Monday, July 10, 2006

Rx plan brings dose of despair

Wednesday, July 05, 2006
Rx plan brings dose of despair
GM employees, retirees see their prescription drug co-pays skyrocket with push to dispense generics.
Sharon Terlep / The Detroit News

Jim and Kathleen Stavropulus opened their mail expecting their regular shipment of prescription drugs.

Instead, the Lincoln Park couple got a notice telling them they owe another $115 for the same three-month supply of prescription drugs that for years has cost them $35.

Jim, a General Motors Corp. retiree, and Kathleen are among autoworkers and retirees miffed over changes in their drug plan.

GM employees and retirees expected higher prescription co-payments this year, but the jump in the cost of some name-brand medications has left some autoworkers, especially retirees, angry and confused.

"If you see a dress in a store that was $35 one day and the next day it was $150, you'd have a fit," said Kathleen Stavropulus, who expected a moderate increase in co-payments. "It's very frightening."

The high cost for some prescriptions stems from a contract change that requires employees and retirees to pay more for a name-brand drug for which there are generic alternatives. The cost can be up to four times more than what they were paying.

Looking to curb health-care costs, GM reduced prescription benefits for its 118,000 hourly workers and 500,000 retirees, surviving spouses and dependants. Other changes have included co-payment increases for other name-brand and generic drugs, under the company's 2003 contract with the United Auto Workers and revisions made last year.

Stavropulus said it took her several phone calls to Medco Health Solutions Inc., which manages pharmacy benefits for GM, and to the automaker to understand that the increase in her husband's prescriptions is because two of the drugs have cheaper, generic equivalents. He chooses the name-brand to manage his Parkinson's disease because his doctor said that's the best choice, she said.

"I didn't know what to do, and he needed his medication," she said.

GM officials said they have worked to inform workers and retirees of the prescription-drug changes -- which took effect last month -- through mailings and by having people on hand to take calls and answer questions.

The company has not seen an increase in calls from people concerned about the changes, GM spokeswoman Sharon Baldwin said.

"We work to communicate any health care changes to our employees, retirees and dependents in a comprehensive manner," she said.

Changes pile on confusion

But the Stavropuluses weren't alone in their confusion.

The overall complex nature of health plans and GM's sweeping changes have been difficult for many, especially retirees, to follow, union representatives said. Adding to the confusion is that some of the health-care changes approved in the 2003 contract are becoming effective at the same time as changes made in the most recent contract.

On the surface, the prescription drug costs are straightforward.

The 2003 contract called for co-payments of $5 for generic drugs and $10 for brand-name drugs.

Last year's agreement increased most of those payments by $5. But the contract also included a provision that calls for employees to pay higher costs for medication when there's a name-brand alternative to the generic drug.

"It shouldn't have been totally new to people," said Ron Perkins, retiree chair for UAW Local 598 in Flint. "But, more or less, they're pretty surprised."

Generics pushed to cut costs

Generic drugs have the same chemical makeup as their name-brand counterparts and are widely accepted in the medical community as a safe alternative. But some patients are hesitant to use no-name drugs and some doctors feel their patients are better off with a name brand.

GM has pushed generics for years as a key part of reducing health costs, which are expected to reach $7.4 billion in 2009.

"GM pays a lower cost for generic drugs, and shares that lower cost in the form of a lower co-payment," Baldwin said. "If a person chooses to select a higher cost brand drug when a generic option is available, they choose to shoulder a higher out-of-pocket cost."

You can reach Sharon Terlep at (313)223-4686 or

© Copyright 2006 The Detroit News. All rights reserved.


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