By Tim Bonfield
The Cincinnati Enquirer
Seniors from Fairfield to Anderson Township will receive a gold-tinted plastic card starting Wednesday that offers prescription drug discounts.
More than 2 million of the new Golden Buckeye cards are being issued statewide.
It will take up to two weeks for more than 150,000 cards to be delivered in ZIP codes starting with 452, 450 and 451. Recipients can use them immediately at most pharmacies for discounts averaging 20 percent on hundreds of medicines.
"Seniors will still get a better benefit if they have insurance available. But this is a much better program than seniors think it is," said Gary Panek, Golden Buckeye Card program manager for the Ohio Department of Aging.
"Until now, seniors without insurance have been paying the highest prices for drugs. Now, they're getting some relief."
Some potential savings look impressive, especially for generic drugs.
Last week, the average retail price was $8.68 for a month's supply of furosemide, a commonly prescribed generic diuretic, or "water pill." As of Oct. 15, Buckeye card members could get it for $4.78, a 45 percent savings.
Deals aren't quite as good for brand name drugs. Detrol LA, the "gotta go right now" pill for controlling overactive bladders, would go for $83.82 through the Golden Buckeye program. That's 14 percent lower than the $97.52 average retail price.
Seniors who opt for mail-order prescriptions will usually save even more. The discounted store price is about $60 for a month's supply of Norvasc, a calcium channel blocker. Mail-order price: about $54.
"This could be good news, if it's true. But I don't have a whole lot of faith in their numbers," said Betsy Exline, a 70-year-old Hamilton resident who has been lobbying politicians for prescription drug relief for several years.
"I'll have to see it work before I'm convinced," said Price Hill resident Emma Harmeyer.
Seniors and others who qualify can flash their Golden Buckeye card at nearly every pharmacy in Ohio - except Wal-Mart and Sam's Club, which refused to participate.
Pharmacies will charge cardholders a single price for a drug, no matter which drug store chain, no matter which town. Discounts would range from as little as 5 percent to more than 60 percent. Stores could charge less than the statewide price, but not more.
Everybody in Ohio aged 60 and up gets the card, regardless of income, plus about 300,0000 younger adults who are disabled.
Most discounts will apply to everybody in the program. Low-income seniors who fill out a form that is sent with the card may also qualify for deeper discounts for 108 drugs made by Novartis, Merck, GlaxoSmithKline and Bristol-Myers Squibb.
There are limitations.
Seniors cannot use the card if they have drug benefits, such as a Medicare HMO or a Medicare supplemental plan. The discounts would apply once a person exhausts spending limits of his plan, or if a drug isn't covered, or if a person must spend a certain amount before benefits kick in.
Some drugs excluded
Not every drug is covered. Among the notable drugs with no discount through the Golden Buckeye Card: Celebrex, the popular arthritis relief drug.
Prices will change frequently and without notice. Some prices already are different than when The Enquirer checked 10 medications on Oct. 15. The Web site www.goldenbuckeye.com will be updated often.
The program has no direct state subsidy. Prices were negotiated on behalf of Buckeye card members by MemberHealth, a Cleveland-based pharmacy benefit management company. When drug makers change their prices - which occurs regularly - those changes will be passed along to consumers.
MemberHealth makes its money by keeping half the rebate some drug makers pay for listing a medication as a preferred drug. As of this week, there were 55 "preferred drugs" in the program offered by 15 companies.
Pharmacies get 5 percent of that rebate. The rest is used to discount prices for consumers, said Scott Hughes, vice president of MemberHealth.
Nobody knows what will happen to the Golden Buckeye program if Ohio lawmakers pass a different drug program. The card also may be affected if Congress ever approves a Medicare prescription drug program.
States are trying lots of ways to help seniors get cheaper drugs, including proposals to import lower-cost drugs from Canada and other countries.
Indiana has a plan that subsidizes prescription drugs for low-income seniors. Kentucky has been discussing a drug benefit program.
Sponsors say the Ohio program has far more support from pharmacies and drug makers than any other state drug program for seniors. And unlike other state programs, many of the savings aren't limited to the poorest seniors.
