Ohio Health Policy Review

More discount drug cards available in Ohio

Two new discount drug cards have become available to some or all Ohioans this week (Source: "Discount drug cards can fill up your wallet," The Columbus Dispatch, April 30, 2008).  One card, the Ohio Drug Card, is available to all Ohioans.  The other card, the Franklin County Prescription Discount Card, is available to residents in Franklin County.

The Franklin County Prescription Discount Card requires no registration and is available to anyone regardless of age or income.  People interested in obtaining a card can get them at public libraries, senior-citizens centers, Columbus health clinics, Franklin County government offices, churches and United Way agencies (Source: "County offers discount drug cards," The Columbus Dispatch, April 30, 2008).

The Ohio Drug Card, offered by a private company, is available to all Ohioans online.  According to its website, this card is free and offers savings up to 75 perecent at participating pharmacies.

Study: Free samples may increase patient drug costs

According to a new study, patients who receive free prescription samples "spent nearly 40% more for medication during the six months they received the samples, and nearly 20% more in the six months afterward, than those who didn't." (Source: "Free drug samples cost more in the long run," MSNBC, March 25, 2008.) "The study, published in the journal Medical Care, renews debate about the role of more than $18 billion in free pharmaceutical samples distributed each year, which drug industry representatives have described as a cost-saving safety net for the poor."

CVS settles improper billing claims with Ohio Medicaid

Ohio Attorney General Marc Dann announced on Tuesday that the retail pharmacy giant CVS has agreed to pay $1.68 million to Ohio's Medicaid Program to settle allegations of improper billing. (Source: "CVS reaches settlement in Medicaid case," Crain's Cleveland Business, March 18, 2008.) "The settlement resolves claims that CVS violated state and federal statutes and regulations by switching dosage forms of ranitidine, an antacid medication commonly prescribed for Medicaid patients." The switch resulted in Medicaid paying "substantially more" for the drug than they should have. The Ohio payment is part of a larger $37 million settlement with the Federal government and 23 states and is the first time a retail pharmacy company has made such a settlement. (Source:  "CVS Caremark to settle Medicaid fraud claims for $37 million" Associated Press, March 18, 2008.)

Youngstown/Mahoning Valley United Way announces success of drug discount card

According to the Youngstown/Mahoning Valley United Way, their free FamilyWize drug discount card saved local people nearly $34,000 on prescriptions the first three months it was offered. (Source: "Discount cards save thousands on drug costs," Youngstown Vindicator, March 10, 2008.) "From November 2007 through January 2008, the FamilyWize card was used to file 2,088 claims in Mahoning, Trumbull and Columbiana counties, for a total savings of $33,987. The average savings per prescription was 33.7 percent or $16.28, said JoAnn Stock, United Way director of resource development and marketing." While the free cards are primarily for people with no health insurance or prescription coverage, they can be used by anyone in the community who needs to buy medicine not covered by their insurance, Medicaid or Medicare plans.

AARP: Prices for drugs used by elderly increased 7.4% last year

"Drugmakers increased their prices last year by an average of 7.4 percent for brand-name medicines most commonly prescribed to the elderly, according to the advocacy group AARP." (Source: "Drug prices climbing, AARP says," Associated Press, March 5, 2008.) "The increase was about 2.5 times overall inflation, continuing a long-standing trend. The advocacy group has tracked drug prices going back to 2002. Specifically, it looks at the prices charged to wholesalers. It noted that the price increases have been slightly greater since the Medicare drug benefit kicked in Jan. 1, 2006."

Survey: Prescription drug ads prompt one-third of Americans to ask doctors about advertised medicines

According to a new national survey conducted by USA Today, the Kaiser Family Foundation and the Harvard School of Public Health, "prescription-drug ads prompt nearly one-third of Americans to ask their doctors about an advertised medicine, and 82% of those who ask say their physicians recommended a prescription." (Source: "As drug ads surge, more get Rx's filled," USA Today, March 4, 2008.) In 2006 a record $4.8 billion was spent on drug advertising, up from $2.6 billion in 2002. "Among people who requested a drug, 44% said physicians gave the one they asked about, while slightly more than half said doctors prescribed a different drug. Sometimes, doctors did both. When duplicate answers were removed, the poll found 82% of patients got some type of prescription." USA Today also has a related article on this subject titled "Analyzing the side effects of drug ads."

