In the midst of storm concerning national bids to bring overpriced U.S. drug prices down and line them with other countries’ charges. However, one Utah underwriter has an unusual route for patients— Pay them to go to Mexico!
Post Employment Health Plan or Public Employment Health Plan (PEHP) covering 160,000 public employees and family members, is providing $500 cash payoff, transportation to Tijuana, and plane tickets to San Diego to patients who are in need of certain expensive drugs for cancer, sclerosis, and autoimmune disorders.
Clinical operations director for PEHP, Travis Tolley said that the compensation amount is quite small when compared to the difference between Mexico prices and U.S. prices.
The insurer introduced its “pharmacy tourism” alternative this fall in retort to state legislation demanding state employees’ insurance plans to tender “savings rewards,” or cash spurs to patients who opt for cheaper providers.
PEHP is putting forward pharmacy tourism doles for about a dozen drugs for which the price difference between the countries in vast. For instance, Avonex—which cures Multiple Sclerosis—costs around $2,200 for a 28-day supply through PEHP’s commissioned clinic in Tijuana, but in the U.S., it costs about $6,700.
Regarding the supply of 3 months’—the maximum allowed under the program—the reserves of $13,500 covers more than the transportation and $500 reward, usually less than $300 per person.
State Representative Norman Thurston, R-Provo who funded the legislation appealing for incentives said, “Why wouldn’t we pay $300 to go to San Diego, drive across to Mexico and save the system tens of thousands of dollars? If it can be done safely, we should be all over that.”
Participating patients will fly the coop to San Diego, transported through a primacy lane at the border crossing and reach a clinic—a top-notch clinic as per the description of PEHP director Chet Loftis—that is comparable to Cleveland or a Mayo clinic in the U.S.
Although medical tourism is not new, PEHP has earlier proffered coverage for out-of-country medical procedures. Loftis stated that patients haven’t used this option since it came without cash incentives. He further adds that more people will participate now as the clients are entitled to up to $3,900 per year in recompense for tours to Tijuana for drugs and procedures.
He said, “It makes sense to not only pay for the cost but also to provide an incentive.”
As the Trump government officials are focusing on the difference between medication prices in the U.S. and in other countries, such pharmacy tourism incentives are launching. On Thursday, the U.S. President Donald Trump rolled out a proposal concerning the cost of drugs under Medicare Part B—a proposal that covers cancer drugs and other drugs provided to the patients in the hospital.
At present, the Federal law prevents Medicare from settling lower drug prices, a rule that Congress has refused to change. However, Trump has propositioned an experimental period that will limit Medicare payments for selected Part B drugs to cost closer to what other countries negotiate.
The experiment would be applicable to only half of Medicare recipients in the selective areas of the country and to some drugs administered by doctors.
Thurston finally added as a signing note, “When you start looking at the list at these higher-priced drugs people are taking, you think, ‘How in the world can there be such a big price differential between the U.S. and other countries? What’s going on? Why wouldn’t we fly our employee to Mexico?”