Baucus understands complexity of prescription drugs and rural areas

2013-02-19T08:00:00Z Baucus understands complexity of prescription drugs and rural areasGuest column by PATRICIA KENT missoulian.com
February 19, 2013 8:00 am  • 

“Know your farmer?” How about “Know your pharmacist?”

George Ochenski’s conspiracy theory regarding Sen. Max Baucus, D-Mont., and corporate pharma (“D.C.’s cult of corporate corruption,” Missoulian, Feb. 3) ignores the complex challenges faced by health care providers to maintain service access and affordability for all Montanans across a vast and sparsely populated state; challenges that Baucus understands well.

The conspiracy du jour relates to bundling treatment services for Medicare patients whereby a provider is essentially granted a monopoly to serve a number of clients at a maximum cost per person, thereby incentivizing cost-effective care.

With respect to kidney dialysis, Medicare services are bundled in Montana but are only available in 12 clinics throughout the entire state.

The “Amgen Windfall,” according to Ochenski, occurs because Baucus delayed implementation of a bill that would have added to the bundle of dialysis services an oral drug named Sensipar and thus subject the drug to Medicare price controls. Sensipar is currently available from any local, independent or grocery store pharmacist, through mail order or online. Had oral drugs been added to the bundle of services, Medicare dialysis patients could only fill their prescription through one of the 12 dialysis clinics.

In other words, without further regulation, Montana’s most vulnerable patients would now be required to drive 50 to 100-plus miles or more each way to reach one of the 12 dialysis clinics in the state to fill a prescription, one otherwise currently available from their pharmacist of choice, all in an effort to save tax dollars.

But at what expense? To fill a prescription, the patient/taxpayer we hope: owns a vehicle; can afford the gas and drive safely to that clinic and home again. If not, what about the cost of missed medication?

Add increased energy use and thus energy dependence, impacted air quality and unnecessary traffic.

Delete consumer choice, convenience and safety.

Finally, bundling oral drugs currently available from a local rural pharmacist effectively undermines if not outsources one more job from rural Montana to our larger urban centers.

All this for a drug that will soon be generic.

Consumer choice, safety and community sustainability are essential Montana values. To allow further study of any bill that affects these values is indeed “smart policy.” Thanks, Max Baucus.

Patricia Kent is the director of Housing and Development for Western Montana Mental Health Center, whose mission is provide meaningful access to treatment and housing for persons with mental illness throughout western and southwest Montana.

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