Nashua pharmacist does his bit for affordable medicine

Roger Hebert, owner and operator of Rice’s Pharmacy on Main Street in Nashua, has launched a local program that addresses a national concern: access to affordable prescription medicines.

The registered pharmacist has no illusions about resolving the crisis, but he’s convinced he can do his part to ease the burden for many of his customers and others in the community who are willing — and able — to switch from brand-name medicines to generic ones, which cost less.

“What we’re trying to do is help people who have a budget understand what the cost of their medication will be before they come in,” Hebert said during an interview in his pharmacy.

Hebert’s program, the “1-Price Prescription Drug Plan,” charges an annual enrollment fee of $19 that entitles a patient to deep discounts on more than 80 generic medications — a list Hebert said may change depending on the market.

Patients may purchase prescription capsules or tablets in quantities of 100, 180, 270 or 365. All drugs listed in the formulary are priced according to quantity: 100 tablets for $19, 180 for $29, 270 for $39 and 365 for $49.

The program is loosely based on one the pharmacist heard about that was started in another part of the country. It depends on buying generic drugs in bulk at a lower price rather than brand-name ones. (Manufacturers don’t sell brand-name medications at volume discounts, Hebert said.)

As a result, customers realize steep savings: One hundred pills of generic Prozac, for example, cost $19 in contrast to $300 for 100 pills of the brand-name drug.

Hebert said he has confidence in generic drugs, given their longtime use as brand-name medicines before going generic. Before a medication can be produced generically, it typically enjoys a 19-year patent without competition, he said.

In most cases, Hebert said, generics are as effective and as well tolerated as the brand names, although they may be less convenient. Some brand-name medicines, for example, require a once-a-day dosing, while the less expensive generics must be taken twice a day.

“They’re good medications,” Hebert said, drawing an analogy with computer technology. “I have a laptop that’s three years old that’s perfect for me, still useful, even though there are newer models.”

But some patients prefer staying on a brand of medication they have taken for a long time.

Others, who take medicines that depend on maintaining specific blood levels, often cannot change to a generic drug without compromising the blood-level measure, Hebert added.

For those faced with either rationing or not taking their medicine, however, the generic alternative is the hands-down winner, Hebert maintains.

“There are studies showing that 50 percent to 60 percent of Medicare hospitalizations are (related to) medications, not taking medications properly or at all,” Hebert said. “Pricing can help with that, cut the health-care costs for the majority of patients, keep them well.”

Increasing access

Hebert said he came up with the idea for establishing his own formulary after hearing about a pharmacy in the western part of the country that had developed its own drug list.

The initiative is not a battle cry for competition, he said, but instead a way to increase access by taking advantage of generic pricing. As the program continues, he added, changes in drug prices are likely to affect changes in his list.

“I’m not trying to cover the market,” he said. “I think a lot of people don’t take their medications now because of the price, and not just low-income (patients).”

Suzanne Keller, director of 55PLUS at Southern New Hampshire Medical Center and overseer of the hospital’s prescription assistance program, shared Hebert’s assessment.

“It’s exciting that another member of our community is doing something to alleviate the barriers to affordable medication,” Keller said. “It’s one more little, tiny thing the pharmacy can do to make some medications available.”

The new program, however, won’t resolve the bigger problem of access, Keller added, noting that 900 patients are currently enrolled in the medical center’s prescription assistance program.

“Applications and calls come in every day, and some have hardships but don’t meet the criteria,” said Keller. “Now, we can say, ‘Here’s something that might be of help.’”

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