NO SURPRISE ACT
Vigilance: “keeping careful watch for possible difficulties; awareness, alertness, wariness, guardedness.” Here are some pharmaceutical issues where careful alertness can benefit you and the Trust.
In the world in which we exist, changes and updates to our personal accounts are driven by technology. ProAct has installed a new pharma base after operating on an Optum platform. As a result, glitches may occur. If they do, let us know and it will be rectified.
It has been brought to our attention members who are on automated prescription refills from ProAct accumulate, over time, a stockpile of medications. How can this be if maintenance drugs are 90 day supplies, provided four (4) times a year, totaling 360 one-a-day items?
Refill rules, probably formulated as a result of lobbying efforts by those with a vested interest, allow for refills of 90 day prescriptions after 60 days. So, if you received a 90 day mail order Rx on Jan. 1, your refill can be done around March 1. The refilled container now lists the refill date as May 1, updating the original 90 day refill date by 30 days. The same occurs with the May refill, resetting the new 90 day date for a refill on July 1. In the two 90 day periods ending June 30, where you were due 2 refills, you have received 3. Compound it through December and you’ve accumulated a stockpile of medications. The Trust has been charged extra and you’ve paid extra co-pays for each 90 day refill.
Contact ProAct and remove yourself from automatic delivery. Of course, now you need to remember to reorder two weeks before the original 90 period expires, but you only need do it four times a year. Sacrificing a convenience that wastes drugs we’re all paying for and creates savings for everyone, is a small price to pay for efficiently managing your health.
Another issue involves the availability of prescription orders for Brand Name drugs through CanaRx. Unlike a Pharmacy Benefit Manager (PBM) like ProAct, CanaRx is a broker. They are not an internet pharmacy. They only deal with groups in securing Brand Name medications in the original factory sealed manufacturers packaging, and delivered direct to your door with $0 copay from certified pharmacies in Canada, the United Kingdom, and Australia. They will personally contact you regarding refills, so you have control. It’s simple, safe, and smart! Here’s the concern.
Although the list of available Brand Name drugs has increased, and despite the benefit of NO Copay, saving members $240/year, there are members who do not use the service. There is, at a minimum, a drug cost savings of a minimum of 50% when compared to drug cost in the U.S. As an example, the cholesterol drug Crestor, when 90 day mail ordered through a U.S. PBM, is $750 plus a member copay of $60. Through CanaRx, the same Crestor costs $90 with no copay for the member.
In 2021, there were 499 Brand Name prescriptions available to our members through CanaRx, yet only 245 went through CanaRx. Those 245 represent 3,761 scripts and an average savings of $880/script (68.6%) for the Trust. Only 49% of eligible drugs went through CanaRx, meaning 51% of the U.S. PBM purchases involved a copay for the member.
In 2021, CanaRx saved the Trust $921,428 in drug costs, yet there was a potential additional savings of $558,098, an average of $2,200/member.
Therefore, as we all have a responsibility for the health of our Trust, all members will be receiving a mailer from CanaRx. It will include a complete description of their services, the dedicated Trust website (KTFMeds.com), an enrollment form, and a complete list of all available drugs.
Your vigilance, your involvement, and your welfare are needed to support your Trust. It’s a simple, safe, and smart way to support one of the two greatest benefits of your profession. When the mailer arrives, make it your 2022 resolution to do the right thing and to use CanaRx for available Brand Name drugs.
Hopefully, after the latest surge of the Omicron variant peaks, it will become more of a footnote; still with us, but manageable.
The Ulster County Department of Health has set up a Covid PCR testing site at SUNY New Paltz that opened on January 11. The center, at the CollegeTerrace, 1 Hawk Drive, is open M-F, 8:30am-4pm and can schedule 225 appointments and 50 walk-in tests per day. More information is available at: http://bit.ly/SUNYNYtest21 and www.vaccinateulster.com.
Also, as they did this past week at SUNY New Paltz and SUNY Ulster, the county will continue to set up distribution sites during January for free at-home test kits and K95 masks. Ulster County is partnering with local municipalities for both at-home test kit and mask distribution. Contact your local municipality for additional details.
With 72% of Ulster County residents fully vaccinated, the county continues to host regular vaccinations at the former Best Buy in the Hudson Valley Mall and at pop-up sites around the county. Register on-line at: covid19.ulstercountyny.gov
Continue to err on the side of caution in keeping you and others safe.
IN MEMORIUM: Bob Beesmer | Marilyn Powers
The Trustee is the official newsletter of the Kingston Trust Fund and is published every month of the school year. The Trustee is distributed to members via ktfesp.org and email. Hard copies are mailed to retirees without email. Active members who would like a hard copy, send your name/school name via PONY mail to Kathy Hyatt at Cioni.