Drug Deals

Prescription drug plan changes raise complaints.

By Catherine Cluett

For many who enjoyed walking to their local drug store, chatting with and getting advice from their pharmacist and picking up their medication on a monthly basis, those days are now over. That is because of changes made to a statewide prescription drug plan from the Employer-Union Health Benefits Trust Fund (EUTF). The new plan has prompted complaints from union members and independent drug stores around the state – especially on Molokai.

The biggest change to EUTF’s policy is making mail-order prescription mandatory for maintenance drugs. That means its members, comprised of state and county workers, will no longer be able to pick up their medication at their local drug store. Istead, it will be shipped from drug company InformedRX, based out of Florida. The changes took effect July 1st. The EUTF Board of Trustees implemented them to cut costs without reducing member benefits.

“The maintenance mail-order plan actually produces a savings for the plan and a savings for the participants, because their co-pays are lower than they would be if they use a retail pharmacy,” said EUTF Administrator James Williams.

But many on Molokai disagree. Molokai Drugs President Kim Svetin says the mandatory mail-order program would negatively impact about 500 customers, or about 10 percent of the store’s business.

Lacking the Personal Touch
Svetin said that by going mandatory mail order, Molokai Drugs will no longer enjoy the close relationships with their customers that they pride themselves on. She added that because all maintenance drugs now must be obtained through a mainland company, pharmacists will not be able to monitor their customers medications as carefully.

“Pharmacists are the last person in the line of health doing the double and triple checking before the medicine is given to the customer,” said Svetin.

“A lot of people think we are just here to hand out medication,” said Kelly Go, a pharmacist at Molokai Drugs.

But customers can tell you Molokai’s pharmacists do much more than that. They have been known to special deliver medications to their customers’ homes, and come in to work on their days off to help residents in emergency situations.

Victoria Burrows, a county employee, is one of many people who prefer the convenience and service of their local pharmacy. They worry about getting their drugs from a mainland company.

“Say you can’t get to the doctor in time to fill your prescription medicine… your doctor can call the drug store and will have your medicine prepared for you,” said Burrows. “This way, we cannot get that service.”

Svetin is worried about how patients will pay in advance for prescriptions when they live paycheck to paycheck. 

“They will have to pay for a three-months’ supply [of medication] up front whether they can afford to or not,” explained Svetin. “And for a lot of our customers who are still cash-based – and a lot of them don’t even have credit cards and debit cards here – it is going to be difficult.”

Williams said 35,000 EUTF members statewide will be affected by the changes. The total savings in premium will be about $10 million per year. He said the mail order program is nothing new – it has been an option for union members for years. But he said only a fraction of members state-wide used the program. Now that it is mandatory, he acknowledged many members are unhappy to have the choice taken away.

Other Changes
Currently, the mandatory mail order program is the only change that went into effect July 1st. Williams said some changes have been deferred after the board’s August meeting as a result of public feedback. 

EUTF postponed implementing a reference-based drug pricing program until January 1st 2010. That program would require patients to use a generic, lower cost alternative when available. If members choose a brand-name drug, they would have to pay the difference.

A second change to the original plan allows an exemption from the mandatory mail-order plan for refrigerated medications, such as insulin. People will be able to continue filling their prescription for those medications at their local pharmacies.

A third change reduces the costs patients must pay for cancer medication.

Anyone who has cancer or is taking a cancer preventative maintenance medicine, will pay a co-pay of $30 no matter what,” said Svetin.

She said before the change was approved, patients would have had to pay 20 percent of the costs out of pocket. That means a patient might have paid as much as $200 dollars a month through InformedRX if their cancer medication was $1000 per month.
Molokai Drugs initially stated the changes might cause them to go out of business, but now Svetin says that’s not an immediate threat. Molokai Drugs is the only drug store on the Molokai and it also serves Lanai.

The pharmacy has requested an exemption from the mandatory mail-order program. Svetin is expecting a response by the end of this month. Like many people opposed to the new program, she says people should have the choice of quality service provided by their local pharmacy.