City considering mail-order prescription program

More people, more savings
Sunday, March 18, 2007 | 12:00 a.m. CDT; updated 9:39 a.m. CDT, Monday, July 21, 2008

The city is considering a mail-order prescription drug program for city employees that would cut medication costs and save the municipal government an estimated $56,000 a year if 10 percent of employees use it. The City Council is scheduled to hear a first reading of the proposal at its 7 p.m. Monday meeting.

The proposal would save employees money on copays and the city on overall expenses, said Margrace Buckler, human resources director for the city.

Other public employers that offer a mail-order prescription drug program to employees include the state of Missouri, the University of Missouri System and Boone County.

Employees affected by the proposal would be those who purchase maintenance medications, which are primarily drugs used for chronic conditions, including high cholesterol, asthma, diabetes and heart disease, Buckler said. Currently, employees fill a prescription that lasts 30 days. Under the new program, employees would purchase a 90-day supply and make copays at 2.5 times the amount they would have paid for the 30-day supply.

Put more simply, a copay that currently costs $30 for 90 days worth of medications would cost $25 under the new plan, saving the employee $5.

One advantage of the program is that employees would not have to make trips to the pharmacy, Buckler said.

Angela Brownfield, a staff pharmacist at D&H Prescription Drug Store, said the personal interaction is an important part of prescription drug care.

“I’m not saying that the (mail-order drug program) doesn’t work,” Brownfield said. But she said from her vantage point she can provide better service for patients who come in.

Brownfield said this is true for one-time prescriptions as well as maintenance drugs.

“It carries over totally into the maintenance drugs,” she said. “As a patient, I would be more inclined to walk into a pharmacy and ask about my long-term medication if I’m having a side effect and I have a relationship at the pharmacy.”

Buckler said employees will have a choice whether to participate in the program or continue obtaining prescription drugs as they have in the past.

However, the more people who sign up, the more money the city would save.

“We estimate the city will save about 2.3 percent on its payments,” Buckler said. If only 10 percent of the eligible employees had participated in 2006, the city would have saved an estimated $56,000 that year, according to Pharmacare, the current administrator of the city’s prescription drug program.

Most of the savings come from changes in how the drugs are purchased by Pharmacare, Buckler said. The plan allows Pharmacare to shop around for lower prices and gives the company added negotiating power when purchasing the drugs from the manufacturers. Some of the savings would be passed down to the city and the employees.

Prescriptions written for one-time uses would not be covered. A trip to the pharmacy to pick up the medications is faster than waiting for them to be delivered in the mail, which can take 3 to 7 days with similar mail-order programs, Buckler said. Also, many one-time prescriptions don’t require 90 days worth of drugs.

The medications available under the current plan would remain the same under the mail-order program, Buckler said.

People would have the option of e-mail, postal mail or phone call reminders, so they are more likely to refill the prescription before their 90-day supply runs out.

The employee benefits committee suggested using the program in the past, but the council decided to wait until the city had re-bid the contract under its pharmacy benefit management program, Buckler said. The city chose to stay with Pharmacare, the same provider it used before the bidding process.

The new contract with Pharmacare gives the city the option of using the mail-order program. The council will decide whether and when to take advantage of the option.

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