PHARMA: Medicare Part D — Cost and Coverage
November 30th, 2006
by
Jane Hiebert-White
|
Coverage: Cost proved to be a key factor in choice of Part D plans by Medicare enrollees. A paper published last week in Health Affairs reports that only 4 percent of the 22.5 million Part D enrollees are in plans offering doughnut-hole coverage for both brand-name and generic drugs. Author Juliette Cubanski, a principal policy analyst at the Kaiser Family Foundation, and Patricia Neuman, a foundation vice president, write:
“In the first year of Part D, beneficiaries’ plan choices appear to have been influenced by name recognition or low premiums, or both. Few enrollees chose plans with gap coverage in 2006, which could be a concern for those with relatively high drug costs.”
Cost: Meanwhile, debate continues on lifting the ban on drug price negotiations by Medicare, a post-election hot-button issue. In last Sunday’s Washington Post, Marilyn Moon says: “This is going to be much more of a morass than people think. . . .[Negotiating drug prices is] a feel-good kind of answer, but it’s not one that is easy to imagine how you put into practice.”
The Post article goes on to quote Robert Reischauer on the cost of Medicare Part D coverage:
“People said it’s going to cost a fortune. And the price came in lower than anybody thought. Then people like me said they’re low-balling the prices the first year and they’ll jack up the rates down the line. And lo and behold, the prices fell again. And the reaction was, `We’ve got to have the government negotiate lower prices.’ At some point you have to ask: What are we looking for here?”
On the other hand, the Post points out:
“Even Medicaid, the federal health program for the poor, appears to employ better negotiators than the private Medicare plans. On January 1, 6 million elderly and disabled people were switched from Medicaid pharmacy plans to the new Medicare program. Overnight, many drugmakers began selling the same drug at higher prices.”
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