Health Care Frustrations: My follow up to Linda Berglin

Senator Berglin,

Thank you for taking the time to read my email and listen to my concerns.

Our biggest obstacle has been access to the specialty pharmacy networks.
Insurance companies are carving out chronic diseases from their pharmacy benefits, directing them to their specialty pharmacy provider and offering little if no choice to the individuals who pay the premiums. The policy holders who have these chronic conditions no longer have the choice that an individual without a chronic condition has. The specialty pharmacies have their own disease management programs that are, at best, medium intensity for this population. Often times they charge an additional fee for these services. We do not ask for additional fees to manage our program.

The specialty pharmacy will defend this by claiming cost reductions. I would challenge that assertion. In fact they are costing us billions of dollars per year and the trend is for these costs to continue to grow. One study published in December of 2007 from the American Journal of Managed Care, claims that “the disease management industry has grown rapidly, with estimated annual revenues increasing from about $78 million in 1997 to almost $1.2 billion in 2005 and projected to top $1.8 billion by 2008.” By eliminating competition and creating a virtual monopoly on the services provided to these populations they set their own price free from competitive pressures, ultimately passing that expense on to every policy holder.

What is even more frustrating is the inherent conflict of interest the Hemophilia Treatment Centers have and their 340B programs. In no other form of health care does the law allow physicians to self refer, except in this case. What is their motive? In fact one of the local treatment centers sub contracts their 340B program to a vendor that just settled a 38 million dollar Medicare fraud lawsuit. This is in addition to approximately 150 million dollars this same company has paid out in other settlements and lawsuits over the past three years! This is where Minnesota tax dollars are going!

We offer an outstanding product in an ethical, patient centric manner that can save an incredible amount of money.

I am attaching a presentation for your review.

I am available to meet most anytime.

Sincerely,

Daniel Kallberg