Posted At Newsday.com

A drug discount plan rolled out recently by 10 pharmaceutical companies promises significant savings for 36 million people with limited incomes and no prescription insurance.

But some say the plan is simply a way for drug companies sponsoring it to discourage the practice of buying cheap prescription medicine from Canada and to head off legislation aimed at making such purchases legal.

Some drug-discount plans - like one offered by Nassau County - have fewer eligibility restrictions. New York City Council members are exploring a plan modeled on Nassau's.

Launched recently in Washington, D.C., the Together Rx Access plan offers discounts of 25 to 40 percent on 275 drugs and products, such as those that monitor diabetes.

For the uninsured

The discounts are for people younger than 65 who do not have prescription insurance or Medicare and who meet annual gross income requirements - no more than $30,000 for a single person and $60,000 for a family of four.

Some of the discounted drugs are Lipitor for cholesterol, Nexium for heartburn, Zoloft for depression, Diovan for high blood pressure, Viagra for erectile dysfunction and certain birth control pills.

The sponsoring companies are Abbott, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Johnson & Johnson, Novartis, Pfizer, Takeda, Tap Pharmaceutical Products and Sanofi-Aventis Group.

The consortium has not released a list of prices. But AstraZeneca spokeswoman Karissa Laur gave an example, saying a 30-day supply of Nexium would cost about $105, compared with about $150 without the discount. However, Laur said each company will decide how much to discount, and prices will vary at participating pharmacies.

"It's an unmet need," said Roba Whiteley, executive director of Together Rx Access.

Some sponsors of the new discounts launched a plan for seniors in 2002 but signed up only about 1.5 million of the 8 million to 10 million eligible. Whiteley called that effort "huge," saying it saved about $700 million for people who used it.

Together Rx has said groups such as AARP and the Mental Health Association in New York State will play a key role in identifying eligible people.

AARP plans to tell members about the discounts in its publications. But John Rother, AARP's policy director, said Together Rx Access needs to prove it plans an all-out effort.

"I think a test of how sincere these companies are is whether they follow the announcement with some real outreach efforts," Rother said. "I wouldn't call that a real outreach yet."

Rother said some people will be difficult to reach - the illiterate, non-English speakers, and those who don't want to reveal their incomes. "When you have an asset test, there is low participation," Rother said.

Getting with the program

Glenn Liebman, chief executive of the New York Mental Health Association, said that his group will try to tell people about the discounts, but that "our sign-on simply means we support the program at this point."

Novartis plans to discount the blood pressure drug Diovan and the breast cancer chemotherapy drug Femara, among others.

"It is our hope that the uninsured take advantage of this safe and legal method of obtaining drugs and do not turn to unapproved drugs, particularly from Canada," Novartis spokesman Kevin Rigby said.

Rigby was referring to the practice of buying Food and Drug Administration-approved drugs over the Internet from Canadian pharmacies, which have lower prices, or traveling to Canada to purchase them.

The federal government has said such purchases amount to importation of medicine, which is illegal. Sen. Byron Dorgan (D-N.D.) sponsored a bill last year that would allow them; the Republican leadership never brought the bill to a vote.

Barry Piatt, a Dorgan spokesman, said that he plans to reintroduce the bill, with bipartisan support, this year and that the discount plan seems aimed at "thwarting" it.

"There's no doubt it probably is calculated to let the air out of the tires of the drive to import medications from Canada," Piatt said.

Duke University health economist Frank Sloan said Together Rx Access seems to be an effort to make money from people who otherwise couldn't afford to buy prescription drugs.

"You can call it charity if you want to, but you're just lowering the prices to keep the business to maximize your profits," Sloan said.

Local representatives of national organizations such as the Epilepsy Foundation and groups such as the Hispanic Federation of New York, New Jersey and Connecticut said they would support the discounts but know little about them so far. The Together Rx group has said it will be working with those organizations.

George Smith, president of the Epilepsy Foundation of New York City, said that his group deals with people who can't afford drugs and that the pharmaceutical companies "have really done quite a bit to ease the situation" by offering discounted or free medications. But of the new plan, Smith said, "The patient still has to pay something, and a lot of people can't pay."

Who's eligible

Here are the main criteria for Together Rx Access. To enroll, call 800-444- 4106 or go to www.togetherrxaccess.com.