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City retirees ask judge not to cut Viagra from health benefits -- even though it would save $425K

Posted: 12:21 PM, Jun 17, 2019
Updated: 2019-06-18 11:49:52-04
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CINCINNATI — Retired city of Cincinnati workers want a federal judge to stop the city from removing erectile dysfunction drugs from their health benefits – a cut that would save the city $425,000.

City retirees filed a motion on Friday asking U.S. District Court Judge Michael Barrett to stop the city from making cuts to prescription drug benefits set to take effect on July 1. They say it violates the 2015 consent agreement between retirees and the city.

“Viagra and Cialis are likely two of the ‘lifestyle erective dysfunction drugs’ that would be removed from coverage. If so, the changes … would constitute a reduction in benefits, which is specifically prohibited (in the agreement),” wrote attorney Peter O’Shea in a motion asking Barrett to stop healthcare changes and award attorney’s fees.

The Cincinnati Retirement System is expected to spend an estimated $34 million on retiree health benefits in 2019 and coverage for prescription drugs accounts for half of that, City Manager Patrick Duhaney wrote in a June 4 memo.

“This trend is expected to increase at alarming rates due to escalating costs for brand-name drugs, new and specialty drugs coming to market at ever-higher prices, and increased utilization,” Duhaney wrote.

The city will continue to cover erectile dysfunction drugs necessary as part of a medical condition, but would end coverage of lifestyle or recreational use of the drugs.

This is the latest dispute in an ongoing battle over city retiree health benefits. In January retired city workers asked a judge to hold the city in contempt for violating the consent decree by not making regular payments into a healthcare trust.

Mayor John Cranley touted the pension deal as “historic” when city leaders finalized an agreement with unions representing city employees in April 2015, ending nearly 15 months of negotiation.

The compromise was supposed to end an $862 million unfunded liability, ensure pension benefits for current and future retirees and shore up the city’s finances for years to come.

As part of the agreement, retirees agreed to allow the city to reduce retiree health care benefits and take $200 million from the city's retiree health care fund and move it to the pension fund in 2016.

But the agreement forbids the city from making cuts to health care benefits without a judge’s approval, according to the motion.

“Removing a drug – any drug – ‘from coverage’ is by definition a ‘reduction’ in benefits,” O’Shea wrote.

Duhaney’s memo to the Cincinnati Retirement System Board of Trustees outlined several changes to prescription drug benefits.

The first change would remove erectile dysfunction drugs from coverage at a projected savings of $425,000 a year.

Other changes would require retirees to get maintenance prescriptions through mail delivery, saving the city $120,000 a year; and add “quantity limits, step therapy and prior authorizations,” on prescription drugs, saving the city between $50,000 and $465,000, according to court documents.

Retirees are asking Barrett to rule quickly on the issue before new drug coverage changes take effect on July 1.