Current Events > Utah paying public employees to go to Mexico for prescriptions

(+) Yeah! (+)

https://www.sltrib.com/mexico-pharmacy-tourism/
<quote>Hospital Angeles towers over a neighborhood that, but for the palm trees and signs in Spanish, could be in Salt Lake City.

TGI Fridays and Sams Club are around the corner. U2 plays on the speakers at a coffee shop across the street. At the end of Paseo de los Hroes, the main street through Tijuanas medical district, looms a massive statue of Abraham Lincoln.

This is where some Utahns fill their most expensive prescriptions under a cost-saving measure that made national headlines when it was announced. In the first year since the states Rx Tourism program for public employees launched, 10 Utahns have traveled over the Mexican border to pick up specialty medications at about half the price charged in the United States. In return, the state covers airfares for the patient and a companion, and offers a $500 cash incentive for each trip.

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 shed have to cover in the U.S. under her plan through PEHP, the insurer that covers 160,000 Utah public employees and family members.

Its kind of like $1,000 in my pocket, Lovell said.

Medical tourism long has been a workaround for Americans seeking procedures that often are not covered by their insurance, and the streets of Tijuanas medical district are lined with clinics for everything from bariatric surgery to dental care and optometry.

Yet pharma tourism for specialty drugs is a relatively new phenomenon here and it's different from the buyer-beware market for medical treatments and procedures.

At the end of the day," said Chet Loftis, director of PEHP, were talking about the same drug.

But the cost is vastly different typically 40% to 60% of the list price in the United States.

In total, the state has saved $225,000 on drugs bought in Mexico by patients who require 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.

Legislators and PEHP administrators had anticipated more people would participate, said Travis Tolley, clinical operations director for PEHP; Rep. Norm Thurston, R-Provo, said in an interview with National Public Radio last year that he hoped for savings of at least $1 million.

But every client who has made the trip to Tijuana has opted to return, Tolley said, and now PEHP is expanding its travel incentive to Vancouver, Canada, where a clinic is right inside the airport.

In the meantime, state officials have been inundated with requests for information from business and government leaders desperate for solutions to escalating prices for specialty drugs. Though they make up only about 2% of all drugs prescribed, they accounted for about half the money spent on prescription medications in the United States in 2018, according to the health research firm IQVIA.

Flying from Salt Lake City to San Diego International Airport takes about two hours. At the base of the baggage claim escalator in San Diego, Javier Ojeda greets first-time patients with a name placard and a driver.

We never leave [patients'] side, said Ojeda, general manager of Provide Rx, the pharmacy that works with Hospital Angeles to obtain and dispense specialty drugs for U.S. patients. 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.

If you blink, you might miss the Mexican border, about 20 minutes from the airport. Southbound travelers arent screened, and the van crosses into Tijuana without stopping. Its another 15 minutes or so to the hospital, via freeways and major thoroughfares.

At 1.6 million people, Tijuana is a sprawling metropolis, but most of the medical services are concentrated in the northern part of the city, not far from the border. Small clinics and large hospital campuses alike stand adjacent to clusters of loft apartment buildings and trendy restaurants in this cosmopolitan neighborhood; there are about a dozen sushi places within a mile of Hospital Angeles.

Pretty much everyone whos a little uncomfortable gets here and says, Oh, this is nothing like the def con 5 situation I thought, said Joe Willix, chief experience officer for Medical Travel Option. The Texas company matches U.S. employers to international health care providers to reduce the costs of employees health care.

At the hospital, patients are whisked past manicured tropical plants and through an airy lobby to a doctors 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 doctors visit may amount to a quick exchange of papers or a more thorough physical, depending on the patients condition. Then Ojeda provides the pre-ordered medication, and the patient is ready to return to San Diego.

From the jetway in Salt Lake City to the exit of Hospital Angeles, getting a prescription can take as little as three or four hours.

Nearly all of the PEHP clients who have visited Tijuana reacted most strongly to the same thing, Tolley said: "The ease of the trip."

Getting back to San Diego can be a bit trickier. 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.

Ojeda said the wait at the border rarely exceeds 90 minutes and usually is much shorter. The Salt Lake Tribune contacted eight PEHP clients who have made the trip, and they reported wait times from 10 to 90 minutes.

But San Ysidro is still the busiest border crossing in the Western Hemisphere, funneling about 90,000 travelers into the United States each day. Patients flights back to Salt Lake City tend to be scheduled late in the day, Lovell said, to provide a cushion of time in case of border delays.

Its a long, long day, said Lovell, 62, who works as a teacher for deaf students. During a trip in February, for example, she left her home at 5:30 a.m. and didnt return until midnight, she said.</quote>

---

It's an innovative solution to a bizarre problem that shouldn't exist. It's sad and insane that our drug pricing is that significantly different that this strategy works.


---

foxhound101 posted...

It's sad and insane that our drug pricing is that significantly different that this strategy works.

It's a bizarre perfect storm of slow regulatory process, fast patent process, overseas price controls, and third-party payers.