Health Program
Resources on Pharmaceutical Costs and Access
Update: August 14, 2008
The following is a selected list of recent government, academic, industry and consumer studies, analyses and related publications, designed to assist state-based research. Most are available on the web, with direct links included. There are numerous additional studies and reports, not listed here, which also have useful information. Omission from this list does not suggest such studies are less useful. For more comprehensive sources and bibliographies, see the source lists and footnotes in some of the larger studies below.
Note: NCSL provides links to other Web sites for information purposes only. Providing these links does not indicate NCSL's support or endorsement of any third party site.
Recent Non-NCSL reports, research and articles
Medicare Prescription Drug law (MMA) - Analyses and Commentary:
H.R. 1 - full text of signed law. Provided by the Library of Congress [PDF format, 415 pages]
Medicare Payments and Beneficiary Costs for Prescription Drug Coverage. Published by Henry J. Kaiser Family Foundation, 3/07. [38 pages,  PDF].
CMS: Medicare Reform Implementation - official web reports and resources by CMS, 2008.
"Medicare Drug Plan: What It Is, How to Use It" - This feature story by Mainstreet.com/The Street.com cites NCSL's report as a primary online source of pharmacy assistance information, 8/6/08 
"The Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D " - This policy brief examines how the role of state pharmaceutical assistance programs, which help low-income Medicare beneficiaries with their drug costs, evolved once the Medicare drug benefit took effect in January 2006. Published by Kaiser Family Foundation, 7/07. [17 pages, PDF].
"The Impact Of Medicare Part D On Prescription Drug Use By The Elderly," - According to the authors, Medicare Part D reduced user cost among the elderly by 18.4 percent, increased their use of prescription drugs by about 12.8 percent and increased total U.S. usage by 4.5 percent in 2006. Health Affairs, 11/07.
"Medicare Part D: The First Year" - IMS Health presents an evidence-based perspective on the first year of the Medicare Part D program and its impact on pharmaceutical usage. The report is based on an analysis of several information sources by IMS consultants and examines the impact of Medicare Part D on key issues such as access to therapy, out-of-pocket spending, rates of compliance and persistency, generic drug usage and the coverage gap caused by beneficiaries reaching their initial coverage limit. Published 7/07. [12 pages, PDF].
One Year In: Sole Community Rural Independent Pharmacies and Medicare Part D" A joint publication of the North Carolina Rural Health Research & Policy Analysis Center and the RUPRI Center for Rural Health Policy Analysis. 11/07
The Nuts and Bolts of PDPs -This issue brief provides an overview of Medicare prescription drug plans (PDPs), with a focus enrollment, premiums, formularies, cost sharing, prices, payment, cost management, and appeals and grievance processes. It also highlights major changes to the PDP landscape between 2006 and 2007. National Health Policy Forum, 11/8/06. [ PDF 18 pages]
"Prescription Coverage Now Act": On March 15, 2007 Rep. Lloyd Doggett (D-TX) introduced the "Prescription Coverage Now Act." The proposed legislation focuses on assisting low-income senior citizens who have not yet enrolled in a Medicare Part D prescription drug program or the low-income subsidy (LIS) available in Part D. Among various provisions, the bill: requires the Secretary of HHS to undertake affirmative outreach activities, including multiple individual notices (in English and other necessary languages) informing beneficiaries of their potential eligibility for the LIS; increases the resource eligibility limits; excludes life insurance and assets in retirement accounts from the resource limits; protects beneficiaries from losing other public benefits because of the assistance they receive through Part D; waives the late-enrollment penalty for LIS-eligible beneficiaries; and provides them with a special enrollment period to enroll in a Part D plan.
