The New York Times and ProPublica have teamed up to investigate who is to blame for skyrocketing drug prices — and have turned up some surprising answers.

This story was co-published with The New York Times.

This much is clear: The public is angry about the skyrocketing cost of prescription drugs. Surveys have shown that high drug prices rank near the top of consumers’ health care concerns.

What’s not as clear is exactly why prices have been rising, and who is to blame.

For the last four months, The New York Times and ProPublica, the nonprofit investigative journalism organization, have teamed up to answer these questions, and to shed light on the games that are being played to keep prices high, often without consumers’ knowledge or consent. Katie reports from the health desk at The Times, and Charles is a senior reporter at ProPublica.

Our reporting journey has turned up some counterintuitive stories, like how insurance companies sometimes require patients to take brand-name drugs— and refuse to cover generic alternatives — even when that means patients have to pay more out of pocket.

Along the way, we’ve asked readers to share their stories about their struggles with high drug costs. We’ve heard from nearly 1,000 people.

In recent weeks, a few stories caught our eye. A woman in Texas, for example, told us that the company that manages her drug benefits, OptumRx, was going to start asking her to pay more out of pocket for Butrans, a painkilling patch that contains the drug buprenorphine. As a “lower cost alternative,” OptumRx, which is owned by UnitedHealth Group, suggested she try painkillers like OxyContin, even though they carry a higher risk of dependence.

A letter sent by OptumRx, a pharmacy benefit manager, to a member in Texas, suggesting she consider switching from the Butrans painkilling skin patch to drugs that carry a higher risk of abuse and dependence. (Letter obtained by ProPublica)

“The whole point of pain management is to take the least amount of medication possible to manage your pain, so that you always have somewhere to go when the pain increases or changes,” she wrote to us. “This is irresponsible and scary ‘cost management.’” She did not want to use her name, saying her employer prohibited her from identifying herself, but she allowed us to share OptumRx’s redacted letter.

Her pharmacy benefit manager, she wrote, is “effectively contributing to the ‘opioid crisis’ with its own policies.”

A spokesman for UnitedHealth, Matthew N. Wiggin, said it takes the crisis seriously and wants to ensure that people with chronic pain get the appropriate treatment.

We’ve closely followed the opioid crisis and efforts to hold various parties accountable, among them drug manufacturerspharmacies and emergency room doctors.

But these stories — about patients who believed their insurers were placing roadblocks in the way of less risky painkillers — felt new to us.

We followed up with several of the readers, and searched social media to see if other patients were talking about this.

Then we asked for documents: billing statements from insurers, denial letters, call logs and doctors’ records. In the case of our lead example, a woman named Alisa Erkes, she also agreed to sign a privacy waiver allowing her insurer, UnitedHealthcare, to comment on her case.

Charles enlisted ProPublica’s deputy data editor, Ryann Grochowski Jones, to analyze data from Medicare prescription drug plans. The results showed that insurers were indeed placing more barriers to drugs like Butrans and lidocaine patches than to cheaper generic opioids.

Insurers say that they are doing their part by placing limits on new prescriptions for addictive painkillers, and that they are also doing more to monitor doctors’ prescribing patterns and to catch abuse by patients. Several insurers said they had seen declines in monthly opioid prescriptions, a sign of progress.

But their behavior has infuriated many patients, who say they want to avoid taking opioids if possible. They argue that insurers are too focused on a drug’s cost, since many of the painkillers with a lower risk of addiction are more expensive.

Our project examining high drug costs is not over. We are already digging into other corners of the prescription drug world, hoping to shed light on more of the hidden forces that are keeping drug costs high. Stay tuned, as well, for more stories that were inspired by our readers.

Have you had trouble paying for prescription drugs? Tell us about it.

 


 

At approximately 2:00 am on Sunday, September 10, 2017, the Gallatin County Sheriff’s Office responded to the area of Sourdough Road and Goldstein Road for a report of gun shots fired.  An errant bullet entered a residence after ricocheting off of a road sign.

The Gallatin County Sheriff’s Office believes the shots were fired from a moving vehicle and are asking any witnesses to come forward with information related to this incident.  This reckless act could very well have cost someone their life; the bullet entered dangerously close to the homeowners.

Anyone with information regarding this event are encouraged to call the Gallatin County Sheriff’s Office, Detective Division at 406-582-2121.  Information leading to the arrest of the suspect(s) may be eligible for a Crimestopper reward.


Bozeman, MT – Everyone in Gallatin County is encouraged to use safe practices with fire over the weekend and for the remainder of fire season.  The conditions in many areas are very conducive to wildfires starting and rapidly growing into large devastating fires.  Gallatin County officials are asking everyone to limit their recreational fire use even in locations where they are still allowed.  “With much of Western Montana inundated with large wildfires, we don’t want to add Gallatin County to that list and we need everyone’s help to avoid wildfires here,” according to Patrick Lonergan, Gallatin County Emergency Manager.

Patrick Lonergan explained, “With wildfires burning across the West, and Hurricane Harvey in Texas, emergency resources are stretched thin.  The lack of resource availability combined with the vegetation and weather conditions creates a situation that makes catching wildfires when they are small very challenging.  The best way to prevent a devastating wildfire from occurring in Gallatin County is for our community to keep a fire from starting.  Officials are asking our community to avoid starting fires and if they do have a recreational fire, use extreme caution.”

Open burning in Gallatin County is currently closed and the Custer-Gallatin National Forest, Montana DNRC and Montana FWP are enacting Stage 1 Fire Restrictions Saturday on their lands within Gallatin County.  Individuals recreating on these public lands should check with the respective agencies on the exact restrictions, but generally this restricts the use of campfires and smoking outdoors.  Recreational fires are still allowed, but discouraged, on private property in Gallatin County that are not classified forest lands (classified forest lands are regulated by DNRC & USFS).

