One of the ideas that emerged from the Minnesota Legislature’s 2019 session for battling high prescription drugs prices is a one-stop website that will be built by the state Board of Pharmacy to give pointers to residents seeking ways to find lower-cost drugs.
Executive Director Cody Wiberg said he hopes it will include every tip he can turn up, from manufacturer rebates, assistance programs, and government programs like Medicare, Medicaid and MinnesotaCare as well as low-cost programs offered by some big pharmacy chains. He said he also wants it to include links to other sites that provide similar information, such as one created by Consumer Reports.
The idea is a vestige of the administration of former Gov. Tim Pawlenty.
Wiberg was part of the team at the Department of Human Services in 2004 when the state created a website called RxConnect, which allowed Minnesotans to order drugs from a handful of Canadian pharmacies that had been inspected by state pharmacy regulators.
It was that experience that gave him the idea when he was meeting with legislators who wanted to respond to constituent concerns about drug prices. “I was just thinking, what else can we do to help people,” he said. “And that’s when I remembered the website we had for the Canadian program.”
The page will be featured on the Minnesota Board of Pharmacy’s website. The health and human services omnibus bill that authorized the program also requires all state pharmacists to promote the new site to their customers.
Wiberg said he wants the new site to be helpful to patients who don’t have health insurance as well as those with high-deductible plans. “It’s basically anything I can think of that might help at least someone,” he said. “Not everything that we have on that website is gonna help everyone. But everything we have on that website should be able to help at least someone.”
It will also contain tips for finding the lowest prices. Because of the complexities of drug pricing, the cash price is sometimes lower than the insurance price, for example.
Wiberg said he will also include ideas for working with a patient’s doctor and pharmacist to explore similar drug therapies that are less expensive. “If you don’t have your own pharmacist, get one,” Wiberg said. “Most pharmacists will sit down and help you.” He also will point out that drug stores charge different amounts, so patients should call around and ask.
Wiberg, who has both a master’s degree and doctoral degree in pharmacy and was a practicing pharmacist in Red Wing before working for the state, said he plans to build the website himself. That makes the timeline for finishing it dependent on other work, but he hopes to have ready sometime before the end of the year.
The idea stems from a program begun in 2004, when then Gov. Pawlenty began a push to tap into lower prescription drug prices in Canada. His initial plan was for state government to import drugs directly from pharmacies across the border. But that initiative was scaled back under threat of federal government intervention. Instead, the plan eventually was to create a state-created website call RxConnect.
Under the program, which ran until 2010, state health officials requested partnerships with Canadian companies, inspecting those that expressed interest. Of those inspected, four were eventually chosen, allowing Minnesotans to make purchases directly from the suppliers.
While the program had some use, it never got close to the 700,000 customers that Pawlenty predicted. It filled 10,054 prescriptions in 2005, the state reported at the time. Over the following years, however, use declined after Congress created Medicare Part D, a prescription drug benefit for American senior citizens.
Wiberg said his work on the RxConnect project helped him formulate the suggestion that something similar — though far more limited — might be one tool in the state’s response to escalating drug prices.
The new webpage will probably not provide a similar service as RxConnect: that is, a direct way to purchase mail-order drugs from Canada. In recent years, U.S. manufacturers have taken steps to deny drug shipments to those pharmacies — or even to distributors who might sell to such mail-order companies. That has forced those companies to find supplies from foreign drug makers. The state isn’t comfortable endorsing the quality of those supplies, said Wiberg.
The site might offer tips for Minnesota patients who might want to drive into Canada to purchase drugs and insulin, though. During a roundtable last month hosted by Gov. Tim Walz, Lija Greenseid, the mother of a daughter with Type 1 diabetes, described how a group of less than a dozen people saved $12,000 on an insulin-buying trip to London, Ontario, in June.
Wiberg said federal regulators and border officials are unlikely to stop individuals bringing back anything less than a 90-day supply of drugs for their own use.
Yet Walz said not stopping people from getting drugs in Canada cannot be all the state does to help. “I just want you to be able to get it, don’t get me wrong,” the DFL governor said. “But I’ll be damned if I’m wanna live in a state where that’s our solution.”
Repository for donated drugs
Another section of the health and human services omnibus bill that Wiberg’s agency is charged with implementing is a new prescription drug repository program. Patterned after a program in Iowa, the law change was pushed by a pair of University of Minnesota pharmacy students — Rowan Mahon and Hannah Van Ochten. The provision had been included the massive omnibus bill from the 2018 session that was vetoed for unrelated issues by then-Gov. Mark Dayton.
The plan would accept drugs, primarily from long-term care facilities and hospitals, that haven’t been used because a patient has developed side-effects, changes prescriptions or dies before the supply is used up.
The donated drugs would be inspected and verified by pharmacists at a central repository and made available to patients who don’t have the funds to pay for their prescriptions. The only cost would be a handling fee similar to dispensing fees charged to recipients of medical assistance and would not be more than $25.
Donations could not be accepted from individuals, and no controlled substances can be accepted, Wiberg said. The Board of Pharmacy is preparing a request for proposals to seek hospitals or health systems that might want to run the program. Wiberg would like to have the program running by Jan. 1, 2020.