‘Leveling

While health maintenance costs are at staggering proportions, prescription coverage controversy has reached peak levels.
It’s an issue Gov. Jennifer Granholm found significant enough to approach in this week’s State of the State address, promising the MI-Rx Card, a program that would pool prescription purchasing to cut costs by as much as 20 percent.
Legislation introduced in the Michigan House of Representatives Jan. 22 is aimed at ‘leveling the playing field? between mail-order and local pharmacies, says Michigan Rep. Ruth Johnson (R-Groveland Twp.), a sponsor of the bill.
Some United Auto Worker members question the UAW’s recently signed contract requiring members to use mail-order pharmacy services for maintenance prescriptions, such as those regulating blood pressure, diabetes, or thyroid conditions.
‘They came out with a list about which drugs have to be ordered through mail-order, mostly maintenance drugs,? said UAW member Tom Peters of Ortonville.
While Peters finds prices ‘fairly reasonable?, he recalls how a similar program became expensive when his mother’s physician changed her prescription and she could not purchase medication locally at the same cost.
The prescription policy was drafted in response to prescription reimbursement costs totaling more than $1.3 billion in 2002, says Doris Powers, communications manager for the GM Health Care Initiative office in Detroit.
A five-bill package being studied by the Michigan House Committee on Health Policy would enable local pharmacies to sell a three-month supply of medication, thus lowering the cost, said Johnson.
Mail-order pharmacies can be cheaper, but without a pharmacist interacting face-to-face with a patient, complications can occur, says pharmacist Daniel Feber of Action Pharmacy in Brandon Township.
Many patients see several physicians, each with a different agenda, Feber says.
‘If somebody isn’t keeping track (of different prescriptions), you can have problems with drug interactions.?
Filling prescriptions in Canada has become such a popular option that some senior citizen organizations offer day-trips out of the country to obtain medication.
Members of Brandon Senior Center have taken advantage of Canadian’s prices to make prescriptions affordable, said Wilma Merrill, Brandon Senior Center coordinator.
Their prescriptions were obtained through Canadian Drug Solutions, an Illinois middleman agency that recently closed, said local agent Michael Bauer.
‘I’m sorry they went out of business,? said Bauer, who says families of home-bound senior citizens had approached him regarding help to obtain the Canadian prescriptions.
Existing contracts, for which seniors paid a $30 annual fee, will be taken over by another company, Bauer said.
Proposed state legislation may also require licensing of those who receive prescription orders, giving state control over middlemen who stand up to scrutiny by the U.S. Department of Justice.
According to a Jan. 26 article posted on DrugTopics.com, a news magazine for pharmacists, CVS Pharmacies has recently joined Walgreen Co. in refusing to participate in future contracts mandating mail-order pharmacies for maintenance medication.
‘I think it’s great,? Feber said. ‘I wouldn’t be surprised if Rite-Aid followed suit.?
‘As medication gets more complex, people have more questions,? said Feber, who takes the time to review patients? charts, make sure they’re receiving the proper medication, screen for drug interactions, and answer questions about taking prescriptions properly.
It’s the way things should be done, Feber feels, for patients? safety and to keep local pharmacies in business. But the long-time local pharmacist’s main issue is with companies who take away consumers? freedom of choice.
‘If it was a matter of not eating, I might use mail order,? said Feber, ‘but even as a senior on a fixed income I’d still want the choice.?

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