Cheaper and Closer to Home

Wal-Mart's $4 Prescriptions Reach Md., Va.

Wal-Mart Stores Inc. is expanding the availability of its $4 generic prescription drugs to 12 states -- including Maryland and Virginia -- after launching the program in Florida last month, company officials said yesterday.

The world's largest retailer held news conferences across the country to describe the expansion, which originally was scheduled to take place next year. The program makes 314 commonly prescribed generic drugs available, starting immediately, for $4 for a 30-day supply, even to the uninsured.

For example, popular diabetes medication metformin normally sells for about $36 for a month's supply, according to advocacy group Consumers Union, but will cost $4 under the program. Customers whose insurance copayments are less than $4 will not have to pay the difference.

"This prescription drug program is making medication more affordable and accessible to people who need it most," Brandon Worth, a Wal-Mart pharmacy regional manager, said at a store in Bowie. "It's about doing what's right for the health of our customers and the health of our nation."

Yesterday's announcement affects 1,008 stores in Maryland, Virginia, Alabama, Georgia, Iowa, Kansas, Michigan, Mississippi, Missouri, New Hampshire, Ohio and South Dakota. Last week, Wal-Mart expanded the program to 1,264 stores in Alaska, Arizona, Arkansas, Delaware, Illinois, Indiana, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Texas and Vermont.

The company has added several drugs to the list since the program's launch, following criticism from some health-care groups that certain popular drugs were missing. These include lovastatin, a statin used to treat high cholesterol; paroxetine, an antidepressant; levothyroxine, a thyroid medication; and megestrol, used in oncology.

But the additions have not quelled skepticism of the program. In a statement early this month, the National Community Pharmacists Association, a trade group representing independent pharmacists, called the rollout an "attempt to gain maximum public relations value while providing minimum value to patients."

Yesterday, Charles B. Sewell, senior vice president of government affairs for the trade group, said Wal-Mart had put some drugs that are several years old on the list rather than newer drugs that may be more effective or have fewer side effects. He cited lovastatin as an example, saying it would take eight pills to equal one 20-milligram dose of Lipitor, which is made by Pfizer.

Wal-Mart's tally of 314 drugs separately counts several instances of the same drug, offered at different strengths. The antibiotic amoxicillin, for example, is listed 11 times.

There is also some debate over how commonly the medications on the list are prescribed. Wal-Mart said it included 14 of the 20 most prescribed drugs in the country, citing Internet drug index RxList. Sewell said a ranking of popular drugs by trade publication Pharmacy Times includes only two from Wal-Mart's list: amoxicillin and levothyroxine sodium.

The American Pharmacists Association said it supports more affordable medications but cautioned that patients should consult medical experts about which drugs are right for them -- and that they may not be the ones on the $4 list.

"It starts to send a message that drugs are just another commodity," said Kristina Lunner, acting vice president of policy and communications. "They're very different."

Already, Wal-Mart's move has sparked intense competition from other retailers. Target Corp. yesterday said it would continue to match Wal-Mart's prices in the states where the program has been implemented. Wegmans Food Markets Inc. yesterday began selling nearly 200 generic drugs for $11.99 for a 90-day supply. That list also includes several strengths of the same drug.

Wal-Mart said customers have embraced the new prices. Four days after the program expanded last week, Wal-Mart pharmacies filled more than 152,000 new prescriptions in 14 states, company officials said.

At the news conference in Bowie yesterday, State Sen. John A. Giannetti Jr. (R-Prince George's), who was elected in 2002 as a Democrat but is running for reelection as a Republican, praised Wal-Mart's decision to include Maryland in the latest phase of its rollout.

"Wal-Mart has taken a lot of hits from the state legislature in the last couple of years," Giannetti said, referring to the political debate that swirled around a law requiring Wal-Mart to spend more money on health care for its employees in Maryland. The law was struck down by a federal judge this year.

"Wal-Mart has stepped up to the plate and hit a home run for our constituents," Giannetti said.

With a shopping cart filled with toilet paper and bottled water, Frank Potter, 76, left the pharmacy counter at the Bowie store flipping through the four-page list of drugs, searching for the ones he takes for his heart condition and arthritis.

The three drugs were among the 314 listed. Under the program, Potter will save $26 a month.

"You don't understand," Potter said, beaming, as he began calculating the figures in his head. "It means a lot when you take it out to a year, that's over $300 a year."

Potter said he didn't expect Wal-Mart to begin the program in Maryland so soon. But he was keeping a lookout for it.

"The cost is becoming increasingly a concern because drug plans have raised their prices more than the cost of living index," Potter said.

Douglas Edwards, a minister who runs Mission of Love Charities, said the program will help many of his clients who have had to "make a choice each month between a prescription, food and paying rent."