Feb. 14, 2008

Pressure on pharmacies to dispense prescription drugs at lowest cost is working

The pressure MAPE members and other state workers have placed on certain pharmacies has borne fruit.

CVS reached an agreement with the pharmacy benefit manager (Navitus) to dispense at the cost of the drug or the copay, whichever is lower effective Jan. 1, 2008, according to the Department of Employee Relations (DOER).

Beginning in 2008 certain pharmacies (notably Walgreens) began charging state employees the full tier copay even if the actual cost of the drug was less than the copay amount. The pharmacies then offered them the option to purchase their prescriptions at the lower at-cost amount if they didn’t use their pharmacy benefit cards. However, by not using their pharmacy benefit cards the members would not get credit toward their yearly out-of-pocket maximum. In previous years, state employees would pay the actual cost of the drug or the copay, whichever was less.

While the corporate Walgreens still insists on charging the copay even if the cost of the drug is less, DOER advised that some local Walgreens pharmacists may agree to dispense at the lower cost. Please check with your pharmacist.

We strongly urge all MAPE members who are in this situation to switch pharmacies, and let Walgreens know why they are making the switch. Specifically requesting Walgreens to forward the prescription to the new pharmacy will help emphasize the point. MAPE members can locate another pharmacy that doesn’t charge the full copay by calling the toll-free Navitus Customer Care line at 866-333-2757.

A list of pharmacies is also available by going to the Navitus website at www.navitus.com and clicking on “Find a Pharmacy” under “Members”. This will not have the specific information about the copays, but members can call the pharmacies directly to ask the question.

Here are the drug copays for 2008: Tier 1 is copay $10. Tier 2 copay is $16. Tier 3 copay is $36.