Pharmacies bear the brunt of the state drug plan.
By Bonnie Washuk
Staff Writer

AUGUSTA – The Baldacci administration acknowledged Wednesday that Maine pharmacies – not the pharmaceutical industry – initially will be paying for prescription discounts that begin Saturday under the new Maine Rx Plus program.

House Minority Leader Rep. Joe Bruno, R-Raymond, said that’s why his 15 stores and Rite Aid, Maine’s largest drug store chain, will not honor the Maine Rx Plus cards. In some parts of Maine people will have to drive 50 miles to find a pharmacy that will, Bruno predicted.

“The state has no financial responsibility under Maine Rx Plus. All that money comes out of the pockets of pharmacies,” Bruno said. “We’re the only ones putting up the money.”

In addition to being a legislator, Bruno is president of Community Pharmacies, which has 15 stores in Maine.

The program will give discounts of 10 to 60 percent to about 275,000 middle-income Mainers who don’t have prescription insurance.

Trish Riley, director of the Governor’s Office of Health Policy and Finance, confirmed Wednesday that Maine pharmacies will cover the cost of the program’s discounts until the state can convince drug makers to offer discounts.

“They’re good guys” and want to help people, Riley said of the Maine pharmacies willing to work with the program. Later this year, when the state has many of the 275,000 eligible Mainers signed up for Maine Rx, the state will turn to drug makers for discounts, she said.

Pharmacies that have volunteered to honor the Maine Rx cards “are priming the pump to get people enrolled so we have the volume to negotiate discounts” with the industry, Riley said.

The dispute over the discount drug program is another rift in what was already a rocky relationship between pharmacies and the Baldacci administration.

Saying they’ve been hit too often for cuts, many pharmacy owners are also unhappy with a Baldacci budget cut that will have the state paying them $2 instead of $3.35 for each MaineCare prescription they fill. MaineCare offers prescription help to Medicaid-eligible Mainers.

The reduction is part of $22 million in health-care cuts to begin on Tuesday. Pharmacies have said the cut may force some stores to close. Rite Aid has passed out fliers to customers that state: “What would you do without your local drug store? On Jan. 20, you might just find out. Call Gov. John Baldacci today. 207-287-3531.”

On Tuesday full-page newspaper advertisements by the Pharmacy Group of New England warned: “If you want your pharmacy to continue to be open when you need it to be, call your local legislator and demand that the MaineCare funding cut be stopped.”

Those threats are “scare tactics” and the wrong approach as lawmakers grapple with preserving services in a tough budget situation, said Lee Umphrey, Baldacci’s spokesman.

Bruno disagreed. When the lower dispensing fee goes into effect Maine will have the lowest Medicaid reimbursement rate in the country, he said, adding that he may have to close some of his 15 stores. “That’s why we’re upset.”

Why would pharmacies accept the Rx card and its discounts “when the governor is proposing to reduce our dispensing fee (under the MaineCare program)?” Bruno asked. “We can’t take both hits at the same time.”

Lots of pharmacies are, Riley said, explaining there will be two implementation phases for Maine Rx Plus. “In phase one, it’s a voluntary program. Pharmacies who want to volunteer. They’re good guys. These are pharmacists who see these poor people cutting pills” because they can’t afford their medicine, she said.

While some pharmacies may initially lose money by participating, they will gain over the long-term, according to Riley. “It will bring more people into their stores,” she said.

By the spring or fall thousands will have signed up, which will allow the state to act as their pharmacy benefit manager. “Once you get that kind of buying power, coupled with MaineCare, coupled with state employees, then you exert yourself with pharmaceutical companies to get the discounts,” Riley said.

bwashuk@sunjournal.