Pharmacists Wary Of New ‘Maintenance Drug Network’
by Hugh McQuaid | Sep 13, 2011 5:30am
(15) Comments | Commenting has expired
Posted to: Business, Labor, State Budget
State Comptroller Kevin Lembo announced Monday the creation of a “Maintenance Drug Network,” designed to let independent pharmacies continue to provide state employees with their medications. But according to a pharmacists group, participating drug stores would lose money.
A provision in the recently ratified state labor concessions package requires state workers to get their prescriptions for daily drugs through a mail order service owned by CVS. The requirement was estimated to save the state $19.87 million in the first year of the budget and $20.5 million in the second.
But independent pharmacy owners who serve state employees quickly cried foul, saying the provision cuts them out of the loop and negatively impacts their profits.
One pharmacy owner in Mansfield shut his doors before the deal was even ratified, telling Mansfield Today he couldn’t afford to stay in business since state workers make up 70 percent of his clientele.
In a statement, Lembo said pharmacies will be allowed to participate in the network so long as they match the rates of the program.
“This Maintenance Drug Network provides all the savings, but with more options for filling prescriptions,” he said. “The network will allow employees to pick up prescriptions at a local participating pharmacy – and still provide the state with cost savings resulting from mail-order pricing.”
But matching those rates will be difficult for most independent drug stores, according to Margherita R. Giuliano, executive vice president of the Connecticut Pharmacists Association. She said she has been hearing from her members that they cannot afford to participate in the network.
Local pharmacies can’t purchase the medications at the same rate as CVS Caremark, so if they chose to take part in the network, they would be doing so at a loss, she said. It leaves independent pharmacy owners with a tough choice, she said.
“It’s problematic. If they don’t participate they lose the patients but if they do they will be operating at a loss,” she said.
Those losses represent a deep cut since maintenance drugs, medications that treat chronic, long-term conditions, are the “meat and potatoes of their businesses,” she said.
She said her organization has been running a campaign advocating people’s right to choose where they get their medications. Many patients have strong relationships with their pharmacists, especially at smaller drug stores, she said. But while talks are ongoing, the state is adamant that the savings from the mail order provision be preserved.
While several stores are exploring the network, as of Monday only Stop and Shop and CVS had agreed to participate, according to Tara Downes, Lembo’s communications director.
Giuliano said she wasn’t sure if any other stores would be joining them.
“I think everybody is giving it a lot of thought. It’s concerning, very concerning,” she said.
Pharmacy owners looking to join the network can find the appropriate form through a link on the right side of the state comptroller’s web page titled “For Pharmacists: Enroll in Maintenance Drug Network Here.”
Tags: pharmacies, labor agreement, lembo, Hugh McQuaid
(15) Comments
posted by: state_employee | September 13, 2011 7:39am
this is malloy at his finest. screaming “we’re open for business” while putting business’s out of business.
posted by: perturbed | September 13, 2011 7:39am
This was just one more way SEBAC found to mislead us all, folks.
From the May 27, 2011 version of SEBAC 2011, in the helpful glossary provided—but later removed from the final “clarified” version (go figure):
“Mandatory Mail Order for Maintenance Drugs: The process by which maintenance drugs will be dispensed. The process will be that the maintenance drugs and the refills will now be delivered to the member by mail. Members who wish to pick up their mail order maintenance drugs may elect to do so at any CVS pharmacy. Otherwise, these prescriptions will be dispensed through the mail.”
And from original Section II.a.1.f.iii:
“Participants may at their option choose to receive their mandatory mail order at any CVS pharmacy.”</b>
Then the July 22, 2011 version of SEBAC 2011—with “clarifications”—offered this nice-sounding revision to Section II.a.1.f.iii:
“Participants may at their option choose to receive their mandatory mail order at any local pharmacy that wishes to participate in the maintenance drug network.”
They didn’t mention the fact that it would be cost-prohibitive for “any local pharmacy” to participate. As of now, the vast “maintenance drug network” consists of two providers, CVS and Stop&Shop;. Local pharmacies are still effectively locked out.
