Utah Flies Public Employees To Mexico To Fill Prescriptions And Isn't That Normal AF?
Utah came up with a great idea to save big money on prescription drugs: Fly public employees who need the most expensive meds to Mexico, where they can purchase the same drugs they'd get in US America for about half what they cost here. And as an incentive, the program, called "RX Tourism," pays airfare for the employee and one family member, plus $500 per trip to get a 90-day supply of meds. The savings in costs to the state insurance plan more than cover the cost of the travel and the $500 cash payouts. It's such a big savings for some employers that there's an entire niche industry built around arranging trips for Americans to purchase drugs at Mexican hospitals. The Salt Lake Tribune ran a jaw-dropping story on the arrangement Sunday.
You know, maybe what we laughingly call our healthcare "system" is completely fucked up if those are the lengths employers and states are going to so they can cover pricey prescription drugs. But at least it's not socialism!
But the cold equations mean that it's literally far cheaper, by thousands of dollars, to fly teachers and office workers -- plus a friend! -- from Salt Lake City to San Diego, then drive 'em to Hospital Angeles, in a nice upscale part of Tijuana, instead of paying what US pharmaceutical companies would charge. The program is targeted at patients who need "any of the dozen or so specialty drugs — mostly treatments for multiple sclerosis and other autoimmune disorders — that PEHP identified as having the most potential for savings." Those specialty drugs (think big brand names advertised during prime time on MSNBC) may
make up only about 2% of all drugs prescribed, [but] they accounted for about half the money spent on prescription medications in the United States in 2018, according to the health research firm IQVIA.
In its first year of RX Tourism, serving just 10 public employees so far, Utah has saved $225,000. It's planning to start a second destination soon, flying patients to Vancouver, Canadaland, where "a clinic is right inside the airport." The state likes it, and so do the employees:
"It was a no-brainer," said Ann Lovell, who has made four trips to Hospital Angeles in the past year to pick up Enbrel for rheumatoid arthritis. In addition to the cash payment, Lovell avoids the hefty copay she'd have to cover in the U.S. under her plan through PEHP, the insurer that covers 160,000 Utah public employees and family members.
"It's kind of like $1,000 in my pocket," Lovell said.
And despite our VERY MISLEADING feature photo of a farmacia in Mexico City, this isn't a dealio where people are turned loose on a street in Tijuana and left to hope what they buy from Dr. Descuento ("To relieve your pocket!") isn't some weirdass ripoff drug. Nope, PEHP contracts with a Mexican pharmacy, Provide Rx, and Hospital Angeles. Provide RX doesn't even have a storefront like the ones you think of when you hear "Mexican pharmacy." Instead, patients make all the arrangements through their docs in Utah and then send the paperwork to Provide RX, which delivers the meds to the hospital ahead of time.
"We never leave [patients'] side," said [Javier] Ojeda, general manager of Provide Rx. [...] Provide Rx also makes all travel arrangements, including a motor service staffed by bilingual drivers, who escort patients out of the airport and into a van for the short drive south [...]
At the hospital, patients are whisked past manicured tropical plants and through an airy lobby to a doctor's office. Patients submit medical records to Provide Rx from their U.S. doctors when the trip is booked, but a Mexican physician must meet with each patient and sign off on the prescription for the pharmacy to fill it, Ojeda said.
The doctor's visit may amount to a quick exchange of papers or a more thorough physical, depending on the patient's condition. Then Ojeda provides the pre-ordered medication, and the patient is ready to return to San Diego.
Total time from the Salt Lake City airport to getting your 90-day supply of meds is only about three or four hours. Getting back can take longer depending on waits at the San Ysidro port of entry, the busiest border crossing on the US-Mexico border. Happily for US medical tourists, though,
U.S. border officials have created a "medical lane" at the San Ysidro crossing to streamline reentry, and Provide Rx briefs patients on the usual script: "Always declare your medicine as personal use."
Sure is good to know the Border Patrol is a lot friendlier to Americans from Utah picking up expensive meds than it is to those awful Central American CARAVAN MS-13 INVADERS who come to seek asylum for trivial reasons like fearing for their lives.
But it works out really well for Ann Lovell, who teaches deaf kids, and needs that Enbrel to control her arthritis. And it works out well for PHEP, too:
Enbrel's list price in the U.S. is nearly $1,300 per weekly dose of 50 mg, and Provide Rx charges less than half that. For 12 weeks of medication, the savings are more than $9,000.
Over a year, the savings for one patient on Enbrel is more than $40,000 — which more than covers four inexpensive plane tickets and the $2,000 in cash incentives.
All this is possible because while technically it's illegal to import foreign pharmaceuticals into the USA, the FDA allows individuals to bring in 90 days worth of meds for personal use. And to make sure the Mexican medications are legit, the insurer makes sure all the drugs are in compliance with Mexican regulations, which are similar to those from the FDA, so Utah patients get virtually identical meds to what they'd get at home.
PEHP officials tracked the supply chain from the manufacturers to Provide Rx, reviewing lot numbers and verifying the pharmacy's relationships with wholesalers and manufacturers.
The article also looks at the growing field of arranging trips to Mexico for US employees, both for meds and for medical procedures. Lotta people making a lotta money off this, yet still being more affordable than the same prescriptions through the US system. The boutique medical tourism outfits almost exclusively serve public systems like PEHP and employers who self-insure.
And yeah, national healthcare could change this mess. In every other industrial democracy with universal care, the government negotiates prices with drug manufacturers, keeping costs far lower. Here, the Wisdom of the "Free Market" makes sure everyone gets a bite of the insurance dollar.
Democrats in the US House passed a bill in December -- you know, when they were supposedly doing nothing but impeachment, those monsters -- that would allow Health and Human Services to negotiate the prices Medicare pays for about 250 of the most common drugs, and to require they be sold at the same price to insurers. But it was DOA in the Senate, and Donald Trump promised to veto it, because government regulation BAD.
Proposals to allow US wholesalers to import Canadian drugs have also been floated, but big surprise, they don't include the most expensive, profitable meds sold here, including insulin-for-fuckssake. Canada is freaked out by that idea, since it could deplete Canadian supplies:
Pharmacies in Canada "are not equipped to support the needs of a country 10 times its size without creating important access or quality issues," the representatives of 15 Canadian health advocacy organizations wrote in July.
One Mexican doctor at Hospital Angeles, Noemí Cabrales, works with Utah's PEHP patients, but told the Tribune she worries about the whole crazy healthcare system to the north:
"In a country like the one you have, as rich as it is, it's inconceivable," Cabrales said. "Looking at the problem as a human being and as a professional in medicine, I feel worried. Yeah, some people can come over here. What about the rest?"
You know, we could maybe try some sort of system where we regulate prices and make sure everyone has coverage. We could call it "Medicare for All," or something. Nah, it could be unwieldy and expensive. Far better to fly some people to Mexico or Canada every 90 days to save a quarter million bucks here and there.
And the uninsured can see what sort of success they have on GoFundMe.
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Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.