"Formulary Variability In Medicare Prescription Drug Plans for Auto-Assigned Long-Term Care Residents" - LTC Pharmacy Alliance, 2/16/07. [ PDF, 77 pages]
Too Sick to Work, Too Soon for Medicare: The Human Cost of the Two-Year Medicare Waiting Period for Americans with Disabilities, R. M. Hayes, D. Beebe, and H. Kreamer, The Commonwealth Fund, 4/07 [ PDF 72 pages]
 "Medicare Prescription Drug Plan Guide: How to Choose Your 2008 Plan" - a joint publication by AHIP, NACDC and NCPA, 10/07
"Shopping for Drugs: 2007," National Center for Policy Analysis describes how "aggressive consumers can reduce the cost of some common drug therapies by more than 90 percent." NCPA Policy Report, 11/15/06. [44 pages]
"Generic Drug Usage Report" A study by ExpressScripts "Reveals $20 Billion in Untapped Generic Drug Savings", 10/24/05.
State Medicaid Outpatient Prescription Drug Policies: Findings from a National Survey, 2005 Update. Published by Kaiser Commission on Medicaid, 10/05.
State Assistance Programs for SSI Recipients, 2005, published by Social Security Administration, 9/05.
Expectations Shrinking for Medicare Part D Enrollment - by Families USA, 2/06
Medicare: Contingency Plans to Address Potential Problems with the Transition of Dual-Eligible Beneficiaries from Medicaid to Medicare Drug Coverage. Released by GAO-06-278R, 12/16/05. http://www.gao.gov/cgi-bin/getrpt?GAO-06-278R
"Guide to Medicare Part D Prescription Coverage for People with Developmental Disabilities" published by the Disability Policy Collaboration, 10/05, updated 3/31/06
Important things to consider when choosing a Medicare drug plan for people with Alzheimer’s disease - Alzheimer's Association, 12/19/05 [PDF, 2 pp.]
"Medicare Prescription Drug Coverage State Partnership Conference" - conference agenda and links by NGA, CMS and CSG, 4/24/05-4/26/05.
State Pharmaceutical Assistance Transition Commission- created by CMS
"States' Issues and Concerns with Implementation of Medicare Part D Prescription Drug Coverage" Report from Academy Health and Rutgers Center for State Health Policy. Data from May; released 7/04.
Families USA has produced a new report called Gearing Up: States Face the New Medicare Law
http://www.familiesusa.org/site/R?i=KHgMbulr42ADRYvcWDDmjg. Issues covered in the report include:
Enrollment of current full dual eligibles in Part D and the low-income subsidy. Processing applications for the low-income subsidy. Screening and enrolling low-income beneficiaries in Medicare Savings Programs. Changes to State Pharmacy Programs (SPAPs). Changes to state Medicare prescription drug coverage. Maintaining drug coverage for beneficiaries in long-term care facilities and other institutions. Upcoming challenges for state Medicaid budgets.
"Riding the Rollercoaster: The Ups and Downs in Out-of-Pocket Spending Under the Standard Medicare Drug Benefit" published by Health Affairs, 07/05-08/05.
State and General Pharmaceutical Reports:
- "Pharmaceutical Benefits Under State Medical Assistance Programs, 2007" - a 650 page manual describing 50-state Medicaid Rx polices; also includes SPAP descriptions and Rx trend data. By the National Pharmaceutical Council (NPC) - published 1/08.
- Health Spending Projections Through 2016: Modest Changes Obscure Part D’s Impact. Over the next decade, U.S. health care spending is expected to double from today’s level, reaching $4.1 trillion and consuming almost twenty cents of every dollar spent, federal forecasters report in an article published in Health Affairs Web Exclusive. Health spending in 2006 is projected at $2.1 trillion, which accounts for 16 percent of the gross domestic product. The average annual growth in health care spending is projected to remain relatively steady at 6.9 percent from 2006 through 2016. (Health Affairs, 2/21/07)
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"Americans pay the most for prescription drugs and still don't take them" - An international study of dialysis patients shows that although U.S. residents have the highest out-of-pocket drug costs, even those who can afford their prescription drugs are far less likely to take them than patients in other countries. Published by Arbor Research Collaborative for Health, U. Mich, 1/8/08.
