Shop till you drop

April 30, 2004

BY HAPPY COINCIDENCE, Attorney General J. Joseph Curran Jr. has posted an online tipsheet for Maryland's best prices on prescription drugs just as Medicare is about to unveil its new drug discount cards.

Mr. Curran's comparison by ZIP code of drug prices at 1,200 Maryland pharmacies won't be of much help to anyone in choosing among the bewildering array of 39 or more discount cards offered. But it will contribute in at least two ways: to illustrate that prices for identical brand-name drugs vary widely from store to store even within the same communities, and to help provide a baseline against which Medicare "discounts" can be judged.

Loud and clear the message should be read: Buyer beware. Picking a discount card worth the label will require lots of study, and in some cases elderly patients can do as well or better by using a mail-order or discount pharmacy, or applying for help through state programs now going begging.

The Medicare discount cards, which take effect in June after an enrollment period beginning next week, represent the first installment of the prescription drug benefit program proposed by President Bush and enacted by Congress last year.

Administration officials predict they will shave as much as 25 percent off retail drug costs for the one-third of Medicare beneficiaries who have no other drug coverage. But the program has so many flaws and loopholes that that prediction seems overly optimistic.

Discount programs are free to change their prices and even the drugs they cover repeatedly after beneficiaries have enrolled and paid their $30 annual fee. But beneficiaries have just one opportunity to switch cards before the program ends in January 2006, when the full prescription benefit is scheduled to be available.

The only ones deemed certain to benefit from the discount program nationwide are low-income Medicare recipients not quite poor enough to qualify for free drug coverage through Medicaid. They include individuals making up to $12,569 a year and couples with an annual income under $16,862.

People in that category pay no $30 fee and automatically receive a $600 annual credit toward drug purchases. Yet a program in Maryland available to that same group of 116,000 or so trims 35 percent off the cost of drugs the state has purchased at discounts through Medicaid.

The smart move for those 116,000 Marylanders would be to sign up for a Medicare card, claim the $600 in benefits, then switch to the state program.

Gotta be a shrewd shopper, though. Getting the most out of any of these plans requires access to Internet sites, some ability to navigate the health care maze and lots of patience on toll-free phone lines.

That's a tall order for older Americans, especially those most in need of this help. Even so, they should do their best to explore the possibilities - keeping in mind that Mr. Curran may have found the sweetest deal right around the corner.

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