VIAGRA NEWS

Source: Coshocton Tribune

Date: 8-Apr-2007

Author: Gi Smith

COSHOCTON - Pharmacist Debra Shaw believes that pharmacists are often on the front line of medical care because patients can direct questions to her without an appointment and free of charge.

"It's nice to be able to help when they have questions or when you know they're obviously confused about (their medicines)," Shaw, who works at Triplett Pharmacy, said.

Like many local pharmacists, she believes that if new federal legislation passes, it would affect countless people who rely on Medicaid to purchase their prescription drugs. That legislation - the Deficit Reduction Act - could be implemented by year's end.

The legislation would slash reimbursements for providing generic prescription drugs to people on Medicaid. This new plan, brought about by the Centers for Medicare and Medicaid Services, or CMS, would pay pharmacists on average 36 percent less than their cost to provide generic drugs, according to a U.S. Government Accountability Office study that was released in December.

Mary Kahn, spokeswoman for CMS, said the legislation would not put Medicaid patients in jeopardy because of the need to reduce the budget.

"We don't believe this change will prevent pharmacies from serving Medicaid patients," Kahn said.

The federal government's reimbursement rates for brand name drugs would not be affected. Brand name drugs make up 41 percent of the drugs being dispensed in the Medicaid program. Currently, pharmacies make anywhere from 1 to 5 percent profit on their drug sales to Medicaid patients, depending on the area of the country they're in and how they're operated, according to the National Community Pharmacists Association, or NCPA.

With 10 percent of the Morgan County's eligible workforce unemployed, many of the patients that pharmacist Jeff Krause serves are on some form of federal medical assistance.

Krause is a pharmacist at Shriver's Pharmacy - the only pharmacy in McConnelsville.

"If they keep decreasing the amount of reimbursements for generic drugs (for people on Medicaid), these smaller pharmacies are going to keep losing more and more money. It could get to the point where the smaller ones will have to stop accepting Medicaid because they can't afford it," Krause said.

He added that the loss of Medicaid patients could drive small pharmacies out of business completely.

A survey conducted by the NCPA polled pharmacies regarding the Medicaid/generic drug issue. More than 80 percent of the pharmacies polled said they would turn down Medicaid patients if the government further dropped generic drug coverage.

If Shriver's McConnelsville location had to stop accepting Medicaid patients, those patients would have to travel to Zanesville or Marietta to find larger chain pharmacies that could fill their prescriptions.

"For every 1 percent shift to generic drugs, the state and federal government saves millions of dollars," said John Coler, owner of Shriver's Pharmacy on Brighton Boulevard in Zanesville.

Coler said in the past, the federal government pushed pharmacists in the direction of generic drugs. He said the reverse in the government's attitude is likely not being done with the patient's best interest in mind.

"But they haven't touched brand name drugs. This is all about the amount of lobbying being done by drug companies."

Coler urges voters to contact their state and federal legislators regarding Medicaid coverage of generic drugs. His pharmacy currently fills between 700 and 1,000 prescriptions for Medicaid patients each week.

CMS denied the GAOs's claim that pharmacies would be underpaid if the Medicaid generic drug reimbursements were cut. CMS said the GAO's results were unreliable because they are based on confidential data that the GAO received from IMS Health, a private company that tracks drug prices, and that the information cannot be verified. Congress mandated the change in reimbursement rates in the 2005 Deficit Reduction Act because under the current formula pharmacists were overpaid, the agency said. The change is supposed to save taxpayers $8.5 billion over the next five years.

But Coler said Medicaid patients who had to travel far distances to find a pharmacy large enough to take the generic drug reimbursement hit would likely go without medication because the travel would be cost-prohibitive.

"Whatever money they say they would save would be spent at the emergency room or by being admitted to the hospital because they've gotten sicker. If people can't afford their medications, they're not going to be able to afford the travel costs to get them if they have to go into the next county," Coler said.

Debra Shaw, pharmacist at Triplett Pharmacy in Coshocton, believes that pharmacists are often on the front line of medical care because patients can direct questions to her without an appointment and free of charge.

"It's nice to be able to help when they have questions or when you know they're obviously confused about (their medicines)," Shaw said.

"We won't be losing any money on brand name prescription drugs," Shaw said. "But if we fill prescriptions using generics, we'll lose our shirts."