Paying for drugs

**Publication date:\
**Sunday, June 01, 2003

![](media/image1.jpeg){width="3.6458333333333335in"
height="2.4479166666666665in"}\
In need of help: Dorothy Cutriss displays a wound on her arm as her
husband, Jack, looks on. The injury is just one of many problems from
which she suffers. The Cutrisses, who are largely homebound, live off
Social Security and struggle each month to pay for medication they've
been prescribed. (KT photo by Tim Bath)

By SCOTT SMITH

Tribune staff writer

Jack and Dorothy Cuttriss met each other at church 67 years ago, and
neither has strayed from the faith. Pictures of Jesus adorn the walls of
their small apartment on Kokomo\'s east side, including a watercolor
Dorothy crafted more than 30 years ago from a paint-by-numbers set.

Their television stays on Christian programming, particularly reruns of
Billy Graham crusades and California Pastor Robert Schuller\'s \"Crystal
Cathedral\" broadcasts. Dorothy loves her CD player, which has the
Gaithers on constant rotation. They speak with veneration of the local
philanthropists who gave them two brand new lift chairs, which they sit
in, side by side, each day. They both laugh like kids when asked if they
still enjoy each other\'s company.

So perhaps it\'s fitting that this couple, married 65 years come August
25, are getting by these days on a little Christian charity. If it
wasn\'t for the help they get from their friends in the First Baptist
Church congregation, Jack, 88, and Dorothy, 85, might not be able to
survive on their Social Security income.

Their problem, familiar to many seniors, is the plethora of medications
they must pay for out-of-pocket. Just the other day their friend John
Nelson, an elder at First Baptist, helped Jack get three prescriptions
filled at Wal-Mart. Grand total: \$155. Not bad these days as far as
prescription prices go, but not so good either for a couple that
doesn\'t have health insurance or a pension.

\"They\'re living on borrowed time,\" Nelson said. \"They live from
\[Social Security\] paycheck to paycheck, and eventually their expenses
are going to cut into food or into prescriptions.\"

\"I tell the doctors sometimes that if you want us to take medicine,
you\'d better give it to us,\" said Jack. Sometimes the doctors have
their cabinets full of free samples, he added. Other times, the cabinets
are empty.

\"I liked it better in the good old days when the doctor just gave you a
shot, and you were all right,\" Dorothy said.

Dan Burton\'s beef

Ask Congressman Dan Burton about problems like the one the Cuttrisses
are facing, and you\'re liable to get a 10-minute lecture, no punches
pulled.

According to Burton, famed for his investigations of former President
Bill Clinton\'s alleged (and proven) improprieties, the blame for the
Jack and Dorothy\'s predicament can be cast wholly on the greed of
American drug companies.

\"It all boils down to the almighty buck,\" said Burton, the
representative from Indiana\'s heavily Republican 5th District. \"When
you have pharmaceutical companies loading profits on the backs of the
American people when they could sell their product a helluva lot
cheaper, that isn\'t right. I believe in free enterprise but I don\'t
believe in the unfair treatment of Americans.\"

Burton\'s latest cause, protecting Americans\' ability to purchase
prescription medicines at a lower price in Canada, has drawn notice from
the powerful drug lobby, which last week launched a major press campaign
in Burton\'s district.

The reimportation issue is a prickly one for the Pharmaceutical Research
and Manufacturers of America (PhRMA), the trade association which
lobbies Congress on behalf of the drug companies. Canada has strict
price controls on prescription medicines, while the U.S. relies on the
fair market system. As a result, drugs are cheaper in Canada \-- much
cheaper. Most medicines there cost about half of what they do in the
U.S. Many medications get even deeper discounts.

Burton claims that drug companies, particularly British giant
GlaxoSmithKline, are now trying to squeeze Canadian pharmacies who
knowingly sell large amounts of prescription medication to visiting
Americans.

