I have a question about prescription drugs.

[Raven]

Under my new health insurance (Massachusetts Blue Cross/Blue Shield) I have a $25 co-pay for each prescription. At first I was paying this co-payment every month because I was told that my local pharmacy could only fill prescriptions for 30 days. Then I was told that if I got my drugs from this mail order place called Express Scripts I could get my prescriptions for 90 days and lower my co-pay substantially. While I don't have any complaints about Express Scripts, it seems to me that my little ma and pa corner drug store (and even the big ones for that matter) must be losing tons of customers. Why is this? Is it only Massachusetts? It doesn't seem fair.

[GOPisEvil]

1. Nope...I have BC/BS in TX

We are "encouraged" to buy the 90-day supply through mail order by the reduced co-pay. Yes, this has the potential to put small pharmacies out of business.

However, I don't have the need for recurring Rx, so I can still get mine at the local pharmacy.

[supernova]

2. Lots of places do this

the 90 days worth of pills on mail order. Merck runs a huge mail order program, IIRC.

I'm sure it hits Mom & Pop drug stores pretty hard. But if you're on a budget 4 copays a year sure is appealing.

I'm only on B.C. right now, but I still get 3 months worth, just because I hate making the same extra errand each month.

[FlaGranny]

3. No, I think it is everywhere.

It's a good deal for people who need regular, ongoing medications. Not a good deal for people who only take drugs on a short-term basis. It probably does hurt the local pharmacy. Buying drugs in Canada and Mexico hurts them too. But people do what they have to do to get their meds.

I'm sure the insurance company and Express Scripts have a mutually financially beneficial agreement.

[Soopercali]

7. Express Scripts etc.

These "pharmacy benefit managers" (PBMs) usually have exclusive relationships with THE DRUG COMPANIES. They agree to support the prescribing of certain medications over others by penalizing drugs (by charging much higher co-pays) whose manufacturers do not have a similar arrangement.

The decisions are not made on the basis of a medication's effectiveness and cost efficiency.

They are unregulated and no one knows whether they actually save money for the employers who use them. What IS known is that they are hugely profitable.

There is a great book written by Kathleen Greider (Bill Greider's daughter) on the drug industry. I can't find it on Amazon, even though I bought it there a few months ago.

[newyawker99]

9. Hi Soopercali!!

Welcome to DU!! :toast:

[greyl]

4. Yeah, it's not fair.

In addition to the DOD connection, it looks they have outsourced some of their work to other countries to save costs.
All I can say is: you can still shop at your ma & pa for other things. :)

snip> ST. LOUIS--(BUSINESS WIRE)--Sept. 26, 2003--The Department of Defense (DoD) announced today that it has awarded the contract for its TRICARE Retail Pharmacy (TRRx) program to Express Scripts, Inc., one of the nation's largest pharmacy benefit management firms. The contract term is for one year with four subsequent option years exercisable by DoD.
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The TRRx program will provide retail pharmacy services to the approximately 2.5 million DoD beneficiaries who currently utilize the retail pharmacy benefit. Overall, there are 8.7 million eligible DoD beneficiaries.

Under the TRRx contract, Express Scripts will provide access to a retail pharmacy network, claims processing services, drug utilization and safety review services, prior authorization services, beneficiary communication materials and a call center to handle beneficiary inquiries.

Full TRRx retail service will begin in approximately six months, following the initial phase-in period of contract performance.

"Everyone at Express Scripts is filled with pride to serve the men and women of our nation's armed forces as we make the use of prescription drugs safer and much more affordable for them and their dependents," said Barrett Toan, chairman and chief executive officer of Express Scripts.

Express Scripts was awarded a five year contract for the DoD's TRICARE Mail Order Pharmacy (TMOP) program a year ago. The TMOP program began operation on March 1, 2003, and recently passed the 2.5 million mark in the number of mail pharmacy prescriptions filled under the program.
<snip
the rest: http://biz.yahoo.com/bw/030926/265472_1.html

[commander bunnypants]

5. It is everywhere

I was with express scripts. Now I am back to Merck-Medco. I save lots of money.


DDQM

[Raven]

6. I understand that it saves money and

I appreciate that, but why should there be a rule that the drug stores cannot fill a 90 day prescription but the mail order companies can?

[commander bunnypants]

8. That is set up through the HMO's

Cost containment I think. and the mail order companies make some bucks off the deal too

DDQM

[ScreamingMeemie]

10. No, Michigan does this as well. I try filling them with excuses like,

going out of town for extended stay, and no dice.