Pay-or-die: The ugly side of U.S. health care

Wayne Magro considers himself a lucky guy. In 2001 doctors diagnosed him with an aggressive form of prostate cancer. A few times since then the cancer has begun to spread rapidly, leading to a prognosis that he had months to live. But each time he has managed to stay ahead of the grim reaper when his doctor prescribed a different drug that successfully slowed the cancer.

He expresses great appreciation for the doctors who have treated him and the scientists who developed the drugs that continue to extend his life, now in its 73rd year.

"I really appreciate what they've done for me, honestly. I've seen five of my grandchildren graduate from high school, two from college, met my youngest grandson," said Magro, who lives in Pawcatuck with his wife of 54 years, Nancy. "I take every day one day at a time and I am very happy I am still here."

But he got a surprise in April when he walked into his local Rite Aid to pick up the drug that he has been using of late to block the cancer growth, Nilandron. For months, under his Medicare drug coverage plan managed by United Healthcare, he had been assessed a co-pay of $95 for the $786 drug. He buys a 30-count of the medicine he takes daily. But in April the co-pay jumped to $601 because the price had increased to $2,777.

Magro thought for sure it was a mistake, but was assured it was not. It was unnerving.

"It's keeping me alive," he said of the drug.

What changed? On April 4 Switzerland-based Covis Pharma Sal purchased the U.S. commercial rights for Nilandron and four other drugs from Sanofi-Aventis for $114.6 million. Covis' U.S. affiliate is Covis Pharmaceuticals Inc., operating out of Cary, N.C.

The price for Nilandron jumped dramatically, it appears, because Covis wanted to recoup its investment.

That's what Magro says he was told when he called the company, eventually reaching Bill Collins, listed as president and CEO of Covis operations in the North Carolina office. Seemed like a nice guy, he said.

"I told him, 'Do you realize people that use this drug are like me, that need it to extend my life? I'm trying to give Corvis a chance to do the right thing.' "

So he asks, "What's the right thing?"

"Bring the price back down," I said.

"He said, 'Oh no, we can't do that,'" recalled Magro.

A Covis worker did call to offer a month of free samples, but by then Magro had decided to complain to the attorney general and Medicare.

"It would've been kind of hypocritical because I am not standing still for this and it's more than a one-month deal," he told me.

Magro got no satisfaction from the attorney general or Medicare because apparently no regulations were violated.

I called Covis' office in North Carolina, too, but did not do as well as Magro. No one returned my calls after I left messages explaining what I was calling about.

You want a handle on what is wrong with out-of-control health care costs? Here is one example. While other countries practice drug price controls, including Switzerland, in the United States a company can jack up the price - not to cover research or because of unforeseen circumstances - just to turn a bigger profit.

As for Magro, who said he managed to build a good middle-class life by working his way up from the shipyard to management during a long career at Electric Boat, he said he will find a way to pay for the medicine as long as it continues working.

Still, the unfairness gets him riled up, he said. That and the knowledge not everyone who needs it will be able to afford it.

Paul Choiniere is editorial page editor.

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