Senators Request Information on Agreements between Pfizer, Drug Benefit Companies, and Insurance Companies Pertaining to Promotion of Heart-Disease Drug Lipitor

Washington, DC - Senate Finance Committee Chairman Max Baucus (D-Mont.), senior Finance Committee member Chuck Grassley (R-Iowa) and Special Committee on Aging Chairman Herb Kohl (D-Wisc.) sent letters today to Pfizer, three companies that manage pharmaceutical benefits and two insurance companies asking for information about agreements aimed at limiting the sale of Atorvastatin, the generic equivalent of Pfizer's drug Lipitor.  The letters were sent after a news report alleged Pfizer agreed to provide discounts to pharmaceutical benefit management companies (PBMs) and insurance companies if the PBMs and the insurers would block prescriptions for Lipitor's generic equivalent.  In letters sent to Pfizer, PBMs Medco, Express Scripts, and Catalyst RX and insurance companies Coventry Health Care and UnitedHealth, the Senators expressed concern these arrangements will hinder access to generic drugs today and in the future.

"We need to do all we can to preserve access to the generic drugs that so are critical to seniors and millions of Americans across the country.  Patients and their families depend on generic drugs and they can't afford to see these generics pushed out of the market," Baucus said. "By working with manufacturers to push brand-name drugs, drug benefit companies may be abusing Medicare to boost their profits and denying generic alternatives to patients - a practice that needs to end immediately.  We need to take a close look to ensure we're protecting both taxpayer dollars and access to the medicine patients need."

"In what's been reported, just about everyone wins except consumers and taxpayers.  That's cause for scrutiny, and these letters reflect a commitment to looking at how to prevent the system from being manipulated so that access to generic drugs is restricted and taxpayers are forced to unnecessarily pay brand-name drug prices." Grassley said.

"Consumers and taxpayers foot the bill when drug benefit companies and insurers manipulate the marketplace to prevent access to generic drugs for millions of Americans.  We hope that scrutiny into these business practices will restore fairness and open the gates to affordable prescription drug choices and tremendous cost savings," Kohl said.

The news report indicated Pfizer and PBMs Medco Health Solutions and Catalyst RX have entered into agreements aimed at undercutting Atorvastatin sales.  Letters sent from the PBMs to pharmacies show the agreements will prevent customers enrolled in certain prescription drug plans from receiving the generic alternative to Lipitor.  While these letters indicate that a plan member's co-pay for Lipitor would be discounted and equal to the cost of a less-expensive generic prescription, the Senators are concerned the PBMs and insurance companies may charge health plan sponsors, including employers and Medicare Part D, full price for brand-name Lipitor from December 1, 2011 through May 31, 2012, while pocketing the discount from Pfizer.  The senators asked for a detailed list of all of all agreements which block generics or favor brand-name drugs and for documents related to the Lipitor deal.

Spending on the Medicare Part D program providing drug coverage for seniors will total $65 billion in the current fiscal year.  In the next four years, brand-name drugs with approximately $100 billion in sales in the U.S. have patents that will expire.  Without the prospect of true competition, generic drug manufacturers will be hesitant to invest the time and resources required to bring low-cost generic drugs to the market.  This heightens the concern that these types of arrangements will become a trend, ultimately compromising access to generic drugs and increasing costs to Medicare.

The United States Senate Committee on Finance has jurisdiction over the Medicare and Medicaid programs.  More than 100 million Americans receive health care and have access to affordable prescription drugs under those programs.

Encourages Commitment to Prevention, Education, Access to Healthcare 

CHICAGO - December 1, 2011. Governor Pat Quinn commemorated World AIDS Day today by urging Illinois residents to support raising awareness, and providing access to education and quality healthcare in the global effort to stop the spread of HIV infection.

"There has been tremendous and groundbreaking work done worldwide to educate the public in the effort to prevent the further transmission of HIV," Governor Quinn said. "But as we observe the 23^rd World AIDS Day, and the 30^th anniversary of the first reported cases of HIV/AIDS, we must continue working globally and locally to reach our goal of zero AIDS-related deaths."

The Joint United Nations Programme on HIV/AIDS estimates that 33 million adults and 2.5 million children are living with HIV worldwide. As a result, the theme for the 2011 World AIDS Day - observed every Dec. 1 since 1988 - is "Getting to Zero."

