GOING FOR THE GOLD

MATTHEW W. EVANS

Supermarkets stand to gain from a prescription coverage movement that is gathering steam.

Many see years passing before the U.S. Congress hammers out a plan for comprehensive Medicare reform, let alone a prescription benefit in Medicare. A more immediate plan, though, has the potential to not only help would-be beneficiaries, but supermarket pharmacies as well.

In October, the National Association of Chain Drug Stores, Alexandria, Va., developed SenioRx Gold, a program the Food Marketing Institute, Washington, D.C., is strongly behind. It's designed as an easily implemented stopgap solution, NACDS says, that would provide prescription benefits to needy senior citizens while the federal government comes up with a Medicare reform plan.

And it's a retail-friendly interim program, specifically for both mass-market chains and independents that operate pharmacies.

"We are supporting NACDS' effort," FMI senior vice president Karen Brown told SN. "We're supporting this program as one that would allow patients to get their prescription drugs at the supermarket, which adds to the convenience factor."

SenioRx Gold would keep needy seniors going to supermarket pharmacies because, for one, it would prohibit incentives used by mail-order pharmacy companies that entice patients to use their services. "It gives them more options of where to go and get their prescriptions as opposed to some [prescription benefit] proposals, which would really force them into mail order," Brown added.

"With nearly 40% of our member stores involved in pharmacy operations, we are very concerned about proposed pharmacy legislation and regulations, particularly the impact such proposals will have on consumers," FMI president and chief executive officer Tim Hammonds said in a press statement. "Our members are committed to serving their customers, many of whom are senior citizens, and we feel that SenioRx Gold will help these shoppers access medications and services in the most timely and cost-effective manner."

Also favorable for supermarket pharmacies that also act as information providers and disease state managers is a major provision to the SenioRx Gold plan requiring medication therapy programs. Pharmacists would get reimbursed for providing these services. Such a provision is important, according to John Coster, Vice President, Federal and State Programs, NACDS, due to the sheer number of prescription drugs taken by some patients.

In May, FMI joined a groundswell of organizations that support the program. The coalition, formed in March, is known as SenioRx Now. It includes the Washington, D.C.-based National Association of Healthcare Underwriters, American Pharmaceutical Association and National Consumers League and the American Society of Consultant Pharmacists, Alexandria, Va. The coalition is pushing for immediate passage of SenioRx Gold.

SenioRx Now would like to see SenioRx Gold passed by Congress, signed by President Clinton and implemented by the states this year. Implementation would be optional for each state. On a voluntary basis, states could apply for federal funds SenioRx Gold would make available.

NACDS estimates that 64% of Medicare beneficiaries are without prescription drug coverage. It also estimates that 7.3 million low-income seniors cannot afford prescription drug coverage. SenioRx Gold funds would assist seniors who live at or below up to 200% of the federal poverty level -- an income of $16,480 for a single person and $22,128 for a couple.

It would take an act of congress to establish SenioRx Gold, one of six such programs currently being eyed by the Senate Finance Committee, according to NACDS, which feels it is significant that the Senate is considering its proposal. "We do feel there is a growing level of recognition among policy makers," said NACDS spokesman Phil Schneider. "As they strive to do something this year, SenioRx Gold provides the voluntary approach that many seek. But there's no clear consensus at this point."

There are further stumbling blocks as well, and crucial time factors that could help or hurt this particular proposal. "Time is increasingly precious because there are only a few legislative work days left in July before the recess for the Republican National Convention. Then the Democratic National Convention is coming up in August," explained Schneider. Even more immediate is "Senate majority leader Trent Lott, R-Miss., indicating that he is going to have the Senate concentrate on appropriations and budgetary matters. So the current issue is whether or not the Senate will be able to address a Medicare benefit in the days remaining before the GOP convention."

The current presidential election year also impacts the proposal's chances. Additionally, election of congressional representatives with an already slim Republican control of congress "has made the Medicare drug benefit a high-stakes issue," said Schneider.

"The degree to which there is a public groundswell for action will dictate a lot of what actually occurs in congress. We intend to press on day in and day out on the merits of the SenioRx Gold proposal because we think it's very viable."

In any event, supporters of SenioRx Gold would like to stay away from a pharmacy benefits manager or insurance company sponsored plan on account of their traditional focus on the bottom line as opposed to patient care and pharmacy reimbursement, according to Coster.