Is it all “clear” now?
—perturbed
posted by: Todd Peterson | September 13, 2011 11:40am
Earlier this summer John Rowland commented on this subject on his radio show - Rowland haters beware!.
He said that this plan reached his desk multiple times during his years in office and that he always opposed it because it would decimate the local pharmacies. Although the plan would save money he didn’t want to effectively sacrifice local businesses to do so.
I am not writing this to advocate one approach over another or elevate one governor over another. I’m just informing here. The reader can make his or her mind up…
posted by: InTheKnow | September 13, 2011 12:42pm
You will all notice that only CVS (its their plan) and Stop and Shop (their business is grocery not pharmacy) are in this program. This isn’t about small pharmacies that can’t afford it, it is about all pharmacies. It is a below cost proposal for chain and independent alike! Mailorder is a different class of trade that has other incentives built into its design that others are not privy to and can’t get. This is bad for all residents of CT - this will “cost” more than it saves, if it saves anywhere near what is proposed. I wonder what happens if the savings are not realized and 30% of the pharmacy outlets in the state are closed? Then what? Not good for the state Governor Malloy, not good for business.
posted by: Unbelievable | September 13, 2011 8:57pm
It will take years to undo what Malloy has done to this State in his first year in office. Let’s vote him out next term and put someone else in office who will rebound this great state back to what it used to be.
posted by: Lawrence | September 13, 2011 9:50pm
Wow—the private sector benefits from state spending?? Who knew?? (most everybody)
And when the worst recession in a generation demands that the state do things more cheaply, the private sector complains??
Who’d a thunk it? (most everybody)
Private sector—stop complaining to CBIA and your chambers of commerce and your GOP reps about “out of control state spending,” and then complain again when your state spiggot gets turned from “high” to “medium.”
YOU CANNOT HAVE IT BOTH WAYS.
posted by: NOW What? | September 13, 2011 10:05pm
Local, neighborhood pharmacies’ business models (whether “independent” or otherwise) were never designed or intended for the widespread distribution of prescription medications taken on a daily basis by the majority of the population. To use them in such a manner is simply cost-prohibitive, incredibly inefficient, and increases the chances of pharmacy errors dramatically.
The advent of enormous percentages of the population taking prescription medications on a daily basis for an indefinite length of time (often the duration of one’s remaining lifetime) is a relatively recent phenomena, particularly due to the development of modern-day cardiovascular, diabetes and central nervous system - acting medications. This development placed enormous, unsustainable strain on local pharmacies and their pharmacists. As these new drugs were developed, entered mass production, became widely available in less expensive “generic” version, and doctors began prescribing them to very large numbers of individuals for taking on a daily basis for indefinite periods of time, many local pharmacies experienced tremendous difficulty keeping up with the workload in spite of a near-constant construction and operation of new local pharmacies. Consequently medication dispensing errors increased substantially (some fatal), lines at pharmacy counters and wait times for pharmacists’ assistance increased dramatically in spite of the hiring of additional pharmacists and pharmacy “technicians” and the addition of pharmacy “drive-throughs,” and the costs associated with dispensing such medications locally rose dramatically.
As a result of these developments, public calls for the allowance of prescriptions in the U.S. to be filled via “mail-order” pharmacies - particularly those established in Canada and Mexico - became increasingly frequent and vocal. The U.S. FDA resisted such calls primarily out of concern for consumer safety, so domestic pharmacy mail-order services developed. Being the largest pharmacy chains in the country - and thus being able to negotiate the greatest discounts with pharmaceutical manufacturers and wholesalers/distributors as well as having the most well developed national retail distribution systems, CVS and Walgreens ultimately developed their own warehouse-based pharmaceutical mail-order operations. Even with the cost of home delivery (usually via the US Postal Service or a hybrid system of private/USPS delivery) the cost to purchase, fill and deliver prescriptions (particularly “maintenance” refillables) through such a model is inherently cheaper than through the local pharmacy model, the process of filling them is more efficient, and utilization of highly effective processes for driving down the frequency of prescription and fill errors in high-volume operations is possible in a way that is not possible or practical in a local pharmacy model.
