Bush to Ask Lawmakers to Back Pharmacy Discount Card Plan

The Bush administration plans to ask Congress to pass legislation that would allow the White House to move ahead with a proposal to offer pharmacy discount cards to Medicare beneficiaries if its original plan, proposed last July, does not withstand the court challenges against it, the Wall Street Journal reports (Lueck, Wall Street Journal, 1/28). Under the original plan, pharmacy benefit managers would negotiate discounts with drug makers and pharmacies and sell cards to Medicare beneficiaries for up to $25, allowing patients to purchase pharmaceuticals at a 15% to 20% discount. The National Association of Chain Drug Stores and the National Community Pharmacists Association filed suit last July to block the proposal, arguing that the Bush administration lacked the authority to implement the plan without congressional approval and violated federal rules by drafting the plan without open meetings or a public comment period. Last September, U.S. District Court Judge Paul Friedman issued a temporary injunction against the plan. He lifted the injunction last November but also issued an "unusual clarifying memo," which said that he lifted the injunction in order to allow CMS to "revise" the plan (California Healthline, 11/26/01). Medicare officials say they will soon publish for public comment a revised version of the proposal that may require drug makers to take on part of the cost of the discounts offered in the plan "in hopes of satisfying pharmacists and courts." However, pharmacy groups have said that the "expected changes won't answer their primary complaint" that the administration lacks the authority to establish a pharmacy discount card program -- a position that Friedman "has suggested he favors" -- and predicted that the administration would have to "go to a legislative approach" to move ahead with the plan.

Sen. Bill Frist (R-Tenn.) has said that he would "push" in the Senate for legislation to allow the administration to implement the pharmacy discount card plan. However, Democrats, who control the Senate, likely will not "hand the GOP a campaign-year victory" on a plan that they have criticized as "flimsy at best," the Journal reports. A report released earlier this month by the General Accounting Office found that pharmacy discount cards on average save patients less than 10% off the retail price of brand-name prescription drugs. The Journal also reports that neither party in the House "is eager to defy the politically powerful" pharmacy industry. Still, the Journal reports that many lawmakers, "under pressure" from seniors this election year to approve a Medicare prescription drug benefit -- which is "unlikely" to pass amid Congress' "partisan differences" and "budget deficit woes" -- have begun "shopping for a short-term remedy" such as Bush's pharmacy discount card plan. According to supporters, the proposal would require "little government funding" but would provide "political cover for vulnerable lawmakers" who "vowed" to pass a prescription drug benefit in their last campaigns. Bush plans to meet with lawmakers at the White House today to discuss the issue and may mention the pharmacy discount card plan in his State of the Union address tomorrow in order to "try to boost" the proposal, while still "stressing the need for a full-blown, long-term drug benefit" under Medicare (Wall Street Journal, 1/28).