Prescription Drug Discount Cards: Savings Depend on Pharmacy and Type of Card Used Page: 5 of 23
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The Medicare-endorsed card initiative has focused interest on private-
sector prescription drug discount card programs. You requested that we
examine these programs and pertinent state laws and regulations.
Specifically, you asked (1) how do existing prescription drug discount
card programs work, (2) how do the prescription drug prices available
with existing discount cards compare to prices available without a
discount card, and (3) how do states regulate card programs?
To obtain information on discount card programs, we used a structured
interview guide to conduct telephone interviews with officials from five
organizations that administer many of the programs. Four of these
organizations are among the nation's largest pharmacy benefit managers
(PBM)4-Medco Health Solutions (formerly Merck-Medco Managed Care),
AdvancePCS, Express Scripts, and WellPoint Health. They administer
numerous nationwide card programs sponsored by a range of entities,
such as health insurers, retail pharmacies, employee associations, and
other organizations.5 The fifth organization was Citizens Energy, a
nonprofit company that sponsors and administers the Citizens Health drug
discount card, which is available to all adults in Connecticut,
Massachusetts, and Rhode Island. We also obtained information from
company Web sites on the prescription drug discount card programs
introduced in the last 2 years by four pharmaceutical manufacturers-Eli
Lilly, GlaxoSmithKline, Novartis, and Pfizer-as well as the Web site for
Together Rx, a card that provides discounts on some drugs produced by
eight pharmaceutical manufacturers.' An estimated 18 to 19 million people
have enrolled in one or more of the drug discount card programs that we
examined. In addition, we examined CMS's final rule on the Medicare-
Endorsed Prescription Drug Plan Assistance Initiative. To understand the
role of drug discount cards in the retail pharmacy marketplace, we spoke
with representatives of three retail pharmacy chains whose pharmacies
comprise about 22 percent of all retail pharmacies nationwide.
4The primary functions of PBMs are negotiating drug prices with pharmacies and
pharmaceutical manufacturers on behalf of health plans, processing drug claims for health
plans, and dispensing prescriptions through mail order pharmacies.
5Discount card sponsors put their name on the card and establish its terms and conditions.
sThe founding members of Together Rx are: Abbott Laboratories; AstraZeneca; Aventis
Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; GlaxoSmithKline; Janssen
Pharmaceutical Products, L.P.; Novartis; and Ortho-McNeil Pharmaceutical, Inc. Ortho-
McNeil and Janssen are owned by Johnson & Johnson.
GAO-03-912 Prescription Drug Discount Cards
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United States. General Accounting Office. Prescription Drug Discount Cards: Savings Depend on Pharmacy and Type of Card Used, report, September 3, 2003; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc293108/m1/5/: accessed May 22, 2019), University of North Texas Libraries, Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.