The required use of a domestic mail-order pharmacy service for the routine filling of refillable “maintenance” medications will indeed save the State a lot of money, and will NOT result in destruction of the local pharmacy business. On the contrary, its wide-spread adoption will allow local pharmacies and their pharmacists to go back to doing what they USED to do so well - namely, providing personalized service to local customers and physicians on compounded (customized), newer and/or highly specialized prescription medications, non-refillable and/or non-“maintenance” prescriptions, and pharmacological advice. The only reason the State chose CVS/Caremark for mail-order service is that the State got the best price offer from CVS for its mail-order and pharmacy benefit management services.
Governor Malloy’s and the unions’ adoption of this mail-order plan for its employees and retirees was the RIGHT thing to do, especially from a government-provided health insurance administration perspective and no matter *how* one looks at it. Any comments that former Rowland may have had on the subject should be considered knowing that it was he who abandoned the State’s practice of self-insuring for healthcare purposes (a practice that the State has since rightfully returned to) in spite of the fact that self-insurance had saved the State a LOT of money, that it was he who abandoned the State’s money-saving employee suggestion program, and that he was sentenced to prison for a VERY good reason (hint: he wasn’t exactly interested in saving the State or its taxpayers any money 
posted by: Upset.Citizen | September 14, 2011 6:02am
@Now What - Ever come home to soggy mail on a rainy day? What happens when my pills get wet?
Are you watching the news about the Post Office’s financial issues, closings, changing from 6 days delivery (possibly down to 1 day in some areas)?
What happens when I get the wrong pills? Now I just call the local pharmacy and they fix it same day.
What happens when my package does not arrive? Recently it took me 12 weeks to resolve an issue over a calendar I ordered off Ebay that was last tracked to MO.
Thanks for your opinion but you can keep it. My glasses are not rose colored, I see the world as it is. In your world it would be cheaper to ship each bullet, one at a time, individually wrapped to our kids fighting overseas… Yeah, that would work! NOT! I spent many years in the shipping industry. I know for a fact it is cheaper to ship in bulk to the last destination possible and distribute items from that point to the locals. Just like the local profit making private sector pharmacies have evolved to do!
posted by: state_employee | September 14, 2011 7:39am
Ok, i’ll start by saying malloy needs to be voted out. he has really hurt our state for a very long time.
ok, that said, i have been doing the mail order med thing for many years. i have never had any problems at all. you can create a profile online and sign up for auto refil and auto renue. the meds come in a water proof mailer. so even though its not ideal that we are now very limited with how we obtain our meds, at least i can truely say it has worked for me for a long time. i hope that may help a little for people who are new to this.
again, this in no way is support of what malloy has done to us. he is an awfull human being, a liar and he is so full of himself.
posted by: NOW What? | September 14, 2011 1:09pm
Upset.Citizen - As state_employee said, the prescriptions arrive in a waterproof, tyvek mailer. Should they ever not arrive, you receive the wrong prescription, or require advice or info about it you can always either telephone the mail-order service or just go to your nearest CVS pharmacy and they’ll take care of it for you.
But given the content of your last post, the FACTS that I’ve presented are *obviously* not what you want to hear. You just want what you want when you want it, and I can assure you those days are *OVER* for state employees so I strongly recommended that you get over yourself and get used to living in the REAL world right NOW. The mail-order prescription service works EXCELLENTLY, and you are FAR less likely to receive an incorrect prescription from it than you are from your local pharmacy. Be HAPPY that you will save money on not having to drive to the pharmacy as often, be THRILLED that you will have such low co-pays on them, and - more than anything else - have TONS of *GRATITUDE* for the genuinely tremendous benefits that you have compliments of your employer and the taxpayer, because your days of “entitlement” are over. If you cannot adapt to such change, even when the change is GOOD, the stress you will endure will cause you FAR more harm than the CVS mail-order service *ever* will.