Illinois has the 7^th highest number of AIDS cases in the nation, with 38,265 cases reported since 1981, with half of those cases being African-American.  Of the Illinois residents diagnosed since 1981, 20,970 have died. The Illinois Department of Public Health sponsors several groundbreaking programs and funds many organizations statewide that aim to prevent the spread of HIV/AIDS. The department also provides access to healthcare services for those living with the disease, including an HIV/AIDS and STD hotline: 1-800-243-2437.

Other programs include :

• Quality of Life Endowment Fund - Proceeds from the "Red Ribbon Cash" scratch off lottery game are used to fund organizations providing HIV/AIDS prevention and support services.
• AIDS Drug Assistance Program (ADAP) - Serves 4,100 low-income persons diagnosed with HIV/AIDS per month access life-saving anti-retroviral drugs.
• BASUAH - Brothers and Sisters United Against HIV/AIDS program promotes HIV/AIDS awareness among communities of color, which are disproportionately impacted by the disease, through education, collaboration and community engagement. Visit BASUAH.org for more information.
• Text 2 Survive - Allows public to find free testing sites and health events via mobile phone by texting "EVENT", "IL" or "ALERT" plus 5-digit ZIP Code to 36363. Spanish speakers can text "CENTRO" plus 5-digit ZIP Code to 36363.

At today's event, Governor Quinn was joined by Congressman Danny K. Davis (D-Ill.), State Sen. Jacqueline Collins (D-Chicago), Chicago Department of Public Health Commissioner Dr. Bechara Choucair, and Kathi Braswell, executive director of the Ruth Rothstein CORE Center, one of the largest HIV/AIDS clinics in the United States.

Governor Quinn also declared today World AIDS Day, presenting the following proclamation:

WHEREAS, preventing the transmission of HIV infection and stopping the spread of AIDS requires a worldwide effort to increase communication, education and action; and

WHEREAS, estimates from the Joint United Nations Programme on HIV/AIDS on the global AIDS epidemic show that around 33 million adults and 2.5 million children were living with HIV at the end of 2009; and

WHEREAS, according to the Illinois Department of Public Health, Illinois has the seventh highest number of AIDS cases in the nation, with 38,265 reported cases of AIDS since 1981. Of those diagnosed with the disease, about 20,970 have died; and

WHEREAS, the World Health Organization has designated December 1 of each year as World AIDS Day, a day to expand and strengthen the worldwide effort to stop the spread of HIV and AIDS; and

WHEREAS, this year marks the 23^rd anniversary of World AIDS Day and the 30^th anniversary of the first reported cases of HIV/AIDS. While we have come a long way since then, there is still much more to be done; and

WHEREAS, the theme for World AIDS Day 2011 is "Getting to Zero" Global leaders have pledged to work towards universal access to HIV and AIDS treatment, prevention and care, recognizing these as fundamental human rights. Valuable progress has been made in increasing access to HIV and AIDS services, yet greater commitment is needed around the world if the goal of universal access is to be achieved; and

WHEREAS, the campaign calls on all sectors of society such as families, communities and civil society organizations, as well as governments, to take the initiative and provide leadership on AIDS; and

WHEREAS, this day in Illinois is commemorated by a number of events across the state, including the dimming of the lights atop the Illinois State Capitol dome and at the James R. Thompson Center in Chicago during the evening hours to coincide with the dimming of the lights at the White House in tribute to those infected with and affected by HIV and AIDS:

THEREFORE, I, Pat Quinn, Governor of the State of Illinois, do hereby proclaim December 1, 2011 as WORLD AIDS DAY in Illinois, and encourage all residents to take part in activities and observances designed to increase awareness and understanding of AIDS, to take part in AIDS prevention activities and programs, and to join in the efforts to prevent transmission of HIV and further spread of AIDS.

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The December 2011 issue of the Harvard Men's Health Watch reports on new research that says social interactions have a ripple effect that extends far beyond household and family units.

Weight: Two of every three Americans are overweight or obese. There are many explanations for our expanding waistlines, starting with lack of exercise and excessively large portions of calorie-dense prepared and processed foods. But an interesting study suggests that social interactions may also play a role.

Researchers from Harvard and the University of California investigated 12,067 people who had been evaluated medically on multiple occasions from 1971 to 2003 as part of the Framingham Heart Study. They found that if one sibling became obese during the study, the chance that another sibling would become obese increased by 40%.

Genetics might account for some of the parallel weight gain in siblings, but not for the fact that if a spouse became obese, the likelihood that the other spouse would follow suit jumped by 37%.  That's no surprise, since spouses share meals and may have similar exercise habits?but scientists also found that if a person had a friend who became obese, his chance of growing obese rose by 57%.

