Staff Reports
A new program is being offered to qualifying patients which offers discounts of up to 25 percent on outpatient prescription drug purchases.
The program, authorized under Section 340B of the Public Health Service Act, is effective immediately and is available to any patient who has received qualifying health care services at Memorial Medical Center, its ER1 Emergency Department, The Heart Center of Niagara or the Diabetes & Endocrinology Center of Niagara provided they get their prescriptions filled at Wegmans Pharmacy, 1577 Military Road, or Pine Pharmacy, 1806 Pine Ave., in Niagara Falls.
Memorial patients are eligible for the program because the medical center is a designated safety net — disproportionate share hospital which serves a disproportionate number of low-income patients as defined by the federal government.
Federal regulations governing the 340B program generally permit only one community pharmacy per qualifying hospital to provide 340B drug discounts. Niagara Falls Memorial successfully applied for permission to incorporate a second pharmacy in order to enhance accessibility across its service area.
Operating under its previous ownership, Pine Pharmacy was the first to participate in the discount program.
Patients may choose to visit any other pharmacy, but if they do, they will not benefit from 340B drug discount pricing.
In general, Memorial patients who stand to benefit will be those who carry health insurance that lacks a prescription drug rider; those who have prescription riders with large deductibles or so-called “doughnut holes” in their coverage, and patients who have no insurance and therefore pay cash for their prescriptions.
The 340B program will be administered by Sentry Data Systems of Deerfield Beach, Fla., one of the nation’s foremost experts in pharmacy management technology. To learn more, call Pine Pharmacy at (716) 282-1112 or Wegmans Pharmacy at 298-3140.
Frequently Asked Questions
QUESTION: What is the DSH 340B Savings Program?
ANSWER: Established by federal law in 1992, it is a prescription drug discount program available to any patient who has received a health care service at an eligible Disproportionate Share Hospital (DSH) site.
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Q: What patients are eligible?
A: Any patient who has received a health care service at an eligible site is eligible. Medicaid patients’ prescription drugs are subsidized by the state, so they do not receive a discount.
Commercial/private insurance patients will continue to pay their normal co-pay, but if a drug is not covered by their insurance they will receive the discount if they go to the contracted pharmacy.
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Q: How does a patient participate in the program? What is the cost?
A: There is no cost to participate in the program, other than the cost of their medications. In order to participate, a patient just takes his or her prescription to the contracted pharmacy for their eligible site. A patient may fill a prescription at any pharmacy of his or her choice, but only the contracted pharmacy for their specific DSH site may offer the discount.
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Q: Can a patient go to more than just one pharmacy?
A: Only designated pharmacies may be used to provide 340B drug discounts. Patients may choose to visit any other pharmacy, but if they do they will not benefit from 340B drug discount pricing.
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Q: How much money will a patient save?
A: The discount varies depending on the drug.
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Q: What if patients have insurance with prescription coverage?
A: The pharmacy will fill their prescription using their insurance. If for any reason, their insurance doesn’t cover a medication prescribed for them, they will receive the discounted price for any medication they pay for.
If the patient has a high deductible or is in the “doughnut hole” of a Medicare Part D plan, they will receive the discounted price. Remember, patients can fill their prescriptions at any pharmacy of their choice, but can only receive the discounted price at the contracted pharmacy.
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Q: What if a patient has Medicaid?
A: Because Medicaid subsidizes medications through the state, a Medicaid recipient is already receiving a discounted price. If the prescription is for a drug not covered by Medicaid, the patient will receive the discounted price.
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Q: What happens to the patients that are referred to a non-DSH doctor?
A: Patients referred to outside doctors may present their prescriptions to the DSH contracted pharmacy. The pharmacy will verify the referral relationship in order to dispense the medication at the discounted price.
