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Carol LeKashman

PO Box 8779 • Saint Thomas, VI 00801

(340) 779-7422 land • (340) 643-5566 cell

March 19, 2008

Mr John L. Wodatch (202) 307-0663

U.S. Department of Justice Civil Rights Division
Disability Rights Section – NYA
90 Pennsylvania Avenue, NW
Washington, D.C. 20530

Dear Mr. Wodatch: I write this on behalf of the approximately 14,400 disabled individuals*
who should qualify for PPArx's FREE/$10 co-payment.


Background: I am 56. I live on Social Security Disability, and assistance from my family.
I have lousy heath insurance, and no coverage at all for prescription drugs. I am bipolar, and
have to take SEVEN kinds of medicine. Fortunately for me five of them are available as gener-
ics and only cost about $10-20/month each. Unfortunately, two of them are only available as
branded products: LAMICTAL made by GlaxoSmithKline which costs me $600.00 yes SIX
HUNDRED dollars A MONTH, and DIOVAN made by Novartis, which is "only" $60.00 a month.

I recently learned about something called "Patient Assistance Programs" (PAPs) where drug
companies reduce the price of these expensive medicines sometimes free, sometimes with a
$10 co-payment, to people who meet three criteria:

1) Their income must be below a certain level;

2) they cannot have any kind of prescription drug insurance coverage, and
3) they must be "US RESIDENTS" (note, not even citizens).

Now, I am a US CITIZEN, but I recently moved to the USVI, otherwise I’d qualify for these pro-
grams. I don't see any logical reason why inhabitants of US Territories or at least the US Cit-
izens living in them should not also be included in this program.

There is a clearinghouse that does work for all of the drug companies that have such PAPs,
The Partnership for Prescription Assistance (PPArx). Their website says:

Many of our companies have pledged that no patient in need should go

without coverage, and they evaluate needs on a case by case basis

Indeed, GlaxoSmithKline's websites say almost the same thing. And they told me, when I first
called that "Living in the VI was ok". On calling back to enroll, I was turned away because "you
live in the VI". Novartis turned me down flat. These companies refuse to serve the US Territor-
ies of Puerto Rico, Guam, the VI, and a few other little islands, with a total population of about
4.4 million, most of whom ARE US citizens: no more than one medium sized state: probably
about 2% of the program’s budget.

PPArx does sponsor a program for Puerto Rico: TogetherRxAssistance. Their website says:
Thousands of eligible hardworking people with no prescription drug coverage are now
saving on the medicines they need with the Together Rx Access™ Card. Most card-
holders save 25%–40%* on brand-name prescription products.

Gee, this would leave me paying just $360/month at best. I’m just as poor as anyone getting
the free medicine in the States. This inequity is totally unfair and unjustified and I believe illeg-
al under Section 504 of the ADA..

The only significant difference between us and the 50 states is we are represented by non-vot-
ing delegates, and we are not able to vote in presidential elections: why should that have any-
thing to do with reducing the punitive cost of needed medicine?

I am sure these drug companies get tax breaks for participating in this program: I believe this
means they are receiving Federal financial assistance. It is for sure they earn obscene profits.
I cannot conceive of any legitimate reason why they don't figure out a way for the US Territor-
ies to be included. If, as they brag, they serve 5 million out of a total US population of about
300 million, adding another population of 4.4 million would probably add only another 80,000
who would qualify for the program, with their stringent income and (lack of) drug insurance re-
quirements: this would include probably about 14,400 who are disabled. Maybe these big
wealthy corporations are afraid some non-US Citizens would slip in. You would think going to
the local passport office and submitting officially notarized copies of our passports and social
security cards would be enough.

In any event, I am starting a crusade, hoping to enlist everyone into shaming these companies
into treating us equally, for I have heard absolutely nothing that would constitute a reasonable
explanation of their failure to include us. My call for action is for you to communicate with the
management of these companies and try to embarrass them into changing their policy. A
simple approach might be to write “SHAME” and your signature on this letter and send it to:

Andrew Witty, CEO Designate

5 Moore Drive
Research Triangle Park, NC 27709
The corporate phone number is 1-888-825-5249
Billy Tauzin, CEO
Pharmaceutical Research and Manufacturers of America
(who sponsor Partnership for Prescription Assistance)
950 F Street, NW
Washington, DC 20004

I would like to extend this campaign to all drug companies, but you have to start someplace.
So please feel free to make copies of this letter and pass it on to others. I thank you very
much for your help in reducing the health care costs of the 4.4 million AMERICAN inhabitants
of the US Territories and particularly the 80,000 with low incomes.

Carol LeKashman
PO Box 8779 St.Thomas, USVI -00801
340-779-7422 cell:340-643-5566