Nursing homes in Maine will soon be throwing away thousands of sealed, still-useful medications because they have no way to return the unused supply to pharmacies under the new federal Medicare drug program.
Maine nursing homes have been allowed to return some drugs purchased through MaineCare, a state drug program for the elderly and disabled. Pharmacists sealed the medications in 30-day supply blister packs and accepted the return of any unused portion. Because the drugs remained sealed, pharmacists could resell them and give MaineCare a credit for the returned pills.
For example, a nursing home patient might be prescribed an arthritis drug. The nursing home would pick up the sealed supply and begin giving it to the patient, but five days into the 30-day supply, doctors realize the dose needed to be stronger. The nursing home could return the 25 still-sealed pills and pick up the new prescription. The pharmacy would credit MaineCare for the 25 returned pills and sell them to another patient.
This return-and-reuse preserved medications – and it saved Maine approximately $1 million a year. Several states had similar policies, according to Jude Walsh, who heads prescription drug programs for the Governor’s Office of Health Policy and Finance.
But as of Jan. 1, most MaineCare patients will be receiving their prescription drugs differently. They’ve been shifted to Medicare Part D, the federal government’s beleaguered drug program. In Maine, 18 private insurance companies are offering drug plans as part of the new federal program.
Those insurance companies would have to provide a mechanism for drug returns. They don’t, experts said.
“So all that product has to be destroyed,” said Richard Legere, executive director for NCS Healthcare, one of the largest providers of pharmacy and other services to nursing homes and assisted living facilities in Maine.
This week, Legere notified his nursing homes about the situation, just as many consultants and pharmacists are doing. The nursing homes will now have to destroy unused drugs that, in the past, would have been returned.
“Everybody is concerned about the waste,” he said.
Walsh said she certainly is.
“That’s a waste of taxpayer dollars,” she said. “It doesn’t seem to me that’s a good way to do this.”
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