In Minnesota, They're Letting People Choose

Recently, the New York Timesran a story that brought a lotof smiles to the faces of peoplein retail pharmacy. Thearticle, entitled "In Switch, Insurer LetsStores Fill 90-Day Prescriptions," wasabout what Blue Cross and Blue Shieldof Minnesota is doing. The storydeserves a closer look. Most importantly,it offers the most recent evidencethat the marketplace is stepping up torecognize the value of letting peopledecide how and where they get theirprescription drugs.

In an experiment that could wellbecome a national model, according tothe Times, Blue Cross and Blue Shieldof Minnesota introduced a unique newprogram. The insurer's officials describeit as "a new network for members,allowing them to purchase a 3-month supply of prescription drugsfrom their community retail pharmacistas an alternative to a traditionalmail-order service."

The officials go on to describe what isbeing called "90dayRx" as a programthat can provide "members with thesame cost-saving benefits of a direct mailservice, while maintaining face-to-faceconsultation with their pharmacist."

Blue Cross Director of Pharmacy AlHeaton said, "90dayRx offers manybenefits to the individual member, andit's allowing retail pharmacists to offera customer incentive that previouslywas only available through an out-ofstatemail-order pharmacy." He added,"It's providing our Minnesota communitypharmacists a level playing field tocompete in the free market."

Thank you, Mr. Heaton!

I do hasten to add that this and otherplans can still contain inequities forretail pharmacy, which is treated as adifferent "class" when purchasingmedication, and it is important that atrue level playing field be establishedwhen 90-day prescription drug programsare designed.

After trying so hard to convey thestrong desire individual patients have tointeract with their community pharmacist,however, this program is welcomenews and the most recent sign that themarketplace is finding a way to meetthe real health care needs of consumers.

There are other examples suggestingthat a trend is growing. WalgreensHealth Initiatives has offered a programcalled "Advantage90" for more than ayear. Today, more than 140 companiesand managed care organizations aresigned up for Advantage90, representing1.5 million lives.

Our retailers also participate in programsthat cover over 9 million livesand give members a choice of having90-day prescriptions filled at retailpharmacies. Organizations such as BlueCross and Blue Shield of Illinois, BlueCross and Blue Shield of Michigan, andWellCare are offering such plans.

Then there are the positive results toconsider from an independent PBM[pharmacy benefit manager], MedImpact.It created a program called"Choice90" to provide members with a90-day prescription alternative at theirretail pharmacy. Perhaps the bestdescription of the program comes froma clearly satisfied customer, DaveSmith, with the furniture companyHerman Miller Inc.: "Today's consumerswant the freedom to choosehow, where, and when they get theirprescriptions and are apprehensiveabout prescription fulfillment bymail-fearing loss, delay, or even medicationerror. Choice90 strengthensindividual empowerment and consumerchoice. Employee satisfaction isenhanced without increasing prescriptioncosts."

These efforts and others in the marketplacerepresent a solid determinationto make sure retail pharmacy isproviding a choice for customers. Peopleshould have the right to choose.These programs suggest that there isreally no place for economic coercionthat drives people away from theircommunity pharmacy.

I hope every payer-whether privateplan or public entity-will ask onesimple question when it comes todetermining where its membersreceive their prescriptions: "Whodecides-your people or your PBM?"The marketplace is clearly ready tomake sure that people can decide!

Mr. Fuller is president and chief executiveofficer of the National Association of ChainDrug Stores.