August 26, 2004

Central-fill pharmacy proposed for state

By Phil Kabler
Staff writer

DANIELS — A state-operated central-fill pharmacy would cost the state a little more than $1 million to set up and run for the first year, but could save West Virginia’s working poor millions of dollars, advocates said Wednesday.

Establishing a central-fill pharmacy was among several recommendations adopted by the state Pharmaceutical Cost Management Council at its Wednesday meeting at the Glade Springs Resort near Beckley.

The recommendations — which also call for a Cabinet-level position of chief pharmaceutical advocate to coordinate all strategies to control drug costs —must be submitted to the Legislature by Sept. 15.

Created by the Legislature earlier this year, one of the missions of the council is to decide whether the state should continue to operate Rx for WV, the Internet-based clearinghouse that helps West Virginians determine if they qualify for free or discount drug programs offered by drug manufacturers.

As recommended, the call center and Internet clearinghouse could continue, but as an offshoot of the central-fill pharmacy.

“Expanding PAPs [pharmaceutical assistance programs] is not the right prescription for West Virginia, but rather establishing a central-fill pharmacy for West Virginia is the right prescription,” council member Dr. Wayne Spiggle said.

Under the proposal, the state would negotiate with drug manufacturers to provide prescription drugs to the central fill pharmacy in bulk at free or discount rates.

West Virginians whose incomes are below a certain level — the legislation sets 200 percent of the federal poverty level or below as the goal — would be able to have their prescriptions filled through the central-fill pharmacy.

Spiggle said that unlike Rx for WV, which makes it easier for patients to determine if they are eligible for free or discount drug plans, but doesn’t eliminate the headaches of filling out applications to the manufacturers, the central-fill process would be comparatively simple.

Physicians would be able to fax or e-mail prescriptions for eligible patients to the state pharmacy.

If the manufacturer of the particular drug was participating in the central-fill program, the prescription would be mailed within three days.

If the particular prescription was not available through the state pharmacy, the participant would be advised of other options, such as local free clinics, manufacturer’s discount programs, or other alternatives.

Cost estimates for the program include salaries for two full-time and one half-time pharmacist, seven technicians and two support staff, and well as the cost of obtaining and equipping the pharmacy warehouse.

Council members Wednesday did not provide cost estimates for creating a chief pharmaceutical advocate. However, it would be modeled after Illinois’ special advocate for prescription drugs, which operates with a two-person office.

In its recommendation, the council said it will require “undivided attention and advocacy” of a Cabinet-level drug czar for the 2004 pharmaceutical act to achieve its goals.

Among the proposed sweeping powers of the advocate would be authority to negotiate discount drug contracts for various state agencies, and to participate in multistate purchasing plans.

Although the council has Sept. 1 and Sept. 15 deadlines for submitting a series of recommendations to the Legislature, it appears unlikely the Legislature will take up the proposals before the 2005 regular session.

To contact staff writer Phil Kabler, use e-mail or call 348-1220.