Drugs-by-mail plan promises big improvement

Sunday, February 27, 2005

It makes sense for Maine to do whatever it can to provide high-quality, low-cost prescription drugs for its residents -- while saving the state a tidy sum in the process.

The state and the Penobscot Nation are doing the right thing by moving forward with a plan that would allow Mainers to buy prescription drugs over the Internet from an Indian Island warehouse in Old Town.

The initiative will establish a pharmaceutical storage-and-distribution facility on the Penobscot reservation. Organizers say it could be up and running by May 1.

State officials say it is expected to save Maine millions of dollars a year and provide jobs and other benefits to the tribe.

Many people stand to gain and no one seems to lose under the arrangement.

Some pharmacists oppose the mail-order drug program, claiming it will cost them business.

While we respect their concerns, the goal here is to do more to make prescription medications, which are often outrageously expensive, more affordable.

For the same reason, we continue to support enactment of a federal law that allows drug reimportation. This would permit Americans, especially senior citizens, to buy cheaper prescription medications from other countries, such as Canada.

Certain lawmakers, mostly Democrats, believe the 2003 Medicare reform law should be expanded to allow reimportation. Some also think it should authorize the federal government to negotiate bulk prescription drug prices for Medicare beneficiaries.

President Bush, who has never vetoed a bill, has pledged to veto any bill that would modify Medicare reform, which would expand the program to include a prescription drug benefit for the first time next year.

The Indian Island project in Maine might help drug companies, pharmacists and even the president get the message that our current system is a mess and needs fixing.

Gov. John E. Baldacci even has requested a waiver from the federal Department of Health and Human Services to allow the Indian Island project to be used as a pilot program for safe drug reimportation from Canada.

Unfortunately, the feds have not responded, at least officially, to the governor's request.

So the Indian Island project is moving forward for now without the benefit of drug reimportation.

The savings are still worth the effort, especially for those enrolled in the MaineCare program -- the state and federal low-income health program also known as Medicaid.

Some 262,000 Maine residents are now enrolled in MaineCare, which costs the state about $300 million a year just in drug costs.

By switching one-third of this business to a mail-order supplier, the Maine Department of Health and Human Services will save about $5 million a year.

To encourage people to switch from their local pharmacies, MaineCare members who use the mail-order system are not required to pay their drug co-payment -- $2.50 per prescription.

That is a great idea.

Until the Indian Island project is operational, the only mail-order supplier for MaineCare members is in Texas -- and only about 2,000 Mainers utilize it.

The Old Town storage-and-distribution facility, which is being renovated with a $400,000 economic development grant awarded last year to the Penobscot Nation, will not only be able to fill prescriptions more quickly, but it will keep more of the revenue and all of the tax dollars here.

Maine needs the money much more than oil-rich Texas does.

Plans for the new mail-order facility call for it to fill 90-day supplies of "maintenance medications" -- drugs that people use continually to treat asthma, heart problems, high blood pressure, seizure disorders and other ailments.

The Indian Island facility will buy drugs at wholesale prices from U.S. distributors and ship orders directly to customers. The state expects to pay about 30 percent less per prescription for MaineCare members who order from the no-frills mail-order center.

The state and the Penobscot Nation are onto something good with a program that provides cheaper prescription drugs for Mainers and saves the state what could be millions of dollars every year.