Drug companies programs may be better than Medicare
By Amy Norton
NEW YORK (Reuters Health) – The new Medicare drug benefit
will soon be a reality, but a study published on Monday
suggests that some lower-income seniors might be better off
using assistance programs offered by drug companies.
Medicare drug coverage, which will be provided by private
insurance companies approved by the federal program, is set to
begin on January 1. The 42 million elderly and disabled
Americans covered by Medicare can begin to enroll in the
voluntary drug coverage starting November 15.
Extra subsidies will be available to Medicare recipients
with incomes and assets low enough to qualify. These
individuals will pay no monthly premium and contribute only $1
to $3 per prescription.
But for lower-income seniors who do not qualify for added
benefits, medication savings could be substantially less. And
the new study, published in the Annals of Internal Medicine,
suggests that a better deal could be found in drug
company-sponsored assistance programs, which provide low-income
patients with certain medications at no cost.
The small study included 137 lower-income Medicare
recipients who got at least one medication through an industry
assistance program. Researchers estimated their likely yearly
savings through the Medicare drug benefit and compared it with
their current savings.
On average, the study found, the Medicare benefit was the
better deal for recipients living at or near the federal
poverty line, saving them 92 percent on annual drug costs.
However, industry programs and Medicare provided comparable
savings to recipients with annual incomes between 135 percent
and 150 percent of the poverty line-or $12,568 to $13,965 per
year for a single person.
And for those with incomes higher than 150 percent of the
poverty line-making them ineligible for Medicare subsidies,
drug companies provided a far better deal. Industry programs
brought yearly savings of nearly 77 percent, on average,
compared with an estimated 31 percent with Medicare drug
coverage.
The findings suggest it would be worthwhile for these
seniors to look into drug company programs, according to the
study’s lead author, Dr. Dawn E. Havrda of the Shenandoah
University School of Pharmacy in Winchester, Virginia.
However, she told Reuters Health, they should also keep in
mind that if they wait too long to enroll in the Medicare drug
benefit, they will have to pay a penalty. People who enroll
after May 15, 2006 will end up paying a higher monthly premium
than they otherwise would have.
Much also depends on the specific medications a person
needs, as only certain drugs are available through drug company
assistance, Havrda pointed out.
Low-income patients can ask their doctors whether their
medications might be covered under a drug company program —
though, as Havrda and her colleagues note in their report, many
patients and doctors alike are unaware of the programs.
The Internet is another resource, Havrda said. She pointed
to two Web sites — rxassist.org and needymeds.com — that
allow users to search for assistance programs based on
medication names.
SOURCE: Annals of Internal Medicine, October 18, 2005.