In January, Glaxo stopped shipments to a number of Canadian wholesalers
and pharmacies. In retaliation, Burton joined forces with an unlikely
ally, U.S. Rep. Bernie Sanders, I-Vt., to propose legislation that would
impose fines on manufacturers who engage in similar attempts to cut off
the Canadian market to Americans.

That move drew a quick response from PhRMA. Last week, Jeffrey Trewhitt,
a PhRMA spokesperson, was traveling Burton\'s district to criticize
Burton\'s stance and reimportation in general.

\"We think Congressman Burton is backing the wrong horse. We don\'t want
to bring in someone else\'s failed price controls,\" Trewhitt said.
\"The free market we have here in the U.S. inspires biomedical
researchers to take expensive risks. We do have the most creative
industry, and it\'s because we believe in the free market system.\"

The drug companies aren\'t Burton\'s only critics on the issue: The Bush
administration, the House Republican leadership and the federal Food and
Drug Administration all are against reimportation.

\"There was \$20 million in campaign donations given out last year by
the pharmaceutical industry,\" Burton said. \"Yes, I\'m getting all
kinds of pressure to get off this, but I won\'t, and the reason is
because \[the drug companies\] lack support from the American people.

\"I\'m not going to stop our hearings \[before the House Subcommittee on
Human Rights and Wellness\]; I\'m not going to stop raising Cain.
They\'re trying to get me to stop, and that is not going to happen. I
investigated Bill Clinton and took a bunch of heat for it. But I didn\'t
flinch then, and I\'m not going to flinch now.\"

However, with no backing from House Speaker Dennis Hastert, R-Ill. and
House Majority Leader Tom DeLay, R-Texas, Burton\'s legislation doesn\'t
appear to be going anywhere.

Hardball Washington politics

One of Burton\'s biggest opponents now is Bush Cabinet appointee Tommy
Thompson, head of the federal Health and Human Services administration,
who is actually responsible for suspending a law Congress passed in
2000, the MEDS Act, which would have basically legalized reimportation.

Safety concerns, Thompson said, make it unfeasible for his agency to
implement the MEDS Act.

\"Opening our borders as required under this program would increase the
likelihood that the shelves of our pharmacies \... across the nation
would include counterfeit drugs, cheap foreign copies of FDA-approved
drugs, expired drugs, contaminated drugs, and drugs stored under
inappropriate and unsafe conditions.\"

In illustrating the dangers Americans might face purchasing drugs
shipped to Canada and then reimported, Trewhitt referred to a
well-publicized case of an Oregon man who was given an immediate relief
dosage of a heart medication in Canada, when his American doctor had
prescribed a time-release dose. The man ended up in the emergency room,
Trewhitt said.

Ironically, Trewhitt\'s example was the same one Burton lambasts as a
single, unsubstantiated case.

\"There\'s a lot more than that one example,\" Trewhitt said before
explaining that he didn\'t have any others readily at hand. \"That kind
of mistake can easily be made.\"

The drug companies, Burton retorted, know full well that plenty of
tamper-proof methods of packing drugs already exist, and that all of the
pharmacies in question are regulated by the Canadian authorities.

Besides, he said, there are hundreds of cases annually where Americans
are sickened by imported produce, and yet produce is subject to far less
scrutiny by customs and the FDA.

The real problem, Burton claimed, is that a \"revolving door\" system is
in operation at key regulatory agencies like the FDA. Regulators become
pharmaceutical executives, and vice versa.

\"The FDA is in bed with the pharmaceutical industry, and you can quote
me on that,\" Burton said. \"They\'ve got a revolving door. When these
people go to a drug company, they can make two or three time the salary
they make in Washington.\"

The drug companies can afford lavish pay packages, like the \$20.7
million in salary and stock options Glaxo\'s chief took home in 2002.
Ironically, Fortune Magazine called 2002 the worst financial year in the
publication\'s 48-year history, yet the drug industry ranked number 1 on
all three of Fortune\'s profitability measures: return on revenues,
return on assets, and return on shareholder\'s equity.

