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In the sister blog to this one, I have discussed the potential consequences the proposed Medicaid cuts will have on Florida nursing homes. While the budget reductions will have a significant impact on residential facilities, pharmacies will also feel the effects.

Florida lawmakers approved the Medicaid overhaul last month and if it is approved by the federal government thousands of beneficiaries will be moved to managed-care plans. On these plans, recipients would be required to use mail-order pharmacies for maintenance drugs, which are medications taken months at a time for long chronic conditions. For urgent prescriptions like antibiotics, recipients would be sent to specific approved pharmacy locations.

Pharmacists argue that switching to a system based on mail orders and phone calls will be difficult for their Medicaid patients. Admitting they have a vested interest in keeping their patients, they contend there is no substitute for a local pharmacist who knows customers by name and can interpret what the customer means when he or she says, “I need my nighttime pill.”

Another concern is the specific approved pharmacies Medicaid patients would be allowed to use for urgent medications. The fear is that customers would be likely be limited to large corporate pharmacies. It could be difficult for patients to reach the designated locations. Furthermore, these large corporate pharmacies often have business practices that push pharmacists to fill prescriptions as quickly as possible, rewarding speed and requiring employees to meet quotas. This can lead to pharmacy prescription errors

The other issue opponents raise revolves around shipping them. Shipping expensive medications or narcotic pain killers that sell well on the black market could lead to theft. If the mail order pharmacy will not replace missing medications, patients would go without. They would also go without while waiting for a replacement. The Florida heat is also a concern as medications might not survive the trips.