Amid a flurry of national proposals to bring exorbitant U.S. drug prices in line with other countries’ charges, one Utah insurer has a different option for patients:
Pay them to go to Mexico.
PEHP, which covers 160,000 public employees and family members, is offering plane tickets to San Diego, transportation to Tijuana, and a $500 cash payout to patients who need certain expensive drugs for multiple sclerosis, cancer and autoimmune disorders.
“That money is pretty small in comparison to the difference between U.S. prices and Mexico prices,” said Travis Tolley, clinical operations director for PEHP.
The insurer rolled out its “pharmacy tourism” option this fall in response to state legislation requiring state employees’ insurance plans to offer “savings rewards,” or cash incentives, to patients who choose cheaper providers.
PEHP is offering pharmacy tourism benefits for about a dozen drugs for which the price disparity between countries is vast. For example, Avonex, which treats MS, costs about $6,700 for a 28-day supply in the U.S., but about $2,200 through PEHP’s contracted clinic in Tijuana.
For three months’ supply — the maximum allowed under the program — the savings of $13,500 more than covers the $500 reward and transportation, typically less than $300 per person.
“Why wouldn’t we pay $300 to go to San Diego, drive across to Mexico and save the system tens of thousands of dollars?” asked state Rep. Norman Thurston, R-Provo, who sponsored the legislation calling for incentives. “If it can be done safely, we should be all over that.”