Trewhitt, however, said Burton\'s focus on drug prices and protecting
reimportation is a distraction from a more important issue: a
prescription drug benefit under Medicare.

Last year, the House passed a \$350 billion, 10-year plan to provide a
Medicare benefit that would be administered through private providers,
Steve Hahn, a spokesperson for the American Association of Retired
Persons, explained during last year\'s election season. The plan was
blocked in the Senate, which passed its own plan. Neither plan passed
both houses.

The AARP contends seniors\' premiums would have been too high under the
House plan, and that a gap in the plan\'s coverage would mean seniors
wouldn\'t realize much in the way of actual savings, Hahn said. But, he
added, it was still technically a plan under Medicare, because seniors
would still have been covered by Medicare if a private provider weren\'t
available in their area.

A similar plan is in the works this year, and Congress is expected to
being working on it in the coming weeks. But because last year\'s House
plan was supported by PhRMA, as is the plan currently being put forward
by the Bush administration, critics like Burton are dismissive.

\"We\'re going to pass a prescription drug benefit, but if we don\'t do
something about the astronomical costs of these drugs, then the
taxpayers are just going to get soaked again,\" Burton said.

Traveling to Canada

Elmer Blankenship is one of the principal causes of PhRMA\'s
aggravation. The president of the Indiana Alliance for Retired
Americans, Blankenship garnered headlines last year when he organized a
Hoosier contingent for a 16-bus national caravan to Canada.

All 38 people on the Indiana bus had obtained a release from their
doctor prior to the trip, and their prescriptions had been faxed to a
Canadian doctor a week in advance, along with a short medical history.

Upon arrival, the bus riders were ushered into a pharmacy/medical
clinic, which Blankenship said had a thriving local clientele.

\"It was right on a public street, and it had signage, and everybody
knew it was a drug store. Canadians were coming in and buying drugs,
just like you\'d do at Wal-Mart,\" Blankenship, a UAW retiree, said.

The doctor reviewed each patient\'s prescriptions with them, and then
each patient was given a package containing their prescriptions. A
pharmacist went over all of the relevant information about the
medications, and then the group was headed back to Indiana.

Blankenship claimed that over a year\'s time, he calculated that each
person on the bus trip saved an average of \$1,664. The members of the
group each received a three-months\' supply in person, and then could
mail order another nine months\' worth. One trip is good for one year\'s
supply, he said.

\"I appreciate Burton\'s position that it\'s OK to import drugs from
Canada,\" he said.

The Cuttrisses at home

Jack and Dorothy Cuttriss, of course, aren\'t able to take any lengthy
bus trips. The couple hasn\'t even been to church for the past five
weeks, mainly because Dorothy took a tumble and her arthritic hip has
been killing her. She said she doesn\'t like the pain pills the doctor
gave her, and that she\'s sticking to Extra Strength Tylenol.

A couple of years ago, the Cuttrisses tried living in a local nursing
home, but decided they couldn\'t afford it, and didn\'t like it anyway.
Both use walkers, and Jack can\'t keep his balance without medication.
Even with the help of Nelson and Grant Poynter, a local senior who helps
other seniors with insurance and prescription drug questions, trying to
find low cost medicine is a headache for Jack.

He worked for 42 1/2 years at Continental Steel, the Kokomo-firm that
went bust in 1986, taking thousands of workers\' pensions with it. Now,
at least, they\'ve got each other, and the memories of raising four
children together, and of nurturing dozens of foster children.

At the revival meeting where they met, Dorothy recalled Jack getting
ready to go up to the altar at the invitation. She also recalled the
preacher telling her \"The Lord\'s calling you for something.\"

\"It must have been taking care of all them babies,\" she said. \"That
was my job all those years.\"

Now it\'s someone else\'s job to take care of her.

Scott Smith, Tribune reporter, may be reached at 454-8569 or via e-mail
at scott.smith@kokomotribune.com

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