Minnesota pharmacies reject 90-day Rx contract

July 25, 2005

The old saying that the "devil is in the details" holds true for Minnesota's Blue Cross and Blue Shield contract letting retail pharmacies fill 90-day scripts, according to pharmacists who have responded to the offer with, "Get thee behind me, Satan."

The old saying that the "devil is in the details" holds true for Minnesota's Blue Cross and Blue Shield contract letting retail pharmacies fill 90-day scripts, according to pharmacists who have responded to the offer with, "Get thee behind me, Satan."

The reimbursement rate for the Blues' 90dayRx program (see Drug Topics, May 16) is so low that pharmacists contend they can't break even under the contract that supposedly leveled the playing field with mail order. The rate for brand drugs is set at average wholesale price (AWP) minus 22% and zero dispensing fee.

"I personally do not know of any independent that can buy for anywhere near that level," said Jon Marcaccini, of Jon's Drug in Eveleth. "It would be encouraging if it was the Blues' intention to make the mail-order type fill a local option, but at these rates, that is not their intention. Their intention was to be able to tell our state attorney general that they have leveled the playing field with this option. Level is right, level me right out of existence. It's a smoke screen that is unacceptable to almost 100% of the independents."

"At first glance, the actions of Blue Cross and Blue Shield seem to be commendable. However, this is obviously not a realistic opportunity for community pharmacies such as ours. These types of opportunities not only hurt community pharmacies but twist the dagger as well," Jeffrey said.

The aim of the 90dayRx contract was to offer retail pharmacies the same opportunity to fill scripts that typically go to mail-order pharmacies, said Blue Cross and Blue Shield spokeswoman Janice Hennings. She declined to discuss the reimbursement as proprietary information but confirmed that retail was offered the same terms as the mail-order pharmacy operated by the Blues' pharmacy benefit manager.

It's not just independents that are having trouble with the Blues' contract, said Julie Johnson, R.Ph., executive VP, Minnesota Pharmacists Association. "It's any retail outlet," she said. "From what I understand, most pharmacies have done the calculations, and there's just no way they can participate. It's not based on economic reality. Thanks for leveling the playing field, Blue Cross. What a joke."

Pharmacists participate in Senior OlympicsThe 2005 Summer National Senior Games, held recently in Pittsburgh and sponsored by Mylan, GlaxoSmithKline, and others, saw numerous pharmacists compete in athletic events such as softball, basketball, cycling, golf, and volleyball. Here, Sam Skeegan, 66, tries his luck on the volleyball court. Skeegan, a native of Pittsburgh and a former retail pharmacist who now lives in Michigan and recruits for the pharmaceutical industry, won the gold medal in the 65-and-over division at the Games. Other pharmacists who competed in the Games in softball included Irene Ada of North Carolina, Judy Clark from Missouri, and Calvin Freedman from Delaware.