Cape County announces drug cards; pharmacists oppose plan

Tuesday, November 29, 2005

The cards come at no cost to the county or the card users, but pharmacists are skeptical that they'll receive their promised rebates.

Beginning today, Cape Girardeau County will issue a free prescription drug discount card intended to help the uninsured and under-insured residents. But some area pharmacists are questioning the actual benefits of the card and say the county could lose some sales tax revenue because of the card.

The countywide discount card can save users up to 20 percent on commonly prescribed drugs, said County Clerk Rodney Miller. The card is available under a program sponsored by the National Association of Counties. Cape Girardeau is one of four counties in Missouri offering the discount card.

Cards may be used by all county residents regardless of age, income or existing health coverage and are accepted at 20 pharmacies in Cape Girardeau and Jackson. A national network of more than 57,000 participating retail pharmacies will also honor the NACo prescription discount card.

"The NACo prescription discount card offers significant savings for the uninsured and under-insured residents of our county, and even those fortunate to have prescription coverage can use the card to save money on drugs that are not covered by their health plan," Miller said. Residents do not have to be Medicare beneficiaries to be eligible for this program.

"The county commission thought this would be a good program for folks who don't have any benefits," said 1st District Associate Commissioner Larry Bock. "With it being close to Christmas and all, we thought it would be an early Christmas present."

The cards are available at various locations throughout Cape Girardeau and Jackson, including the Cape Girardeau County administrative building, Southeast Missouri Hospital, Cape Girardeau and Jackson city halls and the health department.

The card will be distributed with a brochure and can be used immediately by anyone who needs it, said Andrew Goldschmidt, NACo director of membership marketing. Users will be provided with immediate discounts without having to fill out a claim form, and there is no limit on the number of times an individual uses the card.

An individual cannot use the card in conjunction with drug discount benefits received through a medical insurance plan. However, prescription drugs not covered by an insurance plan can be purchased with the discount card.

This card is at no cost to the county or to the individual, Goldschmidt said.

Pharmacy manager Ben Tally at Medicap Pharmacy in Cape Girardeau said pharmacies will lose money when the discount card is used.

"The pharmacy will be the one paying for these cards," Tally said. When the cards are used, participating pharmacies will be required to give customers a discounted price off the pharmacy's retail price of the prescription.

NACo signed a three-year contract with Caremark/AdvancePCS, one of the country's largest pharmaceutical services companies, to administer the program. Goldschmidt said NACo chose Caremark because of its lack of restrictions on who can use the discount card. There is no fee, no forms to fill out and no restriction on the number of times the card can be used.

Dale Thomas, a spokesperson for Caremark, said the pharmaceutical company will receive less than $1 per transaction when the discount card is used. The pharmacy will also receive a rebate check from Caremark for each transaction.

Tally said he will believe it when he sees the rebate check.

"That's a lie," he said. "Caremark will get some of the transaction, but it doesn't go back to the pharmacy. I've never gotten a check from Caremark that was a rebate."

Tally describes Caremark as a clearinghouse, asking large companies, like Procter & Gamble, to join its network to receive discounts on prescription drugs.

When pharmacies sign up with the Caremark network, agreeing to accept certain discount cards, the pharmacy can't discriminate against any additional cards Caremark creates at later dates, Tally said. "If you don't participate in Caremark's network, then anybody associated with them, such as Procter & Gamble, can't have their prescriptions filled at your store. That's about 12,000 lives right there."

While pharmacies join the Caremark network for free, they are required to honor any discount card Caremark creates. "You sign these contracts with Caremark, but they don't tell you of all the other things they're going to come up with later on," Tally said.

Pharmacist John T. McMullin, owner of John's Pharmacy in Cape Girardeau, said he doesn't find the prescription drug discount cards beneficial.

"It's quoted as a discounted card, but most of our cash prices are cheaper than that," he said. "It's kind of a false illusion."

Another benefit provided is the Caremark Mail Service in which card-carrying participants can purchase up to a 90-day supply of select medications from the mail service pharmacy for a fixed price.

This part of the program will take tax dollars away from the county, McMullin said.

"I don't understand why part of the county government would institute a program that would take money away from the county," McMullin said.

Bock said that in other counties using the prescription drug discount cards, only half of a percent of the transactions have gone toward the Caremark Mail Service.

"It's not like we're starting this program to take money away from the pharmacies," Bock said.

"Caremark negotiated terms with them when they signed a contract. If this card hurts the profit of the pharmacies in the area, then if I were them I would get out of that contract," Bock said.

Goldschmidt sees the discount prescription card as a benefit to the pharmacies.

"Let's say I'm an uninsured person and I may only be able to afford two of my three prescriptions at a time. With this card I may be able to afford to purchase all three," he said. "It is also going to bring more traffic through the pharmacy's door. We don't see this as a negative factor on the pharmacies."

The discount cards may also be used for some pet medications.

Nationwide, 150 counties are participating in the prescription drug discount card program. NACo started the program in May, selecting 14 pilot counties to test the program.

Bollinger County Clerk Diane Holzum said the commissioners will discuss joining the prescription drug discount card program and make a decision within the next couple weeks.

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