MARYLAND MAIL Rx RULES DRAW FIRE FROM NEW STUDY

Laws designed to protect Marylandpharmacists from unfair mail-order competitionare driving up prescription coststo the state's consumers by $7 million to$16 million a year, according to a newreport issued by the Maryland HealthCare Commission (MHCC). The analysisfound that Maryland consumers andthird-party plan sponsors spend morethan $4.1 billion annually on prescriptiondrugs, but only $600 million of thatamount—14% of the total—goes formail-order prescriptions.

That figure is well below the 18% averagemarket share commanded by mail-orderpharmacies nationally. It placesMaryland dead last in terms of mail Rxpurchases. The reason, according to thereport, is state laws prohibiting third-partypayers from offering lower copays topatients who order drugs by mail ratherthan at retail pharmacies.

Allowing health insurers to provideincentives to Marylanders who switch tomail-order dispensaries could effectivelyreduce consumer spending for prescriptiondrugs by anywhere from 2% to 6%.Significantly, however, MHCC researchersnoted that those savings would bedwarfed by the resulting losses toMaryland retail pharmacies.

Eliminating the current restrictions onlower copays for mail-order drugs wouldproduce losses to the state's retail pharmaciesof between $88 million and $210million, the researchers estimated. MHCCofficials, however, downplayed the impacton community pharmacies in the state bypredicting that much of the loss wouldbe mitigated by increases in the totalstatewide market for prescriptiondrugs over the next few years.