A state official says the plan would save taxpayers between $4 and $5 million.

A plan to encourage Maine’s Medicaid and Drugs to the Elderly clients to buy some prescriptions through the mail has angered Maine pharmacists, who say it would cost them millions of dollars and “cripple” local pharmacies.

But Gov. John Baldacci and others say the state must find new ways to cut health-care delivery costs.

At issue is a budget proposal that would reportedly save state taxpayers $4 million to $5 million yearly by encouraging clients in the Drugs to the Elderly and MaineCare programs to buy their maintenance prescriptions by mail order, which are generally cheaper.

In addition, those in the Drugs to the Elderly program would save on average $5 to $7 per prescription, according to Trish Riley, director of the Governor’s Office on Health Policy and Finance. For MaineCare clients who buy through the mail, the state would waive their $2.50 co-payments, she said.

Leaders of the Maine Pharmacy Association objected Tuesday, saying the plan will ship “$121.5 million worth of business out of state. Maine does not have a mail-order facility,” said Bob Morrissette of the association.

“They’re hell-bent on getting this through,” Morrissette said. “We’ve proved to them there are no savings in mail order,” but the state isn’t listening.

Often there is waste through mail bulk buying, he said. If a patient buys a 90-day quantity through the mail and then the doctor changes the prescription, the patient is left with “hundreds of dollars worth of pills,” Morrissette said.

In addition, he said, “We just heard that the (mail order) state contract is going to Wal-Mart in Florida. … In the state, businesses are leaving. Yet they’re going to send something that’s now in the state, out of state.”

Sending business out of Maine “is a concern we understand,” Riley said. “If somebody in Maine wants to create a mail-order company, that would be great.”

She said many consumers are already buying prescriptions through the mail. “It’s where the industry is going.”

Riley said she wasn’t sure if Wal-Mart won a state mail-order bid, but did say that “Wal-Mart provided a really competitive bid.”

Morrissette also warned that if lawmakers back the idea, it would mean less face-to-face contact between pharmacists and patients, which would lead to an increase in incorrect prescription use, which could lead to hospitalization. It would “endanger the welfare and public safety of Maine’s entire MaineCare population,” the association said in a statement.

“That’s overkill,” said Sen. Mary Cathcart, D-Orono, who co-chairs the Appropriations Committee and was one of the Democrats on the committee who voted for the proposal. Democrats, who are in the majority on the committee, voted for the plan, Republicans voted against.

Cathcart and committee members Rep. Richard Mailhot and Sen. Peggy Rotundo, both Democrats from Lewiston, stressed that the decision is not final and that it is a voluntary plan.

All three lawmakers expressed support for small businesses, but said the state needs to cut costs in order to preserve other critical state services. The lawmakers said they’re working on an amendment to give $1 million to help independent or “sole community” pharmacies.

Rep. Sawin Millett, R-Waterford, said Republicans don’t support buying out-of-state because it could harm Maine pharmacies. “We do recognize there’s a potential savings to consumers,” Millett said, but he added that the impact of business leaving Maine and what that would do to pharmacies worries him.


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