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Prime Times Weekly feature of the Mail Tribune , Medford, Oregon The other side effects Photo by Bob Pennell Rogue Valley Manor resident Roger Coryell has cut back on the numbers of drugs he takes but still needs a few. The prices of prescription drugs keep rising, meaning some Rogue Valley seniors are left with bad options By JOHN DARLING When you get older, the term "drug problem" takes on a whole new meaning. Drugs -- prescription drugs -- are a crucial tool in modern health strategy, managing symptoms and keeping illness at bay. But they aren't covered by Medicare and can put a huge demand on a senior's budget. And the use of multiple drugs presents a challenge in juggling side effects. Many seniors on fixed budgets cut their prescribed dosage in half to make it last longer, or they simply don't renew their prescription when it runs out, said Sharon Laws, director of the Ashland Senior Program. "They end up feeling worse and having to go back to the doctor for help." For the same longtime prescription he's been getting at Bi-Mart, Oscar Bjorlie of Ashland said the price has gone up each year and his insurer's share of payment has been going down. "The companies have the formula for the drug and they keep ratcheting it up," Bjorlie said after plunking down $38. "It really puts the squeeze on the seniors. We're the ones who need the most drugs, but it hits us harder because we're on limited incomes." Rogue Valley Manor resident Ernestine Coryell gets drugs mail-order and, because of her husband, Roger, at the Veterans Affairs Domiciliary pharmacy. "If you see them advertised on TV or in magazines, those are the ones that cost a fortune," she said. "We just started to use generic drugs now." New drugs are "so expensive," said Steve Bammer, Rite-Aid pharmacist in Ashland, "because drug companies spend a lot on research and development and getting them approved by the Food and Drug Administration. They should be paid back." Drug companies must recoup these costs and realize profits during a seven-year period when they hold the patent of new drugs and before other companies produce generic brand copies, said Pharmacist Jeff Feyerharm, Rogue Valley Medical Center. "Drug costs seem to go up every year," he said. "It's a very serious problem, unless you've really planned for your retirement and have good investments and good insurance coverage with drug benefits." The high cost of drugs sends many seniors on comparison shopping expeditions. The American Association of Retired Persons offers a 15 percent drug discount to those in its "Members Choice" club. And volume purchasing by hospitals, HMOs and drug-store chains keeps prices fairly competitive, said Rogue Valley Manor pharmacist Fred Millan. "We're within a dollar either way of the top 200 meds in town," said Millan, "and if manor residents beat our price, we'll lower it not just for them, but for all residents." Through HMOs and insurers, seniors often can buy a 90-day supply of a drug by co-paying the price on just a 30-day supply, said Kathy Taccini, Jackson County veterans services officer, who follows the practice. Because she is a county employee, her Blue Cross coverage allows her to fill several 90-day prescriptions by mail from Fred Meyer for only the 30-day co-pay of $160. Just one of the drugs, she added, would run $300, but it costs her a co-pay of only $10. Many retired senior veterans and their spouses are able to get drugs at greatly reduced prices on military bases, Taccini said. Some local residents, who declined to be named, take turns gathering up prescriptions and driving monthly to McClellan Air Force Base near Sacramento to pick up drugs. Much of the burden of drug costs and the dangers of taking too many drugs can be reduced by taking only the right drugs, RVMC's Feyerharm said. "By the time people retire, they've been to many doctors. We see some people who are taking 15, 20, 25 different meds (prescription drugs) a day. Maybe five of them aren't necessary. We ask why they're taking them, and some say they can't remember." RVMC has software that can quickly troubleshoot a drug regimen. Feyerharm enters all diagnoses and drugs, then the computer reviews all "significant interactions" and indications (reasons for taking a drug). "If we can't find an indication for a drug, we ask the doctor why it's being taken." The main drugs seniors take -- for hypertension, cholesterol, arthritis, pain, depression and antibiotics -- are available significantly cheaper in foreign countries because they have price controls, said Bammer. Canadians pay about a third less for drugs than U.S. residents. Total monthly costs of drugs can quickly surpass the tag on car payments or mortgage: Zoloft for depression is $65-75; Prozac is $75-80; Celebrex or Vioxx for arthritis is $75. The antibiotic Amoxicillin is about $13 for a 10-day run. Seniors routinely pay $100 a month and some as high as $300 a month for drugs, Feyerharm said. The U.S. should institute drug price controls, said George Aceves of Ashland, who co-pays $15 on an $82 prescription of pain pills. In the meantime, he said, "if you have confidence in your doctor and your health matters to you, it's something you manage to pay for one way or the other." Many seniors think Medicare should be expanded to include drugs, a proposal put forth by President Clinton to a seemingly receptive Congress and also being debated in the presidential race. Ironically, support for Medicare-paid drugs may well increase automatically with America's rapidly growing elderly population. "We're keeping people alive longer," said Feyerharm, "and a lot of that has to do with drugs." Prime Times Mail Tribune Copyright � The Mail Tribune 2000, Medford, Oregon USA