More than 45,000 seniors and disabled Arizonans have saved $3.2 million on prescription drugs in the year since Gov. Janet Napolitano launched her program to help deal with expensive but necessary medication. 

The state program has added 30,000 seniors since eliminating its enrollment fee in January.

But the number of participants remains smaller than what Napolitano envisioned when she launched the program last June. The continued growth of the plan is expected to be tested by a lack of advertising and confusion surrounding a new federal Medicare drug program.

Napolitano's program is simple. Arizona seniors use discount cards at more than 500 pharmacies to get reduced rates on generic and brand-name prescription drugs. 

Critics say that the plan does not help most seniors in the lowest income levels and that the scant advertising has kept a large chunk of eligible seniors from knowing about the program.

"The program has not generated much interest, mainly due to the fact that the marketplace has so many discount cards that it has left the consumer confused," said Bruce Semingson, vice president of managed care for United Drugs. "The addition of the Medicare prescription program added additional confusion."

Although there is no definitive number available on the Arizonans who are eligible for the card, the Governor's Office estimates that there are 150,000 to 200,000 eligible. Originally, Napolitano thought that 600,000 seniors would be eligible. 

Some overwhelmed

Meanwhile, the federal drug card, which debuted last week, has left some seniors overwhelmed with choices. There are 30 federal cards in Arizona. Some are free, some cost up to $30. 

Companies can also change their discounts and medications they offer. 

Most seniors have to sign up via the Internet or call an automated phone system to get information.

David Marks of Phoenix said trying to get information about the federal plan is frustrating.

"This new federal program is a fiasco," said Marks, 50. "I called them seven times, and they kept pushing me to go to the library. The state plan is saving me a lot of money. I have to keep on living. I have a house payment and a car payment."

Marks, who is HIV positive, has saved about $3,600 a year on Napolitano's plan to get discounts on drugs that he needs to stay alive. Marks had been paying more than $2,100 a month for his medication, which has been cut down to $1,800 under Napolitano's plan.

Napolitano, who started the program with an executive order in January 2003, said it's a good option for every Arizona senior. 

The state's CoppeRx Card (called the copper card) is now free. 

Tim Nelson, Napolitano's point man on prescription drugs, said the Governor's Office has a simple message for seniors:

"Carry the federal card of your choice AND the CoppeRx Card. Use the card that will save you the most money on each purchase." 

Pamela Smith, a single mother of three, said Napolitano's plan has been a lifesaver. She had a stroke and was misdiagnosed with multiple sclerosis. She needed expensive medication to combat brain damage just so she could walk. Smith heard about the state's prescription drug program at a Fry's supermarket in Tucson and signed up. 

She now saves about $1,200 a year, or about $100 a month. 

"I use that money to put food in the refrigerator and pay the bills," said Smith, who recently married. "I had to have this medicine so I could function and take care of my kids. 

"This was a godsend for me."

Free alternative

Napolitano said that the state plan is "a free, simple alternative" for seniors. 

"As far as I can tell, the national consensus is that the federal program is confusing," Napolitano said. "The discount on the CoppeRx Card is as great or greater than anything being offered under Medicaid right now." 

But U.S. Rep. J.D. Hayworth, R-Ariz, said it's wrong for Napolitano's office to keep "using a constant drumbeat of confusion" which may discourage seniors from looking at the federal plan. Hayworth said the federal plan can harness the buying power of almost 40 million seniors, a much larger pool of people compared with the state discount negotiated for only 1.1 million seniors.

"I think it can be implied that when she says her card is a simpler alternative that it's pushing seniors away from the federal plan," said Hayworth, who may challenge Napolitano for governor in 2006. "The governor shouldn't say it's her card or no card. This shouldn't be a drive for political brownie points." 

Jeanine L'Ecuyer, Napolitano's press secretary, said Hayworth's comments "are just plain silly."

"The congressman is picking a fight that just isn't there," L'Ecuyer said. 

Getting the word out

Napolitano's program isn't for everyone. Some seniors, who already have health insurance, tried the program but didn't stay on it because they didn't get more of a savings. 

At a recent forum sponsored by AARP, most of the 50 seniors had never heard of the CoppeRx Card. 

"The people that have used it are reporting really substantial savings," said Lupe Solis, a top official at AARP Arizona. "The problem is that there is not enough outreach. We still have a lot of work to do."

Napolitano will be in Flagstaff today pitching the program to seniors. There is no state money allocated to advertise the program.

Napolitano has tweaked it since it started last June.

Fee eliminated

A partnership between Arizona and Eli Lilly & Co. allows about 40,000 low-income seniors to buy medications for such conditions as osteoporosis and diabetes for a discounted $12 per prescription. The state also eliminated the $9.95 enrollment fee for the CoppeRx Cards. 

Earlier this year, the state mailed out their cards to 1.1 million Arizonans who are seniors and/or disabled. 

Some experts say that Napolitano's plan can't compete with the federal program when it comes to seniors at the lowest income levels.

Individuals making less than $12,569 or couples with income of $16,862 can get a credit of $600 a year in 2004 and 2005 under the federal plan. There are about 106,000 Arizona seniors who quality for that subsidy.

Burt Brill, a state coordinator for AARP Arizona, said the $600 credit is great, up to a point. 

"That will last for most people for about three months," Brill said. "Then what do those seniors do for the next nine months?"