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Prescription Drug Expenditures in the 10 Largest States for under 65, 2005 - MEPS Survey data, published by AHRQ, January 2008. [6 pages, ]
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New USA Today/Kaiser/Harvard Poll Finds the Public Sees Real Benefits From Prescription Drugs, But Feels that They Cost Too Much and that Drug Companies Care Too Much About Profits: See the story: Four in 10 Americans Say They Have Trouble Paying for Drugs or Skip Prescriptions or Cut Pills Due to Cost, as reported by Harvard School of Public Health 3/4/08
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State Prescription Drug Price Web Sites: How Useful to Consumers? -report by Center for Studying Health System Change, 2/13/08.
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"Prescription Drugs: Trends in Usual and Customary Prices for Drugs Frequently Used by Medicare and Non-Medicare Health Insurance Enrollees" GAO Report to Congress 9/7/07. [14 pages, PDF]
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2008 Preferred Medication List—Medication Categories Guide - This Walgreens PDL provides one example of a commercial use of PDLs; (Its inclusion here is illustrative only; and does not imply NCSL endorsement or opposition). Effective January 1, 2008.
- 2007 AG Pharmaceuticals Conference by the National State Attorney General Program at Columbia Law School in New York, 5/10-11/07. It featured latest information on pricing and marketing fraud legal cases, state laws and challenges to them, payments to doctors and more. Most materials are now posted on the web, including:
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NJ Prescription Drug Retail Price Registry "helps consumers compare the retail prices charged by many pharmacies for the 150 most-frequently prescribed prescription drugs" based on 2006 signed law.
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- Deficit Reduction Act Of 2005: Impact On The Medicaid Federal Upper Limit Program - Office of the Inspector General, June 2007. [46 pages]
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- Tennessee: 4,200 apply on first day of CoverRX enrollment; Prescription-drug plan targets uninsured, poor. News from Tennessean, 1/4/07.
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Insurance Coverage Of Biopharmaceuticals -"breakthrough biopharmaceuticals pose a difficult challenge to existing arrangements for financing care because of their high costs, the small patient populations they often serve, and problems in measuring their incremental therapeutic value..." Health Affairs, Sept/Oct 2006.
- Qualified State Pharmaceutical Assistance Programs (SPAPs) under the MMA - easy-to-read summary of CMS data, 8/06.
- CMS Fact Sheets: Update for State and Local Government Officials Medicare Part D Implementation - NCSL's one-stop compendium of timely notices from CMS, updated as needed.
- "Hope, at $4,200 a Dose," Because of the economics of the cancer drug market, price does not seem to hurt a drug's popularity. story by New York Times, 10/2/06.
- Wal-Mart speeds $4 drug program Retail giant to offer prescription plan in most states soon - 10/6/06. On October 19, Wal-Mart said it will announce programs with elected officials in the following states: Alaska, Arkansas, Arizona, Delaware, Florida (began 10/5), Illinois, Indiana, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Texas and Vermont. 10/19/06.
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"Medicare Prescription Drug Plan Guide: How to Choose Your 2007 Plan" - a joint publication by AHIP, NACDC and NCPA, 10/06
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State Perspectives on Emerging Medicaid Pharmacy Policies and Practices - report by the National Association of State Medicaid Directors (NASMD), 11/13/06 [ PDF, 45 pages]
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The DRA Related Medicaid Pharmacy Provisions: Average Manufacturer Price (AMP) Regulation, published in the Federal Register on Friday, December 22, 2006. The CMS Fact Sheet regarding this regulation can be found at: http://www.cms.hhs.gov/apps/media/fact_sheets.asp An electronic copy of the Regulation can be found at: http://www.cms.hhs.gov/MedicaidGenInfo/downloads/AMP2238P.pdf Published 12/18/06.
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340B Drug Discount Program: proposed agency changes in patients and pharmacies - release by OPA, HRSA/HHS, 1/12/07.
