Pharmacy changes spur anger at SIUC

When Hope Jurgens went to her local pharmacy last weekend to pick up her prescriptions, her bill was almost double what she normally pays - and she decided to just go without. "It finally hit me in the face that I would have to go to mail order," said Jurgens, who works in the SIUC pharmacy. Many University employees and other government workers across the state are facing similar issues as they struggle to cope with a benefit plan that they say leaves them with too few options.

Central Management Services, the benefits administrator for all state agencies including universities, announced last month, it was changing the company that manages its prescription drug program from Caremark, Inc. to Medco Health Solutions, Inc., beginning July 1. Willy Medina, spokesman for Central Management Services, said the state chose to drop the prescription mail-order giant after numerous complaints from customers. But one independent pharmacy owner and many University employees are wary that conditions may only worsen.

Caremark's contract with the state began early last year, but nothing was officially in place until last November. At first Caremark required all state employees to fill their long-term, or maintenance, prescriptions through mail order. A group of leading legislators pressed for local pharmacies to be allowed to fill state employee prescriptions. This change generated a list of pharmacies throughout the state that chose to join the state plan. Employees pay more to have prescriptions filled by pharmacies not on the state's list. Medina said the state's large budget deficit in recent years forced it to look to mail order prescription process as a way to reduce costs. He said about 90 percent of companies in the U.S. use the mail order system.

"We are just taking that best practice, if you will, and applying it to the state," Medina said. Medina said not only does the mail order process allow cost savings for the state, but also for the consumer because the process is more centralized. But employees like Cheryl Schmit believe that the mail order companies are only large, corporate giants trying to twist her arm. She said she prefers the face-to-face contact of her local pharmacist. Schmit has worked in the pharmacy business for 38 years and said she has continued to see the industry go down hill.

"We should not be forced into mail order," said Schmit who also works in the University's pharmacy. "They are trying to rip us off." Jake Baggott, assistant director of Student Health Programs, said centralized services, like mail order, can help increase discounts, but the trade off is a reduction of services. "This is a whole change from what people are accustomed to," Baggott said. Baggott said the exchange between a customer and the long-time pharmacist is invaluable, and it allows the customer to know that all their prescriptions are coming from the same place.

Another problem with the state system is the participating pharmacies approved by Caremark are few and far between in southern Illinois. The nearest approved pharmacies are in Carterville and Herrin. Baggott is one of many employees who choose to pay greater co-pays at a local pharmacy rather than mail order. Baggott said the issues the state is facing is reflective of the entire nation. But the movement to import drugs from Canada, mostly touted by Gov. Rod Blagojevich, is not the answer either because of questionable quality control, Baggott said. To add even more fuel to the fire, employees are upset with the constant change from brand name prescription drugs to generic forms. Baggott said while he can see the cost-savings in generic substitutes, the drug's effectiveness can differ in the patient.

Schmit said even though people should try the generic drugs because they are cheaper alternatives, companies like Caremark should not force doctors to change prescriptions from name brand to generic. "It is the doctor's decision, not some bean counter out in the middle of Texas," Schmit said. Dennis Lovins, president of HLS Pharmacies, said those larger companies will cut deals with generic drug makers and, in turn, make larger profits. He also said the cost of prescription drugs is skewed because the large corporate companies use under-the-table deals to turn profits.

HLS Pharmacies is a smaller chain that owns small independent pharmacies like Borowiak's IGA in Murphysboro. The local pharmacy was initially a part of the state prescription system, but Lovins pulled it from the list only one month into the agreement. He said there was no way the small pharmacy would make money while in that system. Lovins said he knew they would not turn a profit, but needed evidence first. "We looked at it, saw what has happening and opted out," Lovins said. Caremark has already disclosed it was a part of a larger multi-state probe about business practices, but has denied the charges. Medco also recently finished a similar investigation.

Medina said with Medco, prices will be more competitive for pharmacies, but Lovins said such a thing was unlikely. In fact, he said, he expects little to change under Medco's reign. "What they've done is just changed horses," Lovins said. Schmit agreed. "It's like going from the frying pan to the fire," Schmit said.