Utah to Pay Public Employees to Fill Prescriptions For High-Cost Drugs in Mexico

October 30, 2018
The Center for Biosimilars Staff

The Salt Lake Tribune is reporting that public employees in the state of Utah could be paid by their insurance plan to fill prescriptions for high-cost drugs in Mexico instead of in their local pharmacies.

The Salt Lake Tribune is reporting that public employees in the state of Utah could be paid by their insurance plan to fill prescriptions for high-cost drugs in Mexico instead of in their local pharmacies.

PEHP Health and Benefits, a division of Utah Retirement Systems, is a nonprofit trust that provides health benefits to Utah’s public employees, including county, city, school, and other public workers.

According to PEHP’s members’ website, the Pharmacy Tourism Program allows members who are not enrolled in Medicare the option to fill select drugs in Tijuana, Mexico, rather than in their local pharmacies. For members with certain plan types, medications are covered by the payer’s pharmacy benefit at no extra cost, and members are allowed to fill a 90-day supply.

The payer also arranges and pays for roundtrip airfare from Utah to San Diego, California, as well as car transportation across the US—Mexico border to a facility in Tijuana that will dispense the drugs. Finally, patients who take the option to travel to Mexico are also paid a cash reward of $500.

Among the drugs that qualify for the tourism program plan are biologics etanercept (Enbrel), adalimumab (Humira), abatacept (Orencia), and ustekinumab (Stelara). Notably, potentially cost-saving biosimilars for etanercept and adalimumab have been approved by the FDA, but none of the biosimilar options have launched because of patent protection for the originator products.

Other drugs that qualify for the plan are products that treat multiple sclerosis (including glatiramer acetate, dimethyl fumarate, fingolimod, interferon, and teriflunomide) as well as therapies to treat psoriasis (apremilast), osteoporosis (teriparatide) and cancer (abiraterone).

According to the Tribune, state representative Norman Thurston, a Republican representing Provo, said of the plan, “Why wouldn’t we pay $300 to go to San Diego, drive across to Mexico and save the system tens of thousands of dollars? If it can be done safely, we should be all over that.”