Prescription Pharmacy Rx News

Medications: Prices, availability big issues

Pharmacies may worry about location, location, location, but for their patients seeking medications the current emphasis is on price, price, price. In separate developments, Illinois is challenging the FDA and its authority to regulate medication imports, the Centers for Medicare & Medicaid Services (CMS) is seeking 50,000 patients to participate in a demonstration project that includes injectable products currently covered under Medicare Part B, and a battle is brewing over details of the Medicare prescription drug benefit approved by Congress last year.

Illinois will soon become the first to allow its residents to purchase medications from Canada and Europe, after Illinois Gov. Rod Blagojevich announced this week that the state was contracting with a “nondomestic” PBM to establish a clearinghouse of state-inspected and approved pharmacies and wholesalers in Canada, Ireland, and the UK. Users of the program will be connected to a Canadian clearinghouse through the Internet or a toll-free number.

The state won’t be purchasing medications through the PBM, but its residents will have access to the prices and availability of approximately 100 of the most common brand-name medications used to treat chronic or long-term conditions. The list of available medications will be limited to those that are used for long periods of time and that cannot degrade during the shipping process. The Associated Press reported that generic drugs would be excluded from the program.

Illinois community pharmacies will lose prescriptions to nondomestic pharmacies under the plan. But, with only a limited number of drugs included, many products would remain available only at local pharmacies.

CMS’s demonstration project will provide drug coverage for 50,000 Medicare beneficiaries beginning in September. The Medicare Replacement Drug Demonstration, mandated by the new Medicare prescription drug law, will extend drug coverage to prescription medications that can be self-administered rather than administered by a health care provider. This includes medications that are currently covered under Medicare Part B when given in a physician's office, such as drugs for the treatment of rheumatoid arthritis, multiple sclerosis, pulmonary hypertension, and several cancers.

Under the demonstration project, participants will pay a portion of the cost of the drug that will "mirror the 'standard' Medicare Part D prescription drug benefit when implemented in 2006," CMS announced. Participants with incomes less than 150% of the poverty level will pay substantially less. Participants in the demonstration will be able to obtain their medications at their local pharmacy or through home delivery by Caremark.

To participate in the demonstration, a beneficiary must be enrolled in Medicare Part A and Part B, Medicare must be the primary payer, and the beneficiary cannot have comprehensive drug coverage through other sources. Applications must be received by September 30. Drug coverage will begin as early as September 1 and end on December 31, 2005. Application forms and more information about the demonstration—including estimated savings for certain medications—are available at the CMS Web site listed below.

In another development related to drug prices and availability, the Wall Street Journal (WSJ) today reported that a proposed blueprint for the types of medications covered by the new Medicare drug benefit is expected to be unveiled soon, a step that is certain to intensify the fierce lobbying battle between pharmaceutical manufacturers and insurers. The proposed guidelines, developed under a Congressional directive by the United States Pharmacopeial Convention (USPC), seek a middle ground between the two industries, with the drug makers possibly coming out on the short end, according to the Journal. The paper reported that in some categories—including medications for dyslipidemias and arthritis—USPC was leaning toward an approach that would grant insurers and PBMs flexibility on the drugs they offer, potentially giving them more bargaining leverage. Drug companies reportedly want a large number of narrowly tailored classes of drugs so they could be ensured of their products. CMS however, may end up requiring more medicines than might be necessary under the USPC proposal, according to the Journal.

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Zelnorm More Digestive Health meds	Allegra More Allergy and Asthma meds	Advair-diskus More meds	Norvasc More Cholesterol and Blood Pressure meds
Zyrtec More Allergy and Asthma meds	Aceon More Cholesterol and Blood Pressure meds	Zocor More Cholesterol and Blood Pressure meds	Vytorin More Cholesterol and Blood Pressure meds
Pravachol More Cholesterol and Blood Pressure meds	Mevacor More Cholesterol and Blood Pressure meds	Methotrexate More Pain meds