped taking them altogether because of the expense showed that 35% never discussed the problem with physicians. Most of those patients also said doctors never asked them whether they were having trouble paying for drugs, according to the study, published in the Sept. 13 issue of the Archives of Internal Medicine.

"We encourage patients and clinicians to discuss potential barriers to their medical care, including the cost of prescription drugs, and discuss possible alternatives, such as available drug-cost assistance programs or the use of generic medications," said Carolyn Clancy, MD, director of the Agency for Healthcare Research and Quality, which sponsored the study.

"Partial-birth abortion" ban again ruled unconstitutional

A third federal judge has declared the Partial-Birth Abortion Ban Act of 2003 unconstitutional. U.S. District Judge Richard G. Kopf for the District of Nebraska ruled earlier this month that the law doesn't make exceptions for cases in which the procedure is deemed medically necessary to protect a woman's health.

LeRoy Carhart, MD, the physician who successfully fought a similar Nebraska law in a court case that wound up before the U.S. Supreme Court, and several other physicians filed the lawsuit against Attorney General John Ashcroft when the ink was barely dry on the new law.

The act outlaws "partial-birth abortion" -- a nonmedical term lawmakers and some opponents use to refer to what most closely describes intact dilatation and extraction -- and creates criminal punishment for physicians who do the procedure. The act has not been enforced since it was signed into law because three lawsuits challenged it immediately.

Federal judges in New York and San Francisco similarly ruled the act unconstitutional. Appeals are under way, and the U.S. Supreme Court is expected to have the final say.

Advocates for breast cancer patients back drug reimportation

A bipartisan group of Congress members who support drug reimportation recently stood with advocates from the National Breast Cancer Coalition to put pressure on their colleagues to pass legislation that would allow patients to buy cheaper cancer drugs from Canada.

"Unfortunately, many patients are unable to afford the life-saving medications that my organization and others have worked so hard to make available," said NBCC President Fran Visco. "What good are groundbreaking research efforts like the Dept. of Defense Breast Cancer Research Program and the innovative work going on in academia and industry if the results are not affordable for the patients who need them most?"

Despite broad public backing and growing support in Congress for legalizing drug reimportation, Senate Majority Leader Bill Frist, MD (R, Tenn.), has made it clear that the issue, as well as three pending bills, will not make it to the floor before the November presidential elections. The Bush administration has opposed reimportation.

Medicare drug project enrollment falls below expectations

During the first of two enrollment periods, the Medicare Replacement Drug Demonstration program, designed to give patients with cancer and serious chronic diseases early access to the drug benefit, has enrolled nearly 4,000 beneficiaries, less than 10% of the 50,000-patient limit originally set by the Centers for Medicare & Medicaid Services. The program provides enrollees help with the cost of self-administered drugs that previously were given in the doctor's office. The assistance is equivalent to as much as a 90% supplementation in some cases.

Beneficiaries can still enroll in the second round until Sept. 30 and start receiving benefits on Oct. 18. "If you're living with one of [the covered] serious illnesses and have to pay on your own for these critical modern medicines, we encourage you to enroll," said CMS Administrator Mark McClellan, MD, PhD.

AIDS group sues drugmaker over prices

The AIDS HealthCare Foundation in September sued GlaxoSmithKline, accusing the company of overcharging for pharmaceuticals that were part of the federal "340B" drug discount program, which allows public hospitals, health centers and others to buy prescription drugs for their patients at a reduced rate.

GlaxoSmithKline denies the claims. "We have lived up to our obligation, and we are committed to doing our part in discounting prices to these groups," said company spokeswoman Nancy Pekarek.

The lawsuit was filed in U.S. District Court for the Central District of California in Los Angeles.