State considering changes to Best Rx pharmacy discount program

"With enrollment in the Ohio's Best Rx leveling off and the prescription drug discount program yet to become self-sufficient, officials are rethinking how the state-run initiative fits into the future of the evolving pharmaceutical marketplace." (Source: Gongwer News, Feb. 4, 2008.) Ohio's Best Rx is a state prescription drug discount program which provides prescription discounts to elderly, disabled and uninsured citizens; the program resulted from a collaboration between major drug manufacturers, state policymakers and a union-backed coalition.

According to Department of Aging Director Barbara Riley, because the program is not self-supporting as originally planned, funding for the program "is being realigned as part of the agency's budget recalibration under Gov. Ted Strickland's package of fiscal maneuvers aimed at resolving a $733 million budget imbalance." Riley added, though, that the department is not ending the program, which will be funded from non-GRF sources through the end of the biennium. Instead, her department is studying how the program fits with all the retailer drug discounts offered by grocery chains, especially since many of these chain stores offer similar drug discounts to the program. The average number of monthly participants in the program from July-December 2007 was 20,842, with an average of 50,337 prescriptions filled each month.

"Best Rx is open to any Ohio resident without prescription insurance coverage who is either age 60 or older (regardless of income) or under age 60 with an annual household income at or below 300 percent of the federal poverty level. Under 2008 federal guidelines released this week, an individual who earns $31,200 a year ($2,600/month) is eligible for a Best Rx card. Similarly, a family of four with an annual household income of $63,600 ($5,300/month) or less per year is eligible." (Source: "Ohio's Best Rx updates eligibility guidelines," Lancaster Eagle Gazette, Feb. 2, 2008.)

Strickland delays autism Medicaid rules, reaches psychiatric drug compromise

Last week the Strickland Administration again delayed new rules which would curtail Medicaid funding for certain children's autism treatment services. (Source: Gongwer Report, Jan. 25, 2008.) "The rules proposed by ODJFS and the Department of Mental Health would prevent providers from billing the state's Medicaid program for community psychiatric supportive services for autism that don't match the federal guidelines. The Department of Mental Health's rule summary specifies that day treatment, partial hospitalization, intensive outpatient, adaptive, habilitative, or educational services don't qualify for reimbursement." If the new rules pass a Joint Committee on Agency Rule Review meeting on Feb. 19, they will go into effect July 1st.

In other news, the Strickland administration reached a compromise with mental health advocates over requiring physicians obtain prior authorization before prescribing psychiatric drugs for Medicaid patients. The new policy "will exempt psychiatrists enrolled in managed care plans or working within community mental health centers from the requirement, which mental health advocates said would erect a barrier to effective treatment for a very vulnerable population. Other providers, such as family practitioners, would still be subject to the prior authorization requirement."

Study: Pharmacy drive throughs may lead to errors

A study by an Ohio State University researcher "found that a number of pharmacists think the extra steps it takes to serve customers at drive-through windows can cause dispensing errors, miscommunication among staff members and delays in filling prescriptions." (Source: "Drive-throughs lead to errors, pharmacists say," Columbus Dispatch, Jan. 27, 2008.) In recent years, many pharmacies have built drive throughs, which are popular with customers. However, "with all the tasks being performed at drugstores--filling prescriptions, checking insurance coverage, calling doctors' offices and answering patients' questions--pharmacists say drive-through windows add another chance for errors."

Ohio not meeting demand for new pharmacists

"Ohio State University received more than 900 applications for 125 spots in its pharmacy college in the fall--despite the creation of two new pharmacy programs at other Ohio colleges in the past two years." (Source: "Pharmacy programs are much-needed Rx," Columbus Dispatch, Jan. 28, 2008.) "There are shortages of pharmacists both nationwide and in Ohio. By 2020, 157,000 positions will be unfilled nationwide, including nearly 20,000 in Ohio, according to projections." This shortage has resulted in bidding wars between pharmacies and hospitals for new pharmacists. To meet this need, OSU, Ohio Northern, the University of Cincinnati and the University of Toledo have all recently have expanded their pharmacy programs, while the University of Findlay and Northeastern Ohio Universities College of Medicine opened new pharmacy schools in the past two years. Cedarville University hopes to start offering classes in fall 2009.