In Minnesota, They're Letting People Choose

JUNE 01, 2005
Craig L. Fuller

Recently, the New York Times ran a story that brought a lot of smiles to the faces of people in retail pharmacy. The article, entitled "In Switch, Insurer Lets Stores Fill 90-Day Prescriptions," was about what Blue Cross and Blue Shield of Minnesota is doing. The story deserves a closer look. Most importantly, it offers the most recent evidence that the marketplace is stepping up to recognize the value of letting people decide how and where they get their prescription drugs.

In an experiment that could well become a national model, according to the Times, Blue Cross and Blue Shield of Minnesota introduced a unique new program. The insurer's officials describe it as "a new network for members, allowing them to purchase a 3-month supply of prescription drugs from their community retail pharmacist as an alternative to a traditional mail-order service."

The officials go on to describe what is being called "90dayRx" as a program that can provide "members with the same cost-saving benefits of a direct mail service, while maintaining face-to-face consultation with their pharmacist."

Blue Cross Director of Pharmacy Al Heaton said, "90dayRx offers many benefits to the individual member, and it's allowing retail pharmacists to offer a customer incentive that previously was only available through an out-ofstate mail-order pharmacy." He added, "It's providing our Minnesota community pharmacists a level playing field to compete in the free market."

Thank you, Mr. Heaton!

I do hasten to add that this and other plans can still contain inequities for retail pharmacy, which is treated as a different "class" when purchasing medication, and it is important that a true level playing field be established when 90-day prescription drug programs are designed.

After trying so hard to convey the strong desire individual patients have to interact with their community pharmacist, however, this program is welcome news and the most recent sign that the marketplace is finding a way to meet the real health care needs of consumers.

There are other examples suggesting that a trend is growing. Walgreens Health Initiatives has offered a program called "Advantage90" for more than a year. Today, more than 140 companies and managed care organizations are signed up for Advantage90, representing 1.5 million lives.

Our retailers also participate in programs that cover over 9 million lives and give members a choice of having 90-day prescriptions filled at retail pharmacies. Organizations such as Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Michigan, and WellCare are offering such plans.

Then there are the positive results to consider from an independent PBM [pharmacy benefit manager], MedImpact. It created a program called "Choice90" to provide members with a 90-day prescription alternative at their retail pharmacy. Perhaps the best description of the program comes from a clearly satisfied customer, Dave Smith, with the furniture company Herman Miller Inc.: "Today's consumers want the freedom to choose how, where, and when they get their prescriptions and are apprehensive about prescription fulfillment by mail-fearing loss, delay, or even medication error. Choice90 strengthens individual empowerment and consumer choice. Employee satisfaction is enhanced without increasing prescription costs."

These efforts and others in the marketplace represent a solid determination to make sure retail pharmacy is providing a choice for customers. People should have the right to choose. These programs suggest that there is really no place for economic coercion that drives people away from their community pharmacy.

I hope every payer-whether private plan or public entity-will ask one simple question when it comes to determining where its members receive their prescriptions: "Who decides-your people or your PBM?" The marketplace is clearly ready to make sure that people can decide!

Mr. Fuller is president and chief executive officer of the National Association of Chain Drug Stores.