Despite the increase in drug costs outpacing inflation, Pennsylvania seniors are still paying the same amount for prescriptions that they did in 1990.
The month of May 2023 is a special one for me: I get to join the ranks of America’s most formidable group. Everyone in the state capitals and Washington, DC, is afraid of us. My wife, Denise, has already joined. We’re not joining a motorcycle gang...but we both will be aged over 65 years and officially senior citizens. I will still be working my side hustles, but my days on the bench have come to an end. I’m not nearly as excited about getting a discount at Cracker Barrel as I am about the polit-ical clout that comes with being a member of this “gang.”
From the time I started practicing pharmacy back in 1981, I was aware of the coddling of the senior citizen age group. We have senior citizen discounts, we have senior citizen centers that serve lunch, and we have senior health insurance programs. I’m so happy I now get to say, “I am on a ﬁxed income.” The truth is that my income has been ﬁxed ever since I got my ﬁrst paycheck from cutting grass at the St Mary Cemetery.
I got to see the realities of senior clout in government back in 1983, when Pennsylvania Gov Richard Thornburgh came to Tyrone, Pennsylvania. He had funding for rehabilita-tion of the Tyrone Reservoir. All the local politicians were there, and I was glad to join them. After the governor’s speech, and after the dignitaries ﬁ led out, I was able to have a brief discussion with Governor Thornburgh.
The Pennsylvania Lottery had been in existence for 12 years, and the state was starting a prescription drug program to beneﬁt senior citizens. Many states use their lottery programs to beneﬁ t educational eff orts, but the Pennsylvania Legislature knows better: Kids in college don’t have near the voting bloc that senior citizens have. The young’uns say they are politically active; they go to protest marches carrying signs and they have signs and ﬂags in their yards. My fellow senior citizens vote, and politicians know that.
The Pharmaceutical Assistance Contract for the Elderly (PACE) program1 was set up with generous income requirements; participants had to be over 65 years and a citizen of Pennsylvania for 90 days. As proposed, medication co-pays would be $4 for each prescription.
I introduced myself to Governor Thornburgh and told him that as a pharmacist, I felt this program was unsustainable given the ever-rising costs of prescription medications. He agreed. “We are well aware of that situation,” he said. “We are matching the Blue Cross co-pay of $4 for now. Within a few years we expect to have a co-pay of $20 for that program.”
I ﬁlled my ﬁrst PACE prescription on July 1, 1984. The patient’s ﬁrst name was Howard, and he was delighted to get his medication for $4. Around 1990, the decision was made to increase the co-pay from $4 to $6, and senior citizens went ballistic. During the next gubernatorial election, one of the candidates was criticized for being instrumental in “a whopping 50%” increase in the PACE co-pay.
Thirty-ﬁve years later, the basic co-pay is $6 for generics and $9 for brand. Even with the introduction of the PACENET program, co-pays are only $8 for generics and $15 for brand. We are still nowhere near the $20 co-pay that the governor predicted 40 years ago. According to the US Bureau of Labor Statistics,2 the price increase of drugs was 3 times greater than the rate of inﬂ ation for all other goods, but senior citizens are paying the same amount for their generic chlordiazepoxide today as they did in 1990 if they are enrolled in PACE.
Denise and I are happy to put up with our aching bones, gray hair, and advancing age. And the politicians who want to mess with our well-de-served Medicare ought to watch out…because we vote.
Peter A. Kreckel, RPh, practices pharmacy part time in Lemont Furnace, Pennsylvania.