Drug Stores's Low Cost Prescription Drug
Coverage Plans
(3/22/08)-Look for your local Wal-Mart to become an increasing player in the health care delivery system in the United States. This will be the start of big name national retailers and pharmacy chains entering the health field in a unique way in a large way.
These operations will partner with local hospitals who may not have an ownership stake in the in-store clinic or split a stake in the facility. For companies like Wal-Mart, it gives the community within which it operates an improved image of the company by providing an accessibility to health care service. For the hospital, it provides a way to expand its access to care and extend its primary care network.
In Houston the H.E.B. grocery chain has split a stake with RediClinic and Memorial Hermann. On its web site, RediClinic describes itself as "high-quality, affordable healthcare that fits how we live today. No appointments, no waiting – and routine treatment and preventive care in about 15 minutes. RediClinic's staff provides convenient and affordable treatment for more than 25 common conditions, such as strep throat and ear infections. They also provide health screening tests, vaccinations, immunizations, and physicals". Memorial Hermann’s mission is "to improve the health of the people in the communities they serve. Memorial Hermann serves the greater Houston community through 14 hospitals and many specialty programs and services". The are finding ready partners with retail operators
Steve Case, who stepped down as AOL Time Warner chairman in 2003 and last year founded Revolution Health Group has investment in InterFit Health, driving the expansion of that company's RediClinic retail clinic division.
This type of retail clinic is expected to grow from about 500 clinics to 1500 by the end of 2008. One of the largest of these retail clinics is MinuteClinic, which in a recent survey (Sept. 2007) had 168 clinics in 24 states. On its web site it describes itself as: "MinuteClinic’s team of board-certified practitioners are trained to diagnose, treat and write prescriptions (when clinically appropriate) for a variety of common family illnesses to patients 18 months and older. MinuteClinic is in-network with most major insurers, so patients are responsible for either their copay or the price clearly listed on our treatments and services menu. For those who are uninsured or prefer to pay out-of-pocket, MinuteClinic accepts cash, checks and credit cards."
They are providing on-the-spot health service to those who do not have a primary care physician, or those who want quick emergency service for relatively minor ailments or those who have no insurance and are willing to pay low fees for service. MinuteClinic posts a price list on its web site for various treatments.
Staffing in these clinics usually consists of nurse practitioners or physician assistants, with physician supervision. While the AMA found these clinics "controversial", they decided that the clinics fit AMA policy that encourages "multiple entry points" into the health care system. The AMA has developed principles for in-store clinic operations that tries to ensure patient safety and continuity of care. The question is how well will these standards be monitored as well as whether it is ethical to "refer" patients to your own service. The latter is a concerned expressed by Susan Strate, MD, immediate past chair of the Texas Medical Association's Council on Socioeconomics who felt that the hospital partnerships will result in lowered private primary care physician visits with more patients going to hospital clinics for follow-up care. Pressure will then be put on hospital clinics to lower their waiting time for service and provide greater continuity of care, not using rotating residents as service providers. This may strain the resources of the medical center.
Another important issue is whether this type of service is fragmenting the health service delivery system, setting up a battle between private practice physicians and medical centers. Our future articles will address many of the issues expressed in this first installment.
(1/29/08)- In 2006, when Wal-Mart first announced it would be selling hundreds of generic prescription drugs for $4, the plan was aimed at people who did not have drug coverage plans. The company currently offers more than 350 generic prescriptions for $4. Other retailers were forced to match Wal-Mart's offer.
In a speech before 7,000 Wal-Mart store managers, Chief Executive Lee Scott indicated that the company was initiating a pilot program to help "select employers…manage how they process and pay prescription claims." For more on this topic please see our article Medicare and the Cost of Prescription Drugs - HMOs and Pharmacy Benefits Managers (PBMs) --Part III and also The New Wal-Mart Stores Inc Employee Health Care and Drug Coverage Plan
It seems therefore that Wal-Mart is putting its toes gently into the prescription benefits management (PBM) business.
(10/9/07)- Wal-Mart pharmacies announced that it was adding seven new drugs to the list of drugs it sells for $4. In addition, it added a new $9 pricing for two popular birth control pills. The new drugs added to its list of pharmaceuticals is aimed at younger individuals, thus expanding the program away from the original drugs which was more or less aimed at older individuals.
The two birth control pills-known by the brand names of Ortho Cyclen and Ortho Tri-Cyclem- account for 20% of oral contraception prescriptions in this country. A fertility drug, clomiphene, will be added to the list of drugs available also.
Included among the drugs added to the $4 pricing list were methylphenidae, a drug used for attention deficit and heperactivity disorder. This action by Wal-Mart caused Target to react by announcing it would do the same for its list of pharmaceuticals that it would be selling at sharply reduced prices
Two of the other drugs added to Wal-Mart's list were the generic versions of the heart medication Coreg, and the nail-fungus drug Lamsil, both of which came off patent protection recently.
Two of the nation's other largest prescription drug retailers, Walgreens and CVS, have not announced any changes in their lists to match Wal-Mart's action.
(8/31/07)- Wal-Mart has opened on-site independently owned medical clinics in 76 of its stores in the last two years and plans to have 2000 on site clinics in stores in the next 5 years.
(8/20/07)- Coverage of the August 6, 2007 press conference at the Cape Coral Midpoint Center Publix chain of 684 pharmacies in a five-state area indicated that Publix was initiating a free prescription program covering seven oral antibiotics. These antibiotics are intended for bacterial infections. The seven antibiotics are:
These are prescription drugs, so a medical doctor needs to write a prescription in order to obtain the free medication. The offer has no expiration date. The medication is for a14 day supply.
This Publix program covers people with or without medical insurance as well as patients on Medicare or other government-funded health care assistance. It should prove a great help to those who do not have drug coverage.
Charlie Jenkins, Publix supermarkets chief executive officer, announced the program to the public. Newspapers had full page ads introducing the program. This program joins the Kmart program that offers a 90-day supply of about 300 generic drugs for $15 per month and Wal-Marts $4 prescription program covering 314 drugs. (Thirty-five percent of the prescription drugs filled at Wal-Mart involve this $4 plan and 30% are filled for customers who have no insurance according to Deisha Galbrerth, Wal-Mart communications manager.)
We wonder if these programs will see a dramatic increase in the number of prescription written.
While there is no question that this is a marketing lure, it will be made up by drawing more people into the store. It will prove valuable to those who don’t fill their prescriptions because of the cost.
FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "How to Select a Nursing Home"
Harold Rubin, MS, ABD, CRC, Guest Lecturer
updated March 22, 2008
http://www.therubins.com
e-mail: hrubin12@nyc.rr.com or rubin@brainlink.com