The lack of income restrictions also makes the program better than many of the constantly changing federal Medicare prescription drug proposals, said Charles Hallberg, president of MemberHealth.
"This is better to them (pharmacies and drug makers) than price controls," he said.
Some aren't convinced.
Pharmacists who fought the first version of the Golden Buckeye plan when it was attempted in 2001 were reluctant to accept contracts for the revised program, said Ernest Boyd, executive director of the Ohio Pharmacists Association.
"The good news is that this is the first time in the nation that rebates are going to the pharmacies and the public and not just to the pharmacy benefit managers and insurance companies," Boyd said. "But we're still concerned that this amounts to a central price fixing type scheme."
If pharmacies have to charge the same price statewide, it will be hard to keep stores open in high-crime neighborhoods where stores face higher security costs and suffer more losses from thefts and robberies, Boyd said.
And how pharmacies will benefit from offering discounts to seniors remains a mystery to Boyd, who says tough times already have forced extensive consolidation of stores.
"There are 400 fewer pharmacies in Ohio now than there were in 1994 even though they are filling twice as many prescriptions," Boyd said.
Consumer advocates also have their doubts.
Ron Pollack, executive director of the national consumer group Families USA, praised the ability of seniors to check drug prices via the state's Web site. Few other state programs offer that service.
But Pollack said he is skeptical about depending on drug company rebates to fund the program.
"The benefit manager will have an interest in promoting the most expensive drugs as the most preferred drugs. Getting half of a rebate for a $100 drug is better than getting half a rebate for a $20 drug," Pollack said.
In Cincinnati, the Working in Neighborhoods Senior Action Coalition has been urging people for years to shop around for their medication. Prices vary widely, even among stores in the same chain. To them, the concept of one price at any store sounds hard to believe.
"It certainly sounds better than what I've heard before," said Dave Scharfenberger, coalition administrator. "Any kind of program that helps seniors get cheaper drugs would be good. But the proof will be what seniors find when they actually go to the store."
How to check prices on GoldenBuckeye.com
1. Go to www.goldenbuckeye.com.
2. Click on "Learn more about the prescription drug program..."
3. Click on "Current pricing."
4. In the box that appears, type the drug name or the first few letters of the name. Even partial spellings must be correct.
5. Prices and savings will appear by clicking on the full drug name that appears below the box
6. Mail-order prices will appear by clicking on "Home Delivery Price."
For help searching prices, call (866) 301-6446.
For other information about the program, call (800) 422-1976.
Other parts of the Web site allow people to search for participating pharmacies, to download forms for mail-order medications, to apply for special discounts based on income, and to compare drug prices by category.
Other state drug plans for seniors
Several states are looking at new ways to help seniors pay for prescription drugs, according to the National Conference of State Legislatures.
Pharmacy Plus is an extension of Medicaid that allows seniors to enroll if their incomes are less than 200 percent of the federal poverty level ($23,880 a year for a couple). Seniors who enroll can pay $3 per prescription up to a cap of $1,750, then 20 percent of costs after that. Gov. Rod Blagojevich also urged the U.S. Food and Drug Administration to allow Illinois to OK a plan to import lower-cost medications from Canada.
Legislature approved a program called MaineRx in 2000 that would have required drug makers to offer rebates to seniors and others without coverage. The program was tied up in court until May, when the U.S. Supreme Court ruled that the program could be enacted. But instead of launching the original plan, Maine lawmakers approved in June a different MaineRx Plus program that offers 15 percent to 60 percent discounts for people at or below 350 percent of the federal poverty level.
Dubbed Iowa Priority, this plan began offering drug discounts to Medicare-eligible seniors in 2002. Seniors pay $20 a year to a nonprofit corporation in return for discounts on about 60 medications on a preferred drug list. Program claims the 24,500 seniors who enrolled saved a combined $1.9 million in 2002, an average of about $78 each.
Launched its Healthy Vermonters program in July 2002. It allows enrollees to pay the same prices for medications that drug companies charge to the state's Medicaid program. Some discounts are as high as 30 percent. Seniors qualify for the program if their income is less than 400 percent of the federal poverty level ($48,048 a year for a couple).
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