THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Wednesday, February 14, 1996 TAG: 9602130256
SECTION: MILITARY NEWS PAGE: A8 EDITION: FINAL
COLUMN: Military Update
SOURCE: Tom Philpott
LENGTH: Medium: 68 lines
Retired Marine 1st Sgt. Walter N. Price, 73, and his wife Mayna, 78, figure they get about $4,800 worth of prescription drugs free each year from the pharmacy at Beaufort Naval Hospital, S.C. Short of better health, they couldn't be more pleased.
``They've bent over backwards to service us,'' said Mayna, describing an array of pills the couple needs for conditions ranging from her high blood pressure and diabetes to his failed kidney and prostate cancer.
Not all beneficiaries are as satisfied, however. As the retiree population grows, so do complaints that military pharmacies don't carry the drugs they need.
Air Force Col. Patricia Hobbs, director of Defense Department pharmacy programs, said pharmacies strive to satisfy as many beneficiaries as possible, with priority given to active duty members and to staying under budget. That hasn't changed in her 21 years as a practicing pharmacist.
What has changed, Hobbs said, is the beneficiary population. Sixty percent of pharmacy budgets is spent on retirees. More significant is the explosion in pharmaceuticals. Combined with aggressive marketing, the drug industry has created a demand that the military can't afford to meet. Doctors see a $10-a-tablet antihistamine on television and order it for patients, Hobbs said. ``We may carry a similar pill that costs a nickel.''
In her last assignment as chief pharmacist at Sheppard Air Force Base, Texas, Hobbs made as many as 70 phone calls a day to physicians, trying to substitute her inventory for drugs they prescribed. More than half accepted the recommendations. If not, patients went elsewhere.
Military spending on pharmaceuticals actually is declining. The pharmaceutical budget fell from $920 million in 1993 to $806 million in 1995. Hobbs said that's tied to the force drawdown, not a tightening of benefits. Yet during the same period, pharmaceutical costs as a portion of overall medical spending also fell, from 10.3 percent to 8.4 percent.
Hobbs defended the practice of denying high-priced prescriptions to certain classes of patients, even if carried by the pharmacy. As a base pharmacy chief, she refused to fill prescriptions for Seldane, a pricey but popular allergy medication, for all but active-duty patients. ``We were spending $6000 a week on one drug. It was going to everybody and their brother.''
Dependents and retirees complained bitterly that they deserved free Seldane, Hobbs said. ``But the reality is that a one-striper standing there with a sniffling nose and orders to Bosnia is going to have it.''
Too many patients today don't understand this, she said. Many have received military medications for so long they have forgotten about the cost. A women on birth control pills might offer a month's supply to a neighbor who has run out and return early for a refill, Hobbs said. ``It means nothing to them because it's free.''
Defense contracted for a mail-order pharmacy demonstration in 1994 in six states including Florida, South Carolina and New Jersey. It's open to dependents and younger retirees, and to those eligible for Medicare near base-closure sites in the states. But mail-order usage is lower than expected, Hobbs said, because patients balk at the $8 co-payment on 60-day prescriptions. Compared with typical civilian benefits, ``it's an outstanding deal,'' she said. ``But our beneficiaries are going from free to $8. In their minds, it's a really bum deal.'' MEMO: Comments and suggestions are welcomed. Write to Military Update, P.O.
Box 1230, Centreville, Va. 22020, or send e-mail to: milupdate@aol.com
by CNB