County discount drug program adds enrollees

By Susan Vaughn - November 2, 2006

Dukes County residents are among a growing number of people nationwide who are participating in a fast-growing new prescription drug discount card program.

Dukes County is one of 510 U.S. counties in the country, but one of only six Massachusetts counties, enrolled in the program sponsored by the National Association of Counties (NACo).

Counties are joining the program at a rate of 10 per week, according to figures in a report released by Andrew S. Goldschmidt, NACo's membership marketing director, on the NACo web site. The program has saved more than $14.3 million on more than 1.26 million prescriptions, with an overall average savings of 21.5 percent, he said. The mail order savings is an average of 50 percent, according to Winn Davis, Dukes County manager.

Mr. Davis estimated that Dukes County has distributed 600 of the cards in the few months since it joined the program. He added that he doesn't know the exact number since the county does not keep a record of the card numbers or take the names of people who pick them up.

"Dukes County doesn't want to track the cards. We don't want a violation of confidentiality," Mr. Davis said, in stressing that aspect of the program. The only people who know the names of participants are the pharmacists, who are bound by strict confidentiality laws.

At a time when private and public health care insurance programs can be a mind-boggling maze of paperwork, this program appears to be fairly straightforward. It has no enrollment fees, no forms to fill out, no age or income requirements and no medical condition restrictions, and it covers pet medications, according to the NACo web site. There are no costs to the county, county taxpayers, or consumers to participate. All residents of participating counties are eligible, and entire households can participate in the program with one card.

Neither NACo nor the participating counties receive any revenue from the program, according to the NACo Web site. The association is in partnership with Caremark, a prescription health services company based in Nashville, Tenn., that provides drug benefit services to more than 2,000 health plan sponsors, including government agencies, corporate health plans, managed care organizations, insurance companies, unions, and other funded benefit plans. Caremark had $23 billion in revenues in 2003, according to its web site.

Caremark negotiates the discounts directly with participating pharmacies, which will provide consumers with the lowest prices available, even if their price is lower than the NACo card discount rate, according to the NACo information.

A note at the bottom of a page of directions for enrolling in the direct mail order plan released by the Dukes County offices says Caremark is a discount program and not an insurance plan. "Caremark may obtain manufacturer rebates on your prescription drugs," the note says.

Mr. Davis stressed that participation in the program is voluntary for NACo member counties. He said Dukes County chose to join the program last summer because it seemed like a winning proposition. "Why wouldn't we provide this service to residents?" he asked.

Mr. Davis said he was surprised to learn that some people who have health insurance don't have prescription coverage. People who have no insurance can use the cards, and those who do have insurance can use them as a supplement to their insurance coverage, as well as for extra medication or medication that the insurers won't cover, Mr. Davis explained.

The coverage for pet medications is also unusual. Mr. Davis told of an Island woman who could have used the service. Her dog had diabetes and needed insulin twice a day, but she couldn't afford it, and the dog died. The pet medications can also be obtained at the participating pharmacies.

County sheriffs are also able to get the discount prescriptions for inmates who do not have insurance. The sheriffs are required to give medical attention to inmates, and in the past they had to pay the full market price for medications.

Mr. Davis said he is not sure why other Massachusetts counties have not elected to participate in the program yet, except they may be waiting to see how well it works. Barnstable County is considering enrolling, he said.

Mr. Davis said he plans more outreach about the program to the towns and elderly services. He also will get some help from Island agencies and individuals to inform the Brazilian population about the program. The cards have been distributed to all residents of Gosnold, he said.

All county residents may get the prescription cards and the mail order enrollment forms at the county office off Airport Road. Enrollees need only show proof of residency. Included in the packet is a list of all the medications and costs available through the program.

Four Vineyard pharmacies participate in the program: Conroy Apothecary, the Medicine Shoppe, Leslie's Drug Store, and Stop & Shop Pharmacy, as well as several in Falmouth.