Massachusetts Senior Drug Discount Program Faces Increased Costs; South Dakota Lawmakers Consider Establishing Plan

The 80,000 seniors and people with disabilities who receive prescription drug discounts through Massachusetts' Prescription Advantage program will experience increases in their copayments beginning April 1, and unless the state receives federal assistance, the program could be eliminated next year, the Boston Globe reports. The two-year-old program, which is open to all seniors regardless of income, will increase copays because the cost of the program is "growing so rapidly" that the state cannot afford to maintain it, according to Ronald Preston, secretary of the state Health and Human Services department. Under the new rules, members with incomes less than $16,668 per year will contribute copays of $12 per generic prescription, up from $6, and $30 per brand-name prescription, up from $16. Low-income members also will pay a $20 quarterly deductible. Copays for higher-income members, who already pay a premium and deductible, will increase $2 per prescription. To further contain costs, the program's enrollment also has been capped at its current level. Gov. Mitt Romney (R) reduced the program's annual budget by $10 million to $85 million last month and is seeking federal funds to partly cover the costs of the program's low-income members, Preston said (Dembner, Boston Globe, 2/21). Deborah Banda, director of the Massachusetts chapter of AARP, said that the Romney administration is "limiting access to life-sustaining drugs and shifting costs to the most vulnerable," adding that those with the lowest incomes "are being hit the hardest" (Heldt Powell, Boston Herald, 2/21). However, Jennifer Davis Carey, secretary of elder affairs for the state, said the increases were "the most-responsible thing to do to preserve coverage for the folks who are currently enrolled" (Boston Globe, 2/21).

South Dakota Program
The South Dakota Senate Health and Human Services Committee last week unanimously approved Gov. Mike Rounds' (R) prescription drug discount card plan, which the full Senate is expected to consider soon, the Sioux Falls Argus Leader reports. Under Rounds' plan, people older than age 65 and people with disabilities who do not qualify for Medicaid would receive a discount card to buy prescription drugs at participating pharmacies. The program does not have income eligibility limits, the Argus Leader reports. The plan will save an average of 20% on all drugs according to Deb Bowman, a spokesperson for Rounds. Bowman said, "It's not going to pay for the full prescription-drug costs, but at least it will help." The state would negotiate prices of about 8,000 drugs, and pharmacists would receive a dispensing fee for allowing the discount, according to Sandy Zinter, state personnel commissioner. Pharmacists would also receive a fee for certain activities, such as offering to substitute a less-expensive generic drug for a brand-name drug, she added. So far, about 200 of the state's pharmacists have agreed to join the discount program if the Legislature approves it, Larry Kucker of the Bureau of Personnel said. Anticipating that the federal government will enact a Medicare prescription drug benefit, South Dakota's "short-term" plan has a July 1, 2005, repeal date. However, the state Legislature could extend the program (Woster, Sioux Falls Argus Leader, 2/20).