Pharmacist urges knowing specifics during enrollment
Jean Pierce of Marion isn’t interested in going out of town to get her Medicare Part D prescriptions filled no matter how much insurance companies want to steer business to big chain pharmacies— and neither do her friends.
“I’ll just stick with my local Marion pharmacy,” she said. “We have to keep something local going.”
Some Medicare Part D policies contain a “preferred” clause that designates certain pharmacies as being able to offer prescriptions to seniors at lower costs than non-preferred pharmacies. However, the preferred status went to major nationwide pharmacies like Wal-Mart, Walgreens, and CVS.
Marion Health Mart owner Marlin Buchholz said the change caught him off guard.
“We didn’t realize that some of the new plans were like that,” he said.
He believes the plans are misleading because they present a cost savings, but fail to tell residents where the preferred pharmacies are located, and failed to give local pharmacies a choice to be a preferred provider.
“This isn’t something we turned down,” he said. “We didn’t choose not to be preferred. We were never even offered the option.”
The plans cannot bar customers from choosing their own pharmacy, but they can charge a higher co-pay.
“It’s forcing people to drive to save,” he said. “I’ve lost customers because they can’t afford the higher amount, and I can’t blame them; they don’t have a choice.”
The change especially affects seniors who cannot drive or are on a tight budget, Buchholz said. The difference in costs is only a few dollars per prescription, but seniors on a tight budget who need four or five prescriptions a month are finding it hard to continue to have their prescriptions filled locally.
“That’s where the government has turned their back,” he said. “It’s all about money.”
While the plans that distinguish preferred and non- preferred are currently few, he expects the number to grow steadily every year.
To fight the issue, Buchholz is planning on attending several meetings for independent pharmacies over the next few months and contacting his state and national representatives. He also urges seniors to be aware when enrolling for plans in the fall and research which plans contain the preferred clause and choose a plan that allows them to purchase their prescriptions locally at the same price as the big chains.
“I can’t help believe that something won’t happen to change this down the road,” he said.
In Peabody, Don’s Drug Store co-owner Ken Krehbiel said the plans have forced some of his customers to travel to Newton for their prescriptions.
“Preferred plans say go here or pay higher co-pays, and sometimes the savings is so substantial that there’s no other choice,” he said. “You can’t blame people for that.”
Preferred plans have been around for several years, Krehbiel said.
“They’ve been more transparent about them as of this year, but for the first few years they didn’t tell people what the preferred part meant,” he said.
He said several of his customers, who didn’t realize the savings on co-pay would cost them the drive to Newton, have returned to getting their prescriptions at his store.
“Some have shown loyalty but as the savings have gotten bigger, it’s harder for them to do,” he said.
Because Krehbiel believes local pharmacies must address this issue or lose a large portion of their customer base, he is a member of a group working to remove the preferred clause from Part D policies.
Eric Driggers, owner of Greenhaw Pharmacy, in Hillsboro also believes that small pharmacies must address the issue quickly.
“Legislation already has been proposed to do away with the preferred versus non-preferred distinction,” he said. “I plan on alerting my legislative leaders and telling them how important it is this bill passes.”
Several lawmakers have signed a bipartisan letter written by U.S. Rep. Morgan Griffith of Virginia showing concern for the problem. In January, The Centers for Medicare and Medicaid Services proposed changes that would allow any community pharmacy to participate in a preferred network if willing to accept contract terms.
Driggers has received complaints from customers who are concerned about their insurance trying to push them into mail ordering their medications or traveling to other pharmacies to have them filled at prices they can afford.
“It’s forcing my customers to drive 30 minutes to an hour away, and their question is why can’t we offer the same price here?” he said. “It’s not like we choose to offer their medication at a more expensive price. We had no choice.”
He also expects the number of preferred versus non-preferred policies to grow every year because of agreements between insurance companies and larger pharmacies looking to make more money.
“Unless something changes,” he said, “it’s going to be up to people if they want local pharmacies to be around. They are going to have to make the choice to not travel and pay more and to make a decision on their insurance and what type of insurance they choose. They are choosing whether or not we will be here.”
A sample of a letter that can be personalized to show public support for the change is also available at http://bit.ly/partdsampleletter.
Driggers encourages residents to send the letter to their congressional representative before the public comment period closes March 7.