Generic drugs online

Source: San Jose Mercury News

Date: 1-Jul-2008

Author: Jondi Gumz

Pharmacist Bruce Bettencourt has bad news for customers who rely on Medi-Cal to pay for their prescription drugs.

The state's 10 percent cut in reimbursements, which affects doctors as well as pharmacists, is slated to take effect today.

"We can't afford to fill prescriptions at below cost," said Bettencourt, who owns Bruce's Medical Plaza Pharmacy on Water Street. "We can't make it up selling potato chips."

One customer, frustrated by what the cut would mean for him, yelled at store staff Friday, then called Monday to apologize.

Those most affected by the cut are people with schizophrenia and people with AIDS who count on Medi-Cal coverage to pay for their medications. Medi-Cal, the state's medical insurance program, covers medically necessary care for people with low income and low assets.

Bettencourt, 66, a pharmacist for close to 40 years, said he is feeling squeezed as insurance companies limit how much they will pay for medications. The amounts are getting closer to the so-called "dead net," what Bettencourt actually pays wholesalers for drugs, making it more difficult to cover the costs of maintaining inventory, staffing and higher gas prices.

"There's just five of us," he said, adding that cutting staff wouldn't put him in the black.

It's a big change from when he got out of pharmacy school and followed his father into the profession.

"It was a good life," Bettencourt said.

Across the state, mom-and-pop outfits and chain drugstores face the same situation. As insurers set limits on what they will pay for drugs, pharmacies have to negotiate discounts with wholesalers to stay ahead.

Starting today, Bettencourt is instituting a $2.50 charge for delivery of prescriptions to offset his rising expenses.

He'd like to remodel his store and create a room where he could offer immunizations and private consultations with diabetics and other patients. Given today's cost-cutting environment, he's not sure that's a good investment, and he's not in a position to retire -- even after decades in business.

"Every day I get an offer to sell out," he said, but he's not ready to work for a drugstore chain.

Like other pharmacists, Bettencourt is asking customers to sign a petition asking the Legislature to rescind the 10 percent cut, which was signed into law by the governor in February as a belt-tightening, budget-balancing measure.

More than 150,000 Californians have signed petitions, according to the California Pharmacists Association.

Three weeks ago, eight community pharmacies filed a lawsuit against the state Department of Health Care Services seeking a temporary restraining order to stop the cutback. The state has asked to have the lawsuit heard in federal court but the case was sent back to state court; however, a hearing date has not been set.

"Many pharmacists throughout California who are participating in the Medi-Cal program have expressed great concern about the impact of these cuts, citing that they stand to lose money on nearly every prescription filled," said Lynn Rolston of the California Pharmacists Association.

"Pharmacists will be forced to make tough decisions that will ultimately impact California's most vulnerable patients including turning away new Medi-Cal patients, dropping out of the Medi-Cal program or in a worst case scenario, closing their doors altogether, which will cause a hardship for all of their patients."

Bettencourt said he will suggest customers call Assemblyman John Laird, D-Santa Cruz.

"I feel bad for John -- he's a great guy," the pharmacist said. "He's done everything to help us."