Originally posted August 15, 2014 by Michael Giardina on??http://ebn.benefitnews.com
Providers of prescription drug discount cards are increasing their efforts to reach out to employers, even as the Affordable Care Act is expected to decrease the ranks of those most likely to use the cards ??? those without health insurance.
The FamilyWize Community Service Partnership, which seeks to reduce the cost of prescription medicine for children, families and individuals by $1 billion by the end of 2015, is one provider looking to educate more employers about its discount card program.
???One of the areas we have really focused is with employers with lower waged workers because many of them do not work full-time, or they may not opt for the plan the company is providing because of costs,??? says Lori Overstreet, vice president of marketing for FamilyWize. ???Obviously, if they were part-time, then the company wouldn???t need to cover them, but this would give them a benefit, or if they opt out of the company plan this will also give them a benefit because the card is free to the consumer and free to the company.???
FamilyWize works with Envision Pharmaceutical Services, a pharmacy benefit management company, to negotiate prices at more than 60,000 brand name pharmacies such as Walmart, Kmart, CVS and Target. These negotiated prices are realized when FamilyWize discount drug card are used by consumers.
???The price depends obviously on the chain, the prescription itself, and even where they are,??? says Steve Tremitiere, vice president of strategic partnerships at FamilyWize. He adds that most of the discounts appear with generics, but some can be for brand name drugs.
FamilyWize recently cemented 10-year national partnership with United Way Worldwide in an effort to address needs for the uninsured and underinsured. The average savings for FamilyWize discount card holders is 40% and can reach up to 75%, Tremitiere says.
Tremitiere, wants to be clear that all types of employees and employers can use the benefit, which easily be registered for online and printed out directly from a user???s home or work computer. ???Employers are a good conduit because they are a trusted resource,??? Tremitiere explains.
But not everyone agrees that these types of prescription drug discount cards still offer value in the post-ACA world.
???With the advent now of the Affordable Care Act and what???s involved, you probably have fewer and fewer people that would need it [prescription discount cards] because they can probably get the negotiated discount off their prescription drugs through their employers or exchanges,??? says Michael J Staab, president and co-founder of Innovative Rx Strategies, a pharmacy consulting firm.
Gregory I. Madsen, a registered pharmacist and principal and co-CEO of Innovative Rx Strategies, adds that these discount cards are for ???people who don???t have prescription drug coverage, which is very few people anymore.???
A virtual game changer of the prescription drug discount program was the introduction of Medicare Part D, also called the Medicare prescription drug benefit. The Medicare Prescription Drug Modernization Act was first signed into law by President George W. Bush in December 2003, and was seen as a safety net for seniors who were paying out-of-pocket for their prescription drugs.
???They were the cash-paying customer, they were the cash cows of the pharmacy world,??? says Madsen. ???They were paying cash for all their stuff and these cards were really targeting those people. And then Medicare Part-D came in and they got in under contracted rates and the cash-paying customer sort of went away, except for this small group of part-time employees that were employed.???
Even though the number of uninsured is shrinking because of the ACA, small employers may find value in discount prescription drug cards.
???If they [these employers] have less than 50 employees, they [employees] are part-time, this card will still be a better deal than them paying cash,??? Madsen explains.
Other examples of prescription drug discount cards or prescription discount programs, in general, are surviving the ACA???s implementation. For instance, the National Association of Counties, the only national organization that represents county governments on Capitol Hill, offers the NACo Prescription Discount Card Program. The free program, operated by CVS Caremark, has been in place since 2005.
Andrew Goldschmidt, NACo director of membership marketing, says that the program is one of the ???oldest and most mature??? offered by the association, which dates back to administration of President Franklin Delano Roosevelt.
???You have a lot of folks that have a lot of prescriptions that are off formulary, depending on what kind of plan they have, or if they even have a plan,??? says Goldschmidt. The NACo prescription discount card program has saved $570 million on 45 million prescriptions for employees in over 1,400 counties.
???The prescription drug program [usage] has gone down a bit, and rightly so if people are getting coverage through the ACA that didn???t have it before,??? explains Goldschmidt, while noting that now it can be used as a good complementary program for employers.
Jackie Chin, executive vice president of New York State Restaurant Services, a division that handles all insurance programs for the New York State Restaurant Association, says the ACA ???should not slow down registration??? for its WellCard program. In addition to its prescription discounts, its WellCard offers discounts on dental, medical and vision coverage for uncovered employees and their families.
???Since there is no cost to participate in this discount card program, an employee can still register with WellCard because with regular health insurance through ACA or public health exchanges, your co-pays for prescription may be more expensive,??? Chin explains. The New York State Restaurant Association includes a diverse group of approximately 10,000 members that range from small mom-and-pop restaurant owners to large restaurant groups.
???It differs from other prescription drug discount card because there is no membership fee and there is no cost to the employee and the employee’s family member to avail themselves of any savings they can receive by using this discount card,??? Chin says.