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"Medicare: Negotiated Drug Prices May Not Lower Costs" NCPA free market analysis, 12/18/06. [ PDF 2 pp]
- "Shopping for Drugs: 2007," National Center for Policy Analysis describes how "aggressive consumers can reduce the cost of some common drug therapies by more than 90 percent." NCPA Policy Report, 11/15/06. [44 pages]
- "The Impacts of Breakthrough Drug Classes on Total Health Expenditures" - A scientific study "examining six different groups of breakthrough drugs, including the SSRIs, Statins, Ace Inhibitors, H2 Antagonists, Proton Pump Inhibitors, Calcium Channel Blockers, and Fluoroquinolones. All drug classes except Fluoroquinolones provide substantial cost savings on overall health care expenditures." - Texas A & M Univ. 11/11/06. [41 pages]
- National ADAP Monitoring Project 2007 Report: Formularies from NASTAD and the Henry J. Kaiser Family Foundation, 4/07. [ PDF, 31 pages]
- Improving the Medicare Savings Program (re Dual-Eligibles) - National Academy of Social Insurance, 6/06. [56 pages ]
- Prescription Drug Trends Fact Sheet - KFF Updated June 2006 [5 pages]
- Medicare: Communications to Beneficiaries on the Prescription Drug Benefit Could Be Improved-highlights - Full text of GAO-06-654 [88 pages ], 5/03/06
- Doctors Object to Gathering of Drug Data - featuring legislation in AZ, HI, NH, WV. New York Times, 5/4/06.
- Estimating The Cost Of New Drug Development: Is It Really $802 Million? by Health Affairs 25(2): 420-428, 03/06-04/06.
- Drug Cost Increases are Slowing, New Buck Consultants Survey Finds - 2/23/06– Although employers’ health care costs will continue to increase at a double-digit pace through 2006, the increases for prescription drug programs are slowing. These are among the results of a national survey of health insurers, HMOs and third-party administrators released today by Buck Consultants, an ACS company and one of the world’s leading human resource and benefits consulting firms.
- Pharmaceutical Benefits Under State Medical Assistance Programs, 2004 - A comprehensive data source published for the 39th year by the National Pharmaceutical Council. [Fall 2005. [Full PDF download 18 files = 6+ mb; 650 pages]
- Prescription Drug Prices Increased by 5.5% in First Half of 2005, New Research Indicates - Delta Marketing study posted by Kaiser, 8/2/05.
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Under the Counter: The Diversion and Abuse of Controlled Prescription Drugs in the U.S. - published by CASA, Columbia University, 7/05. (226 pages)
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"Patient Power: Over-the-Counter Drugs" Report by the National Center for Policy Analysis (NCPA), Texas, 8/05.
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"Outreach medication education in Pennsylvania: A non-commercial source of evidence-based information about medication choices for physicians", Presentation by Michele Spetman, M.S., M.P.H.: May 19, 2006 (in PPT format)
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The federal Ryan White CARE Act provides health care for people with HIV disease, through HRSA' s HIV/AIDS Bureau. Updated 5/06.
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" Cost Containment Strategies For Prescription Drugs: Assessing The Evidence In The Literature" - Health Policy Institute, Georgetown University for Kaiser Family Foundation, 3/05. [125 pages] -
National Health Policy Forum, Understanding Medicare and Medicaid: Fundamentals and Issues for the New Congress, An Electronic Briefing Book: Session 10 Fundamentals of Prescription Drug Pricing and Purchasing.
- CUTTING DRUG COSTS: Different Approaches, Different Results (Executive Summary) analysis of state programs in Ohio and Maine (9/29/2005)
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State Pharmacy Assistance Programs: A Chartbook, published by The Commonwealth Fund, 8/04. [PDF, 84 pages].
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Employers Unite in Effort to Curb Prescription Costs - Rx Collaborative and the PBM industry - New York Times Business section, 2/3/05.
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"Taking Steps to Contain State Drug Costs" - Report #SO70 by California Performance Review, a state executive office, posted 12/04.
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Wyoming: State reopens drug program - The state program to help low-income people afford prescription drugs is open for enrollment again as of July 1, 2006.
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Missouri Rx Compare price web site - listing local drug store prices. Launched 2006.