P.S. If you go back and re-read the details in the relevant articles you’ll find that the pharmacist in Mansfield who went out of business did so WELL before the FIRST SEBAC vote was completed - so he clearly had other problems with his business; the State’s switch to CVS mail-order for generic “maintenance” refillables had nothing to do with it.
posted by: Upset.Citizen | September 14, 2011 6:55pm
@Now_What - Please note state_employee posted over an hour and a half after I did.
To both of you - thank you for the info on the waterproof mailers. I did not know this and have not seen it anywhere else. One concern down… millions more to go… Many meds are temperature sensitive. I’ve seen the trucks deliver to the local pharmacies. They have air conditioning for the cargo area. Mail trucks do not have this… Do they pack them in dry ice or something in summer months?
How about addressing the rest of the questions from my earlier post?
I do have an open mind, but I’ve been burnt why too often and I find it hard to believe a politician or manager in the state when I’m told it’s going to be better for anyone! Unless that person is someone rich! I will eat my hat at the end of all this if it all comes true! That’s a promise and I stand by my word!
For the record: Look up entitled and earned in a dictionary! I have never felt entitled. I have always looked at my income and medical as something I earned and keep earning; compensation for my hard work, knowledge, and skills. It is not right that the government is ripping this out from under me to provide it to those who did not take a similar path in life as I did, do not know what I know, did not work several jobs while also working towards the education that I have, have not pulled all-nighters at my state job like I have done, etc.
A form of communism is being forced on us. Take what little the middle class has worked for and give it to those who have not. In the meantime the rich are above it all. Yes this is the real world! A wake up call is coming for those who are in charge! Patriotic Americans are finding their voices and taking action on every level! The next few elections will bear this out!
posted by: perturbed | September 14, 2011 11:33pm
NOW What? (aka “SteveHC”) wrote: ”...and - more than anything else - have TONS of *GRATITUDE* for the genuinely tremendous benefits that you have compliments of your employer and the taxpayer, because your days of “entitlement” are over.”
Spoken by a Tier I retiree. Your days of entitlement aren’t over yet though, are they SteveHC? (No skin off your back, remember?)
You know, when you stop shouting at active state employees what to do, what to think, and how to feel, you sound downright intelligent and interesting (as in your comments on the latest Littman Op-ed).
Then you slip back into the old defensive, hypocritical SEBAC union rants and I remember why you are, most often, not credible.
—perturbed
posted by: NOW What? | September 15, 2011 9:16am
Upset.Citizen and perturbed - LOL!!!
Facts are facts; everything else is just opinionated bs.
Have a *sparkling* day!
posted by: sharewhut | September 15, 2011 5:46pm
Upset,
just a little more clarification on mail order-
At least thru caremarks Specialty unit, meds are shipped FedEx, and you can designate whether or not they can be left without a signature. Heat sensitive are packed with ice packs.
posted by: Upset.Citizen | September 15, 2011 8:07pm
@Now What? Don’t run away, stand your ground if you are right people need to know the truth! If you are BSing then don’t come back!
@sharewhut - Ok, I’m starting to look for hat recipes… but I haven’t started cooking it yet, I still need to see this!
What about the local pharmacist who will have less work to do/lose jobs? For one I think of The Medicine Shoppe. The service they provide is compared to none other! My parents and grandparents used their services and they ensured everything went smoothly! As they got older, like many others, it proved impossible for them to organize their pills on their own. They have free weekly delivery with all pills placed in daily dispensers already!
I still don’t see how mail order can save anyone any money. Shipping a 20lbs package costs a lot less then shipping 80 - 1/4lbs packages… FedEx costs a fortune compared to the good old USPS! Cost of fuel goes up as people’s salaries seem to stay the same. Someone or a machine (google ‘Big Y getting rid of self-serve checkouts’ to be replaced by real people!) somewhere has to dole these out, package them, and ship them. All that sounds like overhead just moves to a location farther away… More jobs leaving the country?