US drug plan frustrates patients, pharmacists

By David Lawder

WASHINGTON (Reuters) – Patients, pharmacists, physicians
and state officials expressed extreme frustration over foul-ups
with the new Medicare drug benefit on Friday, urging lawmakers
to simplify a plan they called confusing and fraught with
potentially life-threatening problems.

Hundreds of thousands of elderly and disabled Americans
have encountered difficulties obtaining prescription drugs
since the new Medicare Part D program went into effect January
1, and many were being turned away empty-handed.

The program, estimated to cost $724 billion over the next
10 years, relies on private insurers, pharmacies and other
health care companies to provide drugs coverage for Medicare’s
42 million beneficiaries.

“I took my insurance card to the pharmacy on January 1,
along with my prescriptions. The computer rejected my card as
if I did not exist,” Ruth Grunberg of Cortland, New York, told
a gathering of Democrats in the U.S. House of Representatives
on Friday.

Grunberg, who enrolled in a Part D drug plan run by United
Healthcare, embarked on a nine-day odyssey of phone calls to
her insurer, pharmacies, lawmakers and even the local newspaper
to try to straighten things out.

So far, at least 26 states and the District of Columbia
have stepped in to pay for drugs for patients also enrolled in
Medicaid, the federal-state program that covers the poor. Those
beneficiaries were supposed to be automatically switched over
to the new benefit but some did not show up on Medicare rolls
in computer systems, leaving many without drugs.

Arnaudville, Louisiana pharmacist Marlene Brantley said she
has dispensed thousands of dollars worth of drugs to needy
patients, but has no idea whether her store will be reimbursed.

Several witnesses told Democrats in the hearing-like
meeting, led by California Rep. Henry Waxman, that they expect
drug costs for Medicaid recipients to rise, because states can
no longer benefit from pharmaceutical company rebates.

“We expect to pay an additional $12 million for a less
comprehensive benefit,” said Jude Walsh, special assistant to
Maine’s Office of Health Policy and Finance.

Waxman, who opposed the 2003 legislation that created the
drug benefit, which aimed to broaden coverage and hold down
drug prices through market competition, said the Part D
problems illustrate the need for reform legislation.

But Health and Human Services Secretary Mike Leavitt said
Medicare officials were working to fix the glitches in various
states and that the situation was improving. “In large measure
it’s getting better every day,” Leavitt told reporters during a
conference call,

(Additional reporting by Lisa Richwine)