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Heinz Family Philanthropies series of studies to determine whether and how states can implement prescription-drug benefit programs. (2002-2005).
Idaho -- Medicaid Pharmacy Report
Maine -- Heinz Plan to Overcome Prescription Drug Expenses
Massachusetts -- Plan for Aggregate Purchasing
Massachusetts -- Heinz Plan to Overcome Prescription Drug Expenses
Mississippi -- Heinz Plan to Overcome Prescription Drug Expenses
Pennsylvania -- Heinz Plan to Overcome Prescription Drug Expenses
Rhode Island -- Plan for Coordinated Contracting
Virginia -- Plan for Coordinated Contracting
- Florida Prescription Drug Prices website - "developed by the Florida Agency for Health Care Administration (AHCA) and the FL Attorney General to help consumers shop for the lowest price in their area for their prescription drugs." Launched 6/05.
- 2003 Drug Trend Report- Report released from Express Scripts, St. Louis, Missouri - 6/04.
- Pharmaceutical Benefits Under State Medical Assistance Programs, 2003 - A comprehensive data source published for the 38th year by the National Pharmaceutical Council. 8/04. [download = 4+ mb; 650 pages]
- State Purchasing Pools for Prescription Drugs: What's Happening and How Do They Work? published by NGA Center for Best Practices Health Division, 8/04.
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Medicaid’s Reimbursements to Pharmacies for Prescription Drugs - Congressional Budget Office, 12/04. [24 pages]
- Shopping for Drugs - Report on wide price variations, by Devon Herrick, National Center for Policy Analysis. 6/03[15 pages].
- "Demonizing Drugmakers: The Political Assault on the Pharmaceutical Industry," Policy Analysis 475 by Doug Bandow, 5/8/03, Cato Institute.
| Private Patient Assistance Programs (free pharmaceuticals) |
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- Benefits Checkup helps people to find programs for people ages 55 and over that may pay for some of their costs of prescription drugs, health care, utilities, and other essential items or services." A service of the National Council on Aging.
- Partnership for Prescription Assistance (PPARx), sponsored by PhRMA. Examples of state-specific free and discounted assistance information, '2008:
- Patient Assistance Now by Novartis - This newly expanded service links to Novartis products at no charge or at a discount and related PAP features. 8/08.
- RxAssist is a web-based searchable database, providing "up-to-date information on accessing more than 70 manufacturers' programs." Information on that project also is available by telephone, toll-free at 1-877-844-8442 or 401-729-3284.
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Rx Outreach is "an easy and affordable way for people of all ages to get more than 55 generic medications that treat a wide range of conditions including diabetes, asthma, heart disease, and depression. People may take advantage of the program even if they receive medicines through another discount program. The program is open to people with incomes of up to 250 percent of the federal poverty level. For a family of four, this figure is $53,000 per year. [updated 2/08]
- RxHope.com is an online clearinghouse of no-cost and low-cost prescription drugs, described as a "patient assistance Internet initiative financially supported by PhRMA (Pharmaceutical and Research Manufacturers of America) and participating pharmaceutical companies.
- "AZ&Me" launched by manufactrer AstraZeneca in 2006, as a user-friendly patient assistance program. Eligibility requires annual income up to $30,000 for an individual; $60,000 for a family of four, no Rx coverage from other sources and a current prescription for an AstraZeneca brand product (including Nexium, Crestor, Merrem, Pulmicort, Seroquel®) and about 20 others.
- Privately run state-based programs are hosted by:
- MedBank Foundation of Georgia is a non-profit volunteer organization formed in 1992 to assist the uninsured in obtaining prescription medications free-of-charge from pharmaceutical companies. The organization works with citizens who reside in three Eastern Georgia counties (Chatham, Bryan, and Effingham.)
Medbank of Maryland, now funded in part with state funds authorized beginning in 2001. 419,431 prescriptions were processed statewide for 34,847 patients as of June 2006.
http://www.medbankmd.org/
- Prescription Connection for North Dakota. The program is the result of state legislation passed in 2003, which appropriated $100,000 for it, with the Insurance Department providing another $100,000.
