Utah insurer plans to send patients to Mexico for cheaper medicine


    A Utah insurer has a new solution to help cut costs for prescription drugs. (Photo: KUTV)

    (KUTV) -- A Utah insurer has a new solution to help cut costs for prescription drugs.

    PEHP Health and Benefits provides insurance to 170,000 of Utah’s public employees. The company now plans to send willing patients across the border into Mexico to get cheaper medication.

    “We’re trying to be part of the solution in health care,” said Chet Loftis, Managing Director of PEHP.

    It’s a term called “pharmacy tourism.” PEHP will fly patients to San Diego, California. From there, a private car will pick them up at the airport and drive them across the border to Tijuana where they will pick up their medication.

    “The hospital down there is an accredited hospital like any other in the United States,” Loftis said. “Certainly, we wouldn’t do something if we thought we were putting people at risk.”

    People who are willing to travel will also receive $500 cash-back incentive.

    “It’s cheaper for us to pay for the drug down there, send them down there and then give them $500 than it is for us to do it here,” Loftis said.

    The prescriptions cost insurers roughly half the price if purchased in Mexico.

    “From a cost perspective, the average drug within the program costs about $4,500 a month within the United States. Over the course of three months, that’s $13,500," Travis Tolley, Clinical Operations Director at PEHP said. "At 40 to 60 percent off the top of that, we expect to pay roughly $6,000 for a three-month course of therapy."

    Currently, there are 13 different medications included in the program:

    • Ampyra
    • Aubagio
    • Avonex
    • Copaxone
    • Enbrel
    • Forteo
    • Gilenya
    • Humira
    • Orencia
    • Otelza
    • Stelara
    • Tecfidera
    • Zytiga

    Most of these prescriptions are used to treat multiple sclerosis or rheumatoid arthritis.

    PEHP’s pharmacy tourism program is a response to legislation passed last session that requires state employee insurance programs to offer savings. House Bill 19 was sponsored by Rep. Norm Thurston, R-Provo.

    “If you engage as a consumer and you go shop and you save your plan money then you should get some of the money back," said Thurston. "You should be rewarded."

    He predicts other health insurance providers will follow suit.

    “This is sort of the first wholesale example, especially for pharmacy and I think it’s just the tip of the iceberg,” Thurston said.

    PEHP said it has 100 people currently eligible for the program, four of which are in the process of getting passports to make the trip to Mexico.

    News In Photos

      Loading ...