Scientists suspect a major factor is that a social network influences what its members perceive as normal and acceptable. If a man sees his friends become obese over time, he may accept weight gain as natural, even inevitable.

Mood: The Framingham Heart Study's database also served as the foundation for a study of happiness. In this case, 4,739 people who were tracked between 1983 and 2003 served as the primary study population. Together, these subjects reported a total of 53,228 social ties to family, friends, neighbors, and coworkers. Detailed medical and psychological information was available for many of the Framingham volunteers.

The researchers used the Center for Epidemiological Studies Depression Scale to evaluate happiness at the start of the study and at subsequent follow-up examinations. Researchers looked at changes in mood over time.

The Framingham study confirmed many earlier findings about the factors that determine a person's happiness. But it added an unexpected finding: happiness can also spread more diversely and broadly across social networks.

The scientists found that if one spouse became happy, the likelihood that the other spouse would become happy increased by 8%. Siblings who became happy increased the other sibling's chance of becoming happy by 14%. In fact, the spread of happiness seemed to reach across at least three degrees of separation, spreading, for example, from a friend to the friend of a friend and then to the friend of that friend. However, the impact diminished with each degree of separation, and even within first-degree contacts, it began to wane after six to 12 months.

If doctors learn to harness the benefits of natural social networks to spread healthful habits, positive attitudes, and wise lifestyle choices through communities, they may be able to improve public health. This new area of research is worthy of further study, so for now, call it a network in progress.

Read the full-length article:  "Social networks and health"

Q&A on Medicare open enrollment with U.S. Senator Chuck Grassley

Q:    What does open enrollment mean for seniors?

A:    The Medicare open enrollment period for 2012 is under way.  Any enrollee who wants to change plans needs to do so by December 7, 2011.   The annual enrollment period applies to Medicare Parts A and B, which is traditional Medicare; the alternative to Medicare Parts A and B, which is Medicare Advantage; and Medicare Part D, which is the prescription drug program added to Medicare in 2003.

During open enrollment, Medicare beneficiaries don't have to make changes if they don't want or need to.  They can switch from traditional Medicare to a Medicare Advantage plan, move from Medicare Advantage to traditional Medicare, or switch from one Medicare Advantage plan to another.  They can enroll in a Medicare prescription drug plan, drop Medicare prescription drug coverage, or switch from one drug plan to another.

Helpful consumer information is available at www.Medicare.gov/find-a-plan.

Q:    What happens if plans are discontinued?

A:    Most Medicare enrollees will not need to change plans, and most enrollees whose current coverage won't be available next year - whether it's Medicare Advantage or one of the Medicare drug benefit plans - will be enrolled automatically in a new plan, as spelled out in a Notice of Change that insurers were required to send beneficiaries in October.  However, automatic re-enrollment is not always the case, so it's important to read any paperwork you receive this fall.  You may need to re-enroll yourself.

Some insurance plans make changes to prescription drug plans.  It might be higher or lower costs, or the dropping or adding of medications.  Medicare beneficiaries should examine their plans for 2012 changes.  It's important to review your options every year for both financial and health needs.

For 2012, Medicare beneficiaries have plan options that offer enhanced coverage, including zero deductibles and coverage in the gap for generic drugs.  In Iowa, there are 33 Medicare prescription drug plans available for 2012.  These plans offer additional options, such as coverage in the standard benefit's coverage gap and a deductible below the standard $310, including plans without a deductible.  For 2012, the lowest Medicare prescription drug plan available in Iowa for 2012 is $15.10 per month.  Overall, drug plans have seen a slight decrease in premiums for 2012.  I co-authored the legislation that created the Medicare prescription drug program.  Competition among insurers was built into the program design to keep costs low for enrollees, and the program has delivered consistently better-than-expected results in keeping premiums low and affordable.  Beneficiary satisfaction also is high, with 95 percent of enrollees saying their Part D plan works well, and 94 percent saying it's easy to use, in a survey conducted this year.

Q:    What kind of help is available to sort through enrollment questions?

A:    Many states, including Iowa, have set up Senior Health Insurance Information Programs.  Iowa's program provides confidential guidance to individuals, and it's free of charge.  Those who have questions about plan options or unresolved issues with plans should call the Senior Health Insurance Information Program, or SHIIP, at 1-800-351-4664.