- NeedyMeds a nationwide non-profit service that "help identify med cost assistance programs," now based in Massachusetts. Their web site claims 10 million visitors between 1997 and 2008.
- The Virginia Rx Partnership is a public/private partnership which exists to provide free prescription medications for Virginia's eligible uninsured. Since it was founded in 10/04 the state has appropriated $93,750 in general funds; manufacturers have provided $4.9 million in Rx to 5,600 patients as of December 2005, through bulk donations to 20 free clinics and community health centers. Previously the VA Health Care Foundation ran a free program for more than five years.
- As of mid-2008, 27 states created or authorized programs that offer a discount only (no subsidy) for eligible or enrolled residents; of these about 18 are in operation. The latest are in Colorado, Florida and Iowa, starting in 2008. Some of these states also have a separate subsidy program. . Descriptions and the current status of these programs are available on the NCSL's State Pharmaceutical Assistance Programs web page.
There are several private-sector plans that offer to provide eligible individuals with discounts on some or all prescription drugs. Although these plans are not established or usually regulated by state law *, the following information is provided as examples for general and comparative purposes. The claims listed by these programs have not been verified and are subject to change.
- Rx Outreach: Rx Outreach is a recent Patient Assistance Program developed by Express Scripts Specialty Distribution Services, Inc. (ESSDS). The program provides qualified low-income individuals and families access to generic versions of medications. It is available to anyone with an income under 250% of the Federal Poverty Level (e.g., $24,500 individual; $32,075/couple; $50,000 for a family of four) and provides 110 generic drugs used for many chronic conditions. It is termed "very affordable," with a fee of $20 to $30 for each 90-day prescription filled by mail order. The application form is simple and no supporting documentation is required. The state of Georgia features this program on its GA Community Health Dept. website.
- Merck: Starting April 2005, the Merck Prescription Discount Program will provide assistance when, where and how patients need it. It is innovative in several important ways: the program is offered to all uninsured patients, regardless of age or income. Patients do not have to fill out complicated enrollment forms or wait for a card in the mail to access an immediate discounts on many Merck medicines. Patients can enroll in the Merck Prescription Discount Program to realize greater continuous savings. The program is free-of-charge, easy to enroll in and use, and conveniently offered through almost all pharmacies nationwide. Plus, there are no annual membership fees for the life of the program. Estimated savings is 15-40% per Merck prescription. For more information, please click: http://www.merckhelps.com/uninsured/
 Together Rx Access card: In early 2005 12 pharmaceutical manufacturers launched a new discount program, aimed at uninsured people of modest means younger than 65. People can qualify for the cards if they are younger than 65 and not eligible for Medicare, if they have no public or private coverage for drug costs and if their annual incomes do not exceed $30,000 for an individual, $40,000 for a couple, $50,000 for a family of three and $60,000 for a family of four. The new program offers savings on 275 drugs including Crestor and Lipitor, for high cholesterol; Norvasc, for high blood pressure; Nexium, for heartburn and ulcers; Viagra, for erectile dysfunction; and Zoloft and Paxil, for depression. The companies participating in the new program are Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Janssen, Johnson & Johnson, Novartis, Ortho-McNeil, Pfizer, Sanofi-Aventis, Takeda and TAP Pharmaceutical Products. Another 7 joined later in 2005. For more information, please visit: http://togetherrxaccess.com/
- Together Rx Card: Seven manufacturers joined together in April, 2002 to provide discounts "of approximately 20-40% on more than 130 medicines." Eligibility includes Medicare beneficiaries with income of less than $28,000 per year ($38,000 for a couple). Enrollment reached 1,458,439 cardholders as of December 2004, who have saved "more than $640 million." The program ended on December 31, 2005 with the start of Medicare Part D.
