To the Editor: A closer look at the sky-rocketing costs of the category of drugs known as specialty pharmaceuticals validates a proposal to rein them in, offered by TWU Local 100 President Tony Utano, in contract talks with the MTA.

Let’s look at the differences between ‘traditional’ & ‘specialty’ drugs to understand the astronomical gap in prices between these two groups.

Traditionals are made of small molecules that can be synthesized chemically, and taken by mouth as pills. Over time, when they become generics, their costs are lower than when they first appeared as brand-name drugs. For example, think of prescriptions for high blood pressure, cholesterol, & Type 2 Diabetes.

By contrast, specialty drugs are often made from living cells called biologics. They are designed to treat rare and complex diseases, and may require injection or infusion in a hospital setting. Their preparation, storage, delivery, and monitoring are very expensive. But survivors of Hepatitis C, HIV, some cancers, and auto-immune diseases, to name a few, continue to benefit from specialty drugs.

New and older specialty drugs, although they represent only 2 percent of all prescriptions written, account for 40-45 percent of the pharmaceutical market. Traditional drugs represent 98 percent of all scrips written. These are nationwide numbers, but hold true in our region.

A 12-day course of a drug to retard Hepatitis C can cost $50K. A drug to manage leukemia complications can go for $6,800 a month. With these facts in mind, lead negotiator Utano logically reached out to a reputable Specialty Drug Cost Management Service, called Payer Matrix, to bring down costs.

For instance, if infusion is carried out in a hospital, a high rate of reimbursement may be required. But if the infusion could be safely done in a doctor’s office, or at home, an alternate setting could substantially lower costs. Payer Matrix arranges for that change, if workable.

Keep in mind that Payer Matrix is partnered with Amalgamated Life. The Amalgamated Bank family has a solid labor identity going back to the 1920’s. The bank was owned for many years by Workers United.

I applaud the efforts made by Tony Utano and his team to bargain a good contract for our members. Although he received a provocative communication from NYCT Prexy Foye, I know that our union will not take the bait. There is no feud between the union and the MTA, even though a too-eager press loves to represent one, where it doesn’t exist.

A decent contract will be the outcome of the current creative, adroit and well-run contract campaign. I am sure of that.

RUSS SMITH


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