###

Below is a detailed release of the fire restrictions taking effect this weekend:

Stage 1 Fire Restrictions Implemented Across the Zone

Thursday, August 31, 2017—Beginning at 00:01 a.m. Saturday, September 2, 2017 Stage I Fire Restrictions will be extended to include most areas in the South Central Montana Fire Zone on federal, state and some county lands.  Yellowstone National Park, the Absaroka Beartooth Wilderness and the Lee Metcalf Wilderness Area will not go into Stage 1 fire restrictions at this time.  The agencies were prompted to implement fire restrictions over a broader area because there was an increase in fire activity east of the Continental Divide since Wednesday, which further depleted firefighting resources.  In addition, red flag warnings are predicted.

In summary:

  • Custer Gallatin National Forest  The national forest is in stage 1 fire restrictions with an exemption for campfires in improved recreation sites with metal fire rings starting Saturday 9-2-17 at 00:01.  The Absaroka Beartooth and Lee Metcalf Wildernesss are excluded from restrictions at this time.  The East Zone is already in Stage 1 restrictions.
  • BLM lands in both Park and Gallatin Counties will move into Stage 1 restrictions with an exemption for campfires in improved recreation sites with metal fire rings starting Saturday 9-2-17 at 00:01
  • Fish Wildlife and Parks lands which includes fishing access sites and state parks: Park County sites are currently under Stage 1 Restrictions with no campfires. Gallatin County sites will move into Stage 1 restrictions with no campfires starting Saturday 9-2-17 at 00:01
  • Department of Natural Resources classified forest lands in Park and Gallatin County will move into Stage 1 restrictions with no campfires starting Saturday 9-2-17 at 00:01
  • Gallatin County has closed open burning under burn permits and does not implement staged fire restrictions. 
  • Yellowstone National Park has no fire restrictions at this time. However, campfires are always restricted to improved recreation sites with metal fire rings. 

 The purpose of fire restrictions is to reduce the risk of human-caused fires during periods of very high to extreme fire danger. These areas are experiencing critical fire conditions, including dry fuels, hot temperatures, low humidity, and high winds, all of which are expected to continue.

For more information about fire restrictions, and to check what areas are under restrictions, visit the Fire Restriction website at: https://firerestrictions.us/mt/ or call your local fire management agency, volunteer fire department, or county office.

Media Contacts: 

South Central Fire Zone Coordinator:  Greg Coleman This email address is being protected from spambots. You need JavaScript enabled to view it. 406/222-4188

Acting Public Affairs Officer, Custer Gallatin National Forest for forest related questions:  Teri Seth, 406/587-6703

 


 

July 14, 2017

Helena - On Wednesday, July 12, 2017, Governor Steve Bullock and Lt. Governor Mike Cooney welcomed over 400 business leaders and entrepreneurs from across Montana to the 2nd annual Innovate Montana Symposium. The two-day event featured keynotes, workshops, and networking receptions to encourage business growth and increase economic opportunity and innovation in Montana.

“Montana is experiencing strong business and job growth, and our small business owners and entrepreneurs are the engines that drive our economy,” said Governor Bullock. “Hard work and innovation run through our veins here in Montana, and this event will showcase all the incredible work and new ideas being developed under the Big Sky.”

The Innovate Montana Symposium was held July 12 through July 13, 2017, in downtown Billings at the DoubleTree by Hilton, Northern Hotel, and Pub Station. The event highlighted the innovation of Montana’s small businesses and connects diverse industries with economic opportunity through informative panels, breakout sessions, and networking opportunities for attendees.

The Innovate Montana Symposium was launched by Governor Bullock’s Main Street Montana Project to bring business leaders across the state together to grow businesses, train and educate Montana’s workforce, increase economic opportunities and encourage innovation.


 

July 5, 2017

Gallatin County, Mont. Monday was a typical start of summer day.  Sheriff’s Search and Rescue Volunteers from all over Gallatin County going about their business, working or getting ready for a family day on the 4th.   At 6:03 P.M.  pagers go off for a rescue on the Castle Rock Trail just inside the Gallatin Canyon: a 29 year old man from Tennessee has collapsed on the trail.  Search and Rescue Deputies were the first to respond.  They are typically on duty and have skills to gather information, coordinate resources and direct the volunteers.  In this case the emergency was in an area where both responders from the Big Sky Division of Gallatin County Search and Rescue and the Valley Division were sent on the call, setting up a race of sorts where the patient is the winner.  Communications in that area of the county are poor and the Deputies have their hands full trying to gather information and communicate direction.  Rescuers from the Gateway Fire Dept. and AMR Ambulance arrive first and started up the trail.  The patient was stable but needed a ride down the trail and a trip to the hospital.  Now all they wait for is a wheeled litter, a kind of super stretcher with one big wheel designed for trail use.  There are several wheeled litters in the county but they are on trucks coming from the Fairgrounds and Big Sky.

Along comes Taylor Green, a young, fit, back country savvy veteran of SAR who owns Square One Welding & Fabrication at Four Corners.  For months now he has not been satisfied with the weight and stability of the wheeled litters used by SAR.  In his spare time he has been designing, engineering and fabricating a better one in his shop.   It just so happens his prototype was in his truck and he was closer than the Rescuers coming from Big Sky and the Valley.  Up the trail he and a couple other SAR volunteers go.  Light, easy to handle and suited for the trail, the new litter goes along on it’s first real deployment.  A little while later the Rescuers, patient and litter emerge from the trees.  The rescuers are smiling and so is the patient.