- AARP Prescription Savings Service is sponsored by the not-for-profit senior organization, AARP. It features a discount card that is free but only to those who also are AARP Health Care Options insured participants, and "it will not be valid if you discontinue your participation in AARP Health Care Options." On average, it provides "15% off of brand name drugs and 50% - 55% off of generic alternative drugs when you order for mail delivery." The program now is administered by UnitedHealth of Minnesota and run by Express Scripts.
- The Readers Digest YourXplan is a discount prescription program for individuals who don't have coverage, from the two names in health services and information: Reader's Digest and Merck-Medco Managed Care. For an annual fee of $25 for an individual and $40 for a family, enrollees get a card that entitles them to a discounted price at 40,000+ participating retail pharmacies or mail order.
- GlaxoSmithKline, in October 2001, launched The Orange Card, a discount program open to eligible persons age 65 and over. The program provides access to products only made by this manufacturer. The sponsors described it as a first-in-the-nation program. A Feb. 7, 2002 report indicated that 25,000 people had signed up.
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OPTIMIZERx™ offers special savings & free trial programs to help you better afford your prescriptions and over-the-counter medicines, beginning in late 2006. It is described as "simple and free", requiring no additional enrollment into any insurance or pharmacy program. Registration required for offers.
- National Association of Chain Drug Stores (NACDS) on March 11, 2002 announced the PharmacyCare OneCard "to give seniors easy access to an array of manufacturer discounts, open to all drugmakers." How to structure discounts would be up to individual manufacturers. The group said it would license the card to pharmaceutical claims processing companies meeting specific criteria. The program began enrolling eligible low-income seniors in April 2002. Income limits were not specified in the initial descriptions of the program.
- MedbankUS - Founded in 2000, is a non-profit that sponsors a discount card, the Prescription Plan. It states that "all FDA approved brand and generic prescription medications are covered" and that "everyone can enroll" and benefit from the plan. They report typical 15% savings on brands and 40% savings on generics. Their card can be printed online instantly and is free.
- WisconsinRX, the Wisconsin Prescription Drug Purchasing Coalition is a not-for-profit coalition of employer groups, providing employee discounts, full transparency in pricing and an emphasis on evidence-based research. In 2006 it expanded to include National CooperativeRx, with large partners in Alaska and Minnnesota and elsewhere. In 2007 it had 230,000 members. For 2007-08 both structures are administered by Caremark, a PBM.
A number of retail pharmacies have established discount plans, with cards or enrollment, for customers or senior citizens. NCSL has not attempted to quantify or describe these other commercial programs.
Regulating Discounts: * Back in 2000-2001 four states, Minnesota (SB 2579), New Hampshire (HB 591), South Dakota (S 88) and Texas (SB 893) enacted laws to regulate or restrict pharmacy discount cards or buyers clubs.
Additional Pharmaceutical Facts, Opinions and Advocacy
- Pharmaceutical Research and Manufacturers of America (PhRMA) - the industry trade association maintains numerous online documents and releases about Rx policies and laws.
- Pharmaceutical Price and Reimbursement Regulation in Europe: by Michael Doodson (former VP of Merck)- National Association of Attorneys General meeting, 1/26/05.
- Prescription Access Litigation Project: As part of Community Catalyst, PAL was created in 2001 to make prescription drugs more affordable for consumers through class action litigation and public education. PAL has grown quickly and now is a diverse coalition of over 102 organizations, including state-based groups representing 36 states and the District of Columbia as well as several national organizations.
- Safety Net Hospitals for Pharmaceutical Access (Formerly Public Hospital Pharmacy Coalition) an organization of approximately 400 public and private non-profit hospitals and health systems throughout the U.S. that participate in the Public Health Service 340B drug discount program.
- ADAP Advocacy Association - seeks the support of advocates, community, health care, government, patients, pharmaceutical companies and other stakeholders to assure that access to services recognize and afford persons living with HIV/AIDS to enjoy a healthy life.
Disclaimer: The opinions and/or policies expressed in non-NCSL materials are those of the authors, sponsors or sponsoring organization, and not NCSL. NCSL takes no position for or against state health legislation.
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