thedrifter
08-22-06, 01:30 PM
August 28, 2006
Medicine-by-mail push angers some druggists, patients
Program cuts DoD’s prescription costs
By Gayle S. Putrich
Staff writer
As health care costs rise, particularly when it comes to prescription drugs, the Defense Department is in the expensive position of trying to run a war and a health insurance program at the same time.
One way the Pentagon is trying to cut costs without trimming medical services is by encouraging Tricare beneficiaries to use a mail-order system instead of heading to the local drugstore when filling a prescription.
But despite increases in the amount of mail-order prescription traffic, some say the post office is not always the best option for patients.
Last year, the Defense Department spent $54 billion on prescription drugs, $3.16 billion of it at retail pharmacies. Total prescription costs are expected to rise to about $60 billion by the end of 2006, “so we really do need to be diligent in keeping those costs as low as possible,” said Capt. Tom McGinnis, the Defense Department’s chief pharmacy officer.
The Defense Department pays about 40 percent less when beneficiaries use the mail-order service compared with when they have prescriptions filled locally, McGinnis said.
Mail order also benefits the customers, he said. In one year, someone using mail order to buy a maintenance drug that must be taken daily would spend $12 instead of $36 for a generic drug and $36 instead of $108 for a brand-name product — about a 66 percent savings.
Ordering by mail gets the patient a three-month supply of a drug, and as with any other product, buying in bulk saves money.
Prescriptions are free to patients at military medical facilities because the Defense Department gets a special rate agreed to by the pharmaceutical industry. Most federal employees, Medicare and Medicaid patients get the same break.
The Defense Department gets the same federal rebates when drugs are ordered through the mail-order pharmacy, which is run by a contractor, Express Scripts. It does not get such rebates at local pharmacies in the Tricare networks — which is why the Defense Department is so keen to nudge people toward mail order.
Patient choice vs. price
That arrangement has retail druggists upset. Pharmacy chains, as well as small, locally owned drugstores, deserve the same “best pricing” courtesy and should be on a level playing field with military dispensaries and the Express Scripts mail-order company, said Charlie Sewell, co-president of the Coalition for Community Pharmacy Action.
Sewell said the issue is not just about the financial health of local pharmacies, it’s also about what’s best for patients.
Some drugs have a short shelf life and start to decompose on the way to a customer, while some medications may not be kept at the proper temperature while in transit, he said.
“We say, leave it up to the patients,” Sewell said. “Medicare and Medicaid don’t tell patients where to get their medications. Why should [Tricare patients] be forced to use a service if they don’t want to?”
That’s the view of Gordon Flanagan, a retired Marine master sergeant in Winston-Salem, N.C., who served in World War II, Korea and Vietnam.
In an Aug. 8 letter to Navy Times, Flanagan said he “strongly” feels “that military families should not be denied access to community pharmacies because drug manufacturers refuse to provide lower prices to the Defense Department for retail prescriptions.
“Because my family and I use many medications, it is important for us to have access to our local pharmacist,” Flanagan wrote. “Our pharmacist is our resource to let us know about dangerous medication interactions or to answer health-related questions we may have. We should not have to forfeit the personal touch and hands-on interaction of the community pharmacists that we know and trust.”
It’s not just patients who are affected, Sewell said.
“Frankly, mail order has not been providing the kind of savings [the Pentagon] would like to see,” he said, because most prescriptions filled through the mail are for brand-name drugs, not cheaper generics.
Congress has jumped into the fray this year, with the House and Senate versions of the 2007 defense authorization bill offering different solutions to the problem of high drug prices.
The House measure would raise co-payments at retail pharmacies but eliminate co-pays for mail orders, putting that program on par with going to an on-base military pharmacy to fill a prescription.
The Senate version would freeze co-pays at the current rate and require maintenance drugs to be purchased through the Express Scripts mail-order service. Budget officials estimate savings to the Pentagon of more than $1 billion a year.
A vote on the defense bill will likely take place in September.
In the meantime, McGinnis said, mail-order prescriptions are up, albeit slightly. A little more than 7 percent of the Pentagon’s prescription orders now go through the mail-order system, compared with 6 percent in 2005.
McGinnis said the Pentagon’s near-term goal is to see 10 percent of prescriptions ordered through the mail by the end of this year.
