The cost of drugs is important to consumers…

1. The cost of drugs is important to consumers… • According to recent data* 11.4% of the population in Michigan (over 1.1 million citizens) are uninsured: • 6.3% of children in Michigan are uninsured. • Even Seniors who are Medicare D eligible and who have enrolled in Medicare D are sensitive to drug prices. * Source: Robert Wood Johnson Foundation

2. MEDICARE PART D “DONUT HOLE” Saving Seniors Money • Seniors on Medicare have to pay 71% of the first $5,100 in prescription drug costs which amounts to $3,600 out of pocket.

3. A typical older American takes four prescription drugs. Source: AARP “Trends in Manufacturer Prices of Brand-Name Prescription Drugs Used by Older Americans – 2006 Year-End Update”

4. Since 2000, manufacturer prices of 153 widely used prescription drugs by older Americans increased by more than 53.6%. Source: AARP “Trends in Manufacturer Prices of Brand-Name Prescription Drugs Used by Older Americans – 2006 Year-End Update”

5. In 2004, I began the fight to create an interactive prescription drug cost website in Michigan. www.MichiganDrugPrices.com

6. After three Attorney General investigations, three years of hard work and public pressure, the Department of Community Health (who houses the necessary data) still needs to make substantial improvements to the website. • Current Inadequacies Include: • Only 30 drugs. • Many top prescribed drugs missing • No drugs listed to treat some major diseases • Fails to clearly identify whether price is for brand name or generic drugs. • www.michigandrugprices.com

7. Consumer searches for drug.

8. Brand name drug referenced but generic drug prices (Fluoxetine HCL) provided.

10. 30 drugs is not enough! • Minnesota website lists 200 drugs; • http://www.state.mn.us/portal/mn/jsp/home.do?agency=Rx • New Jersey website lists 150 drugs; • http://www.njconsumeraffairs.gov/njpdr/ • New York website lists 150 drugs; • http://www.nyagrx.org/ • Florida website lists 100 drugs; • http://www.myfloridarx.com/

11. 30 drugs on the MDCH site is not enough for several reasons: • It does not list many of the top prescribed drugs (e.g., drugs in May 2007 Prescription Drug Survey such as Singulair, Advair Diskus, Effexor XR, Plavix, Prevacid, and Ambien). • The drugs listed do not cover a wide array of conditions – MDCH’s Web site lists 30 drugs disproportionately weighted with drugs for indications of anxiety (3), depression (4), schizophrenia (2), and pain (3). • No drugs listed to treat major diseases such as diabetes, osteoporosis, cancer, or Alzheimer’s.

12. New York features 150 drugs and their 2006 Drug Web Site Report: • Analyzed 1,898 drug price comparison searches performed by consumers on NY Drug website (www.nyagrx.org) during the two week period of January 12-26, 2006. • Senior citizens could save $833.28 a year by searching for the best price on the website1. 1Based on an average saving of $17.36 per prescription times 4 prescriptions per month for 12 months.

13. Generic drugs exhibited the greatest price variability and therefore the largest potential savings.

14. Conclusion from NY study… … more drugs listed on website, including generics, results in greater savings for consumers.

15. A local Prescription Drug Finder website is important and here’s a good example why:

16. AG Cox May 2007 Prescription Drug Survey: • 11 drugs in 10 communities; • 20 pharmacies per community; • Drugs not listed on MDCH Web site; • Top prescribed drugs; • Drugs to treat wide variety of conditions.

17. DRUGS SURVEYED

18. Pharmacies Surveyed Randomly selected approximately 20 pharmacies in the following communities: • Detroit • Flint Area • Grand Rapids • Kalamazoo Area • Lansing Area 6. Marquette/Upper Peninsula 7. Saginaw/Bay City Area 8. Traverse City Area 9. Troy 10.Warren

19. Consumers’ Right to Know • Consumers have a right to know the price of prescription drugs when they ask in person or by phone (MCL 333.17757). • Pharmacies must conspicuously display written notice at each drug counter the consumers’ right to ask for drug prices. • Report violations to the Bureau of Health Professions at the Michigan Department of Community Health by calling (517) 373-4972.

20. Survey ResultsExtreme Price Differences in Detroit $98.00* $102.00* $68.80* $69.77* * Difference between High and Low

21. Survey ResultsExtreme Price Differences in Flint $56.93 * $54.99* $92.79* $45.29* * Difference between High and Low

22. Survey ResultsExtreme Price Differences in Grand Rapids $54.20* $57.30* $82.00* $78.61* * Difference between High and Low

23. Survey ResultsExtreme Price Differences in Kalamazoo $42.99* $76.99* $75.23* $42.83* * Difference between High and Low

24. Survey ResultsExtreme Price Differences in Lansing $46.99* $98.99* $53.99* $45.94* * Difference between High and Low

25. Survey ResultsExtreme Price Differences in Saginaw $82.81* $97.64* $75.89* $56.39* * Difference between High and Low

26. Survey ResultsExtreme Price Differences in Traverse City $36.03* $51.99* $37.04* $42.00* * Difference between High and Low

27. Survey ResultsExtreme Price Differences in Troy $59.60* $77.99* $61.70* $47.59* * Difference between High and Low

28. Survey ResultsExtreme Price Differences in Upper Peninsula $61.06* $67.30* $42.90* $49.70* * Difference between High and Low

29. Survey ResultsExtreme Price Differences in Warren $68.60* $45.70* $84.17* $60.21* * Difference between High and Low

30. AG Recommendation: Governor & Department of Community Health Should Improve Website: • Increase drugs to at least 150 and include several common dosages. • Ensure top prescribed drugs are included on the site. • Ensure drugs listed to treat all major diseases. • Clearly identify pricing for both generic and brand drugs.