updated 11/8/2004 6:18:17 PM ET 2004-11-08T23:18:17

St. Louis-based Express Scripts Inc., facing scrutiny of its generic drug prices, is offering discounts on dozens of generic medicines to low-income Americans.

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The program includes prescription drugs for arthritis, asthma, cancer, high cholesterol, high blood pressure, diabetes, depression and heartburn. It is open to people who earn no more than $23,000 a year, or $47,000 for a family of four, regardless of age or insurance coverage.

“Folks don’t need to make choices here,” said Cynthia Meiners, an Express Scripts vice president. “It is designed to complement whatever other means folks have to obtain medications.”

Participants pay $18 for a three-month supply or $30 for a six-month supply of any of more than 50 drugs, which are available only by mail. The average pharmacy price of three months’ worth of the medicines is $100, Meiners said.

One of those drugs, 20-milligram tablets of generic tamoxifen for breast cancer, costs $200 for a six-month supply at the online pharmacy drugstore.com. On the other hand, the blood pressure drug atenolol costs just $21.

About 70,000 enrolled so far
Dee Mahan, deputy health policy director for the consumer group Families USA, said the Express Scripts program is not a substitute for a good prescription drug coverage. “But certainly anyone who’s on a generic drug that’s not one of the cheapest generics should look into it,” Mahan said.

About 70,000 people have enrolled so far in a trial program the company is now taking nationwide, beginning Wednesday.

Generic drugs make up roughly half of all prescriptions written in the United States, but only about 10 percent of the dollar value. Generics typically become available when patents expire on expensive brand-name medicines.

Drug manufacturers have a variety of discounts for low-income patients who take their brand-name medicines. But Express Scripts said its program is the first of its kind for generics.

Express Scripts is among the nation’s largest pharmacy benefit managers, essentially a middleman that negotiates on behalf of its clients for discounts from drug makers.

The company recently announced that its earnings for the third quarter were lower than anticipated, saying the decline was related to shareholder and fraud lawsuits.

Company embroiled in lawsuit
New York authorities sued Express Scripts in August, accusing the company of pocketing as much as $100 million in drug rebates that should have gone to the state.

The lawsuit accuses Express Scripts of inflating the cost of generic drugs — and of fraudulently or deceptively inducing physicians to switch patients’ prescriptions and then collecting a fee from the new drug maker.

Express Scripts says it has saved New York State more than $2 billion in drug costs since 1998. The state got all rebates for which it contracted and more rebates than guaranteed, the company said.

Half the participants so far in the generics discount program are Medicare beneficiaries, said Jake Wilson, a pharmacist who works for Express Scripts and helped design the program.

The company is likely to be part of a team that offers prescription drug insurance to Medicare’s 41 million beneficiaries beginning in 2006.

But Wilson said Express Scripts is not attempting to use the discount program to lure beneficiaries to drug insurance programs it might administer. “Our intention is not to use this as a marketing tool,” he said.

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