Ellie
Medicine-by-mail push angers some druggists, patients
Program cuts DoD’s prescription costs
By Gayle S. Putrich
Staff writer
As health care costs rise, particularly when it comes to prescription drugs, the Defense Department is in the expensive position of trying to run a war and a health insurance program at the same time.
One way the Pentagon is trying to cut costs without trimming medical services is by encouraging Tricare beneficiaries to use a mail-order system instead of heading to the local drugstore when filling a prescription.
But despite increases in the amount of mail-order prescription traffic, some say the post office is not always the best option for patients.
Last year, the Defense Department spent $54 billion on prescription drugs, $3.16 billion of it at retail pharmacies. Total prescription costs are expected to rise to about $60 billion by the end of 2006, “so we really do need to be diligent in keeping those costs as low as possible,” said Capt. Tom McGinnis, the Defense Department’s chief pharmacy officer.
The Defense Department pays about 40 percent less when beneficiaries use the mail-order service compared with when they have prescriptions filled locally, McGinnis said.
Mail order also benefits the customers, he said. In one year, someone using mail order to buy a maintenance drug that must be taken daily would spend $12 instead of $36 for a generic drug and $36 instead of $108 for a brand-name product — about a 66 percent savings.
Ordering by mail gets the patient a three-month supply of a drug, and as with any other product, buying in bulk saves money.
Prescriptions are free to patients at military medical facilities because the Defense Department gets a special rate agreed to by the pharmaceutical industry. Most federal employees, Medicare and Medicaid patients get the same break.
The Defense Department gets the same federal rebates when drugs are ordered through the mail-order pharmacy, which is run by a contractor, Express Scripts. It does not get such rebates at local pharmacies in the Tricare networks — which is why the Defense Department is so keen to nudge people toward mail order.
Patient choice vs. price
That arrangement has retail druggists upset. Pharmacy chains, as well as small, locally owned drugstores, deserve the same “best pricing” courtesy and should be on a level playing field with military dispensaries and the Express Scripts mail-order company, said Charlie Sewell, co-president of the Coalition for Community Pharmacy Action.
Sewell said the issue is not just about the financial health of local pharmacies, it’s also about what’s best for patients.
Some drugs have a short shelf life and start to decompose on the way to a customer, while some medications may not be kept at the proper temperature while in transit, he said.
“We say, leave it up to the patients,” Sewell said. “Medicare and Medicaid don’t tell patients where to get their medications. Why should [Tricare patients] be forced to use a service if they don’t want to?”
That’s the view of Gordon Flanagan, a retired Marine master sergeant in Winston-Salem, N.C., who served in World War II, Korea and Vietnam.
In an Aug. 8 letter to Navy Times, Flanagan said he “strongly” feels “that military families should not be denied access to community pharmacies because drug manufacturers refuse to provide lower prices to the Defense Department for retail prescriptions.
“Because my family and I use many medications, it is important for us to have access to our local pharmacist,” Flanagan wrote. “Our pharmacist is our resource to let us know about dangerous medication interactions or to answer health-related questions we may have. We should not have to forfeit the personal touch and hands-on interaction of the community pharmacists that we know and trust.”
It’s not just patients who are affected, Sewell said.
“Frankly, mail order has not been providing the kind of savings [the Pentagon] would like to see,” he said, because most prescriptions filled through the mail are for brand-name drugs, not cheaper generics.
Congress has jumped into the fray this year, with the House and Senate versions of the 2007 defense authorization bill offering different solutions to the problem of high drug prices.
The House measure would raise co-payments at retail pharmacies but eliminate co-pays for mail orders, putting that program on par with going to an on-base military pharmacy to fill a prescription.
The Senate version would freeze co-pays at the current rate and require maintenance drugs to be purchased through the Express Scripts mail-order service. Budget officials estimate savings to the Pentagon of more than $1 billion a year.
A vote on the defense bill will likely take place in September.
In the meantime, McGinnis said, mail-order prescriptions are up, albeit slightly. A little more than 7 percent of the Pentagon’s prescription orders now go through the mail-order system, compared with 6 percent in 2005.
McGinnis said the Pentagon’s near-term goal is to see 10 percent of prescriptions ordered through the mail by the end of this year.
Ellie