PRxN® Mail Order Pharmacy

Indian people who live near, and receive care from, one of the eight clinical access points of the Cherokee Rural Health Network of northeastern Oklahoma are fortunate to be able to get most of the prescription drugs they need from the pharmacies there. This is one benefit of the public health care package available to tribal citizens through their "Indian health care."

Occasionally, however, a patient may have a need for a prescription drug which is not included in the approved formulary for the clinics and hospitals of our health care system. When this occurs, the patients must purchase the drugs out-of-pocket, which can be very expensive. Many calls are also received from Cherokees who live elsewhere, asking if we can help them get needed medicines they are unable to obtain from the Indian health care facilities where they live. Because the Cherokee Nation Health Service is always looking for ways to improve our patients' benefit package, an agreement with the Pequot Pharmaceutical Network (PRxN®) has been developed. The PRxN® is based in Connecticut, and is an enterprise of the the Mashantucket Pequot Tribal Nation. The company provides mail order pharmaceutical service to Native Americans who are members of Indian tribes throughout the United States. It offers prescription medicines at costs lower than those of retail pharmacies.

PRxN® is a wholly owned entity of the Pequot Nation. The company is able to offer medicines at reduced prices through the tribe's access to federal supply rates. PRxN® can control costs by volume pricing, innovative plan designs, good management and efficient operations that include electronic transmission of pharmacy claims.

In June of 1999, the Cherokee Nation Health Service Office of Managed Care added the services of this "mail order pharmacy" to its range of services. It is an added service, and does not effect the availability of drugs prescribed and dispensed from our clinics or the IHS hospitals.

Pharmacy service to eligible patients is an integral part of our health care system, and one for which there is a constantly increasing demand. It is also one of the most expensive aspects of providing health care. In 1998, pharmacy services accounted for nearly half (48.5%) of the total patient visits at the tribally operated clinics in the Cherokee TJSA. Over two million dollars was spent on purchasing drugs to supply the clinic pharmacies, and this does not include the pharmacy budgets of the two Indian Health Service hospitals here (Tahlequah and Claremore) which also operate in-house pharmacies.

The Cherokee Nation Health Service has a responsibility for providing high-quality, cost effective health care to the beneficiaries of our health care system. We do this in a variety of ways, and assisting our patients in accessing the services of the PRxN® is one. Cherokee patients who choose to purchase their prescription medicines from the PRxN® must have their Indian eligibility certified by the Cherokee Nation. An application form must be submitted by the patient (or patient's guardian) to our Office of Managed Care, where records are validated and certification is submitted to the PRxN®. When the patient orders his or her first prescription from the mail order pharmacy, an identification card is returned to them bearing their PRxN® number and instructions for future orders, including a toll-free phone number. The PRxN® operates on a cash and carry basis, and the 800 number allows patients to obtain a price quote before purchase. Written prescriptions from the patient's physician must be mailed to the PRxN, and, when filled, the medicine is returned by mail or Federal Express, depending on the urgency of the need.

Cherokee patients interested in obtaining their prescription medicines at the reduced costs of the PRxN® should contact: