Missouri Prescription Drug Plan Finds Few Participants

Wednesday, August 8th 2007, 7:21 am

By: News On 6

JEFFERSON CITY, Mo. (AP) _ A few years ago, as prescription drug costs soared, the Missouri Legislature created a new program to help redirect extra, unused prescription drugs to the needy.

But today, the state is aware of only one organization that offers to collect medications and share them with people who struggle to pay for them _ and the phone number listed on the program's Web site has been disconnected.

The program targeted pharmaceutical companies, hospitals and nursing homes, which were believed to have extra drugs they would have to throw away if they couldn't find recipients.

But they say the program is not working as intended.

At least 33 states have passed laws creating similar programs, but less than half are implemented at this point, according to the National Conference of State Legislatures. It's hard to determine whether programs in other states are more successful, said Richard Cauchi, the conference's health program director.

``There are several states where this has become a sort of popular idea. The all-important question is to what degree are these programs quantitatively successful?'' Cauchi said. ``The question of exactly to what extent it's working is to be determined.''

It's unclear whether Missouri's program is reducing medicine costs. The state Department of Health and Senior Services has no way to track any savings for the state and no oversight of the program.

Groups are not required to inform the state if they begin participating.

The law allows a dispenser of drugs, such as a hospital, a wholesale drug distributor or an individual to donate medication. But the person must never have had control of the medication.

In other words, if a person is prescribed a drug while staying at a nursing home, but the patient's doctor changes medicines, the unused portion of the prescription could be donated to another clinic, if the patient agrees.

But the family of a person living at home who died before finishing a three-month supply of medicine would have to throw it away.

The rules are tight because the state must ensure the safety of the drugs, said Susan McCann, who runs the state's Narcotics Bureau. If someone didn't store a medicine properly, for example, it could be altered and the next recipient could be harmed.

``These are highly complicated and sensitive substances that are not always really stable,'' said McCann, a pharmacist.

The rules have limited interest in participating in the program. Among those unable to take part are nursing homes, according to Missouri's nursing home lobbying groups.

Generally, nursing homes work with off-site pharmacies and only bring in what they need, so they don't have a lot of leftover drugs, Health Care Association executive director Jon Dolan said.

Also, the rules don't allow a nursing home to take drugs destined for one patient and give them to another. Instead the home would have to send them to an outside clinic, pharmacy or hospital.

Missouri Association of Homes for the Aging chief executive officer Denise Clemonds wasn't even sure the program had been implemented and didn't know of any homes participating.

``We're throwing away thousands and thousands of dollars every day. The state of Missouri has paid for those prescriptions, and they're not being used,'' Clemonds said. ``We all were hoping we would have a very user-friendly program where those could be basically utilized instead of being thrown away. We're not there at all.''

Dolan said federal government rules guiding packaging and storage of prescription drugs also make it difficult for the program.

When the bill passed in 2004, Republican Sen. Charlie Shields, said the new program could save the state millions of dollars in drug costs.

Shields said Tuesday it was a good idea in theory but proved hard to implement, and doesn't think a minor change in law would do it.

``It's still a good idea, but I don't know if we can overcome all the regulatory burdens enough to make all the participants feel comfortable doing it,'' said Shields, who is also a project coordinator for Heartland Health System, a hospital and health care company.

He said the Medicare prescription drug benefit has eased the burden somewhat since the legislation passed.

Drug manufacturers are not getting involved in the state-level system, saying they are addressing high drug prices through a national program to make drugs more available.

Pharmacists say they would rather direct patients to that program, where drugs are new, safe and available, than to state collection sites with limited and inconsistent supplies.

``It's definitely not the grand vision and implementation that many legislators (sought) because the bureaucrats haven't let us go there,'' Dolan said.