PARIS – Oxford County Commissioners talked with the jail doctor Tuesday about ways to save money on drugs administered to inmates.

Commissioner Steve Merrill suggested that the county consider purchasing medications in Canada, where some drug prices are significantly lower than in the United States.

An average of $3,000 a month is spent on medicines, both over the counter and prescription, at the Oxford County Jail, said Oxford County Sheriff Skip Herrick. He said one inmate now at the jail has cost the county $6,000 over the past six months for medicines deemed necessary by jail physician Dr. Lonnie Lauer.

Lauer works once a week at the jail, and authorizes medications that are self-administered. These medications are supplied by Ketner Pharmacy of Norway.

Most of the prescription drugs used at the jail are of the psychotropic category, treating symptoms of depression, anxiety or other mental disorders, including psychosis. But a goodly amount of over-the-counter medicines, such as Benedryl and Tylenol, are routinely used as well, Lauer said.

Lauer said the jail has an agreement with Ketner’s that the pharmacy will provide a generic equivalent of a drug whenever possible. But for most of the newer, safer psychotropic drugs, the drug companies still retain the patent. Until the patent expires, there is no generic equivalent, he said.

Merrill pointed out that the county also saves by using Lauer as an in-house physician, rather than contracting the service with a vendor. The daily cost per inmate at the Cumberland County Jail, which uses a vendor contract, is $13 a day. In Oxford County, that cost is $6 a day.

The only downside is that the county “inherits the liability” if “the wrong medication is given to the wrong inmate,” Merrill said. The staff training that enables guards to oversee self-medication dispensing rarely, he said, results in the “wrong medication being given to the wrong inmate.”

Merrill said the Maine County Commissioners Association is talking about coming up with a group purchase plan among counties that could apply to drug purchases at bulk rates.

Merrill said he’s aware that the York County Jail gets its medicines from Canada, and said it was a progressive idea worth exploring.

But Lauer noted that stockpiling certain medicines bought through a group purchase plan or from Canada wouldn’t be practical, since the jail population is constantly changing.

The jail can return the unused portion of medications to Ketner’s for a credit, but it couldn’t do that with a Canadian supplier, Lauer said.

Time is also of the essence in some cases, when a drug is needed immediately for an inmate who’s gone out of control.

An inmate on prescription medication can bring that medication along at the start of his or her sentence, Lauer said, “as long as we can identify the container and its contents.” But when it comes time to refill that prescription, and the inmate is still serving time, the county must pick up the tab, even if that inmate has MaineCare, formerly known as Medicaid, pay for his medications on the outside.

“The inmate may have Medicaid through the state, but that gets whacked when he walks through the door,” Herrick said.

Commissioner Jim Carey Jr. said the Legislature ought to pass a bill requiring inmates to reimburse the county for their medication costs.

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