It shouldn't take generous strangers to help patients cope with drug prices

Aug. 18, 2017 3 AM PT

The inherent goodness of people was made clear this week when a pair of readers offered to pay for a 75-year-old Encino man’s prescription meds after the drug maker imposed a $1,100 deductible to be eligible for financial assistance.

Meanwhile, the warped priorities of our for-profit healthcare industry once again tumbled into the open as the drug company in question, Eli Lilly & Co., responded to this demonstration of humanitarian fellowship with a shrug of its corporate shoulders.

Call me a starry-eyed optimist, but I had a notion that Lilly, shamed by this act of generosity, would have bent its own arbitrary rules and waived the deductible for a cash-strapped senior.

Instead, the company dug in its heels and refused to even take the money, insisting that it be spent instead at a drugstore before Lilly’s financial assistance would resume.

I wrote on Tuesday about Ed Wright, who for 14 years has received the growth hormone Humatrope from Lilly free of charge under the company’s Lilly Cares program. Most drug makers offer such assistance for eligible patients, typically people on fixed incomes who have chronic medical conditions.

This year, Lilly imposed a requirement that most program participants spend $1,100 on prescription drugs before being eligible for the company’s largesse. Steven Stapleton, president of the Lilly Cares Foundation, explained to me in a statement that the company wanted to “balance all the criteria for the program.”

Whatever that means.

What it meant for Wright, though, was that he’d no longer be able to afford his medication, which even with Medicare can cost about $700 a month. He told me he’d started rationing his doses and expected to run out within a few weeks.

Shortly after the column appeared, Ventura resident Karen O’Neil, 71, contacted me to say she’d be willing to pay the $1,100 on Wright’s behalf.

“I could very easily be in the same boat,” she said, adding that she felt moved to do something after reading about Wright “taking half-doses because he can’t get his medication.”

I was contacted as well by Richard Geringer, 66, an Aliso Viejo lawyer who also was willing to pony up the $1,100. He said he was motivated by the fact that he too relies on a costly medication for his own condition, ulcerative colitis, which he described as “like having a million little volcanoes” in his intestines.

“I’m fortunate that Medicare covers my treatment,” Geringer told me. “When I read about Mr. Wright, I thought, ‘This isn’t good.’”

After I informed Wright about the offers of financial assistance, he called Lilly Cares to ask if he could arrange for the money to be sent to the drug maker so he could resume his Humatrope doses.

Wright told me they turned him down flat, insisting that he had to go out and spend $1,100 at drugstores before Lilly Cares would care again.

Stapleton, the Lilly Cares Foundation president, said in a second statement that the program “cannot be involved in connecting a patient with a donor,” which seems beside the point considering that it’s me, not the foundation, doing the connecting.

He also said that Medicare beneficiaries such as Wright are required to spend $1,100 “on any prescription drug made by any manufacturer to be eligible for free Lilly medicine for the rest of the year.”

I asked a Lilly Cares service rep why the company is so determined to have people spend money on any drug from any manufacturer. What’s the benefit to Lilly, except to maintain the drug-market status quo? The rep said she had no answer to that question.

Jason Doctor, an associate professor at USC’s School of Pharmacy, said it appeared that Lilly had made it pointlessly difficult for a person in need to receive the company’s aid.

“It seems fair to say that their patient-assistance program is not working well for people who can’t afford drugs,” he said.

The obvious workaround here is for O’Neil and Geringer to give Wright enough to purchase a couple of doses of Humatrope, thus qualifying him once again for Lilly’s assistance. I’m now setting that up.

But it’s all so unnecessary. The only thing that has been accomplished is that Lilly has goosed its sales a little higher while still enjoying the pretense of being a good corporate citizen. (The company receives a healthy tax write-off for its Lilly Cares program.)

Actually, what’s also been accomplished, thanks to O’Neil and Geringer, is recognition that there are decent people out there ready to help someone in need, no strings attached.

Drug companies point to their patient-assistance programs as evidence that their hearts are in the right place.

The Lilly Cares website says that “it’s important to us to make sure that those who can benefit from these medicines have access to them.”

I don’t want to imply that Lilly isn’t doing good by making millions of dollars worth of meds available to people who couldn’t otherwise afford them.

But there’s another road they and other drug companies could take: charging reasonable prices to begin with.

O’Neil put it best: “It’s great that we can help one person. But there are thousands and thousands of others out there.”

And not enough Good Samaritans to go around.

David Lazarus’ column runs Tuesdays and Fridays. He also can be seen daily on KTLA-TV Channel 5 and followed on Twitter @Davidlaz. Send your tips or feedback to [email protected].

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