Wednesday, January 21, 2004

Maine RX Plus launches amidst protest

Published in the Current and the American Journal; co-written with Kate Irish Collins

Despite a much-hailed launch, a new state prescription drug program called Maine Rx Plus is not getting support from three pharmacy chains in Maine.

RiteAid, Community Pharmacy and CVS are not participating, saying Gov. John Baldacci asked them earlier this month to accept a reduction in state administrative fees and is now asking them to voluntarily cut prices of prescriptions.

Hannaford and Shaw’s, through their pharmacies, are participating in the program, which will allow low-income people to get reduced-price prescriptions when they present a state-issued card.

Wal-Mart has not made a formal decision about the program, but a pharmacist at the company’s Scarborough store said that if someone arrived with a card, they “would likely honor it.”

The program was launched last week by Baldacci, state legislators, the attorney general and activists interested in the issue. The governor hailed the program as making Maine “a leader in bringing lower-cost drugs to our citizens.”

Cardholders will be eligible for 10-25 percent discounts off brand names and 60 percent off generic brands for a wide range of drugs that are also listed as preferred drugs in the state’s Medicaid program.

Discounts became available on Saturday.

Pharmacies participate in the plan voluntarily and can opt not to honor the cards. RiteAid, Community Pharmacy and CVS objected to a proposal in which the Medicaid program would cut pharmacy administrative fees 40 percent. The companies said they will “consider” participating in Maine Rx Plus if the governor withdraws the proposed cut, which they termed “devastating.”

Prescription drug costs have long been an issue in Maine. After the Maine Rx program was challenged by federal regulators and then upheld by the U.S. Supreme Court, state officials reworked the plan.

“We have reconfigured the program to meet federal concerns, to integrate it with Drugs for the Elderly and to make it ready to coordinate with the new Medicare drug benefit when that program starts,” Baldacci said.

Maine Rx Plus will also use its volume to negotiate discounts from drug companies “later in the year,” he said.

House Speaker Patrick Colwell added, “Maine Rx Plus will negotiate lower cost prescriptions for Maine seniors and working families by using our buying power as a state. The Medicare bill Congress recently passed takes the opposite approach by forbidding the federal government from negotiating prices.”

“Until the federal government allows the bulk reimportation of prescription
drugs,” said Rep. David Lemoine, a member of the National Legislative Association on Prescription Drugs, “Maine’s Rx Plus model is by geography and price the nearest thing to Canada.”

To be eligible, individuals must earn less than $31,440; for couples it is $42,420. For a four-person family, the cutoff is $64,400. Program enrollment will be phased in. Maine Rx Plus cards will be sent automatically
to 73,000 Maine residents, who had participated in the now defunct Healthy
Maine program, which was halted by the federal government in December 2002. Others who may qualify can apply for a card by calling 1-866-Rx-Maine (1-866-796-2463).