DrugTrendsToday.com

Making the Most of Medicare Open Enrollment

With Medicare open enrollment fast approaching (it starts November 15^th), there are three key considerations seniors should keep top of mind:

1) Exercise your right to choose.  While you may be happy with the plan you currently have, it doesn’t hurt to shop around.  At the very least, you may find that the current plan is making changes to premiums or drug coverage that will impact your expenses next year.  Your drug coverage needs may also have changed due to changes in your medications. Or you may be surprised to find another plan that covers all of your needs – for less.

2) Look at the big picture.  The plan with the lowest monthly premium may not necessarily be the lowest cost option.  Take into account all anticipated out-of-pocket costs – including premiums, drug co-pays and other medical expenses such as doctor visit co-pays.

3) Consider lower cost alternatives for prescription drugs.  Combined with the optimal plan, choosing generic or therapeutically comparable options can maximize savings – and help avoid the dreaded “doughnut hole”.

Our PlanCompare Tool offers Medicare beneficiaries a convenient and easy-to-understand way to compare, choose and use the Prescription Drug Plan (PDP), Medicare Advantage Plan (with or without prescription drug coverage) or Medicare Supplemental plan that is best for them and their families.

AARP Tool Will Help Seniors Avoid the Medicare Part D Doughnut Hole

The AARP Doughnut Hole Calculator launched today, giving seniors another way to access and calculate the most cost-efficient options for purchasing their prescription drugs.  The goal, ultimately, is to avoid the dreaded “doughnut hole,” Medicare Part D’s coverage gap where beneficiaries are responsible for the full cost of their prescription drugs before the drug plan once again starts picking up the bill.

DestinationRx is powering the calculator as part of a special arrangement between AARP and CMS, using the same data accessed by the Medicare Prescription Drug Plan Finder.  Where the Plan Finder tool is designed to help beneficiaries pick the best plan, the user interface of the AARP Doughnut Hole Calculator is designed to help beneficiaries optimize the benefits of their current Part D plan.

We have studied the impact of such optimization of drug costs on seniors enrolled in Part D, with positive results: our most recent report, which covered the top five health plans in one particular zip code, showed that the average Part D enrollee with osteoarthritis, GERD, high cholesterol, and hypertension could save an average of 88%, or $4,461.36 annually – and avoid the doughnut hole entirely – when following a DestinationRx-optimized drug regimen.  Download the full text version of the 2008 Doughnut Hole Study.

 
~ Jim Yocum, DestinationRx

PhRMA/Baucus Deal: Benefits Beyond Cost Savings for Seniors in the Medicare Part D Doughnut Hole

We’ve been working to run some numbers to calculate the impact of the PhRMA /Baucus deal announced over the weekend, which aims to cut in half the cost of brand-name drugs for seniors in the Medicare Part D “doughnut hole” coverage gap.  A preliminary analysis suggests that the average senior entering the gap will save about a thousand dollars a year.  The analysis does not consider any means testing that might be applied.  There are obvious benefits for seniors in terms of immediate cost, but it may also end up being an excellent trade-off for branded drug manufacturers: the self-rationing that seniors engage in during the doughnut hole is much more heavily weighted to branded drugs, and once a drug therapy is interrupted, a significant majority of patients do not resume that therapy while another segment switches to generic alternative therapies.  The discount applied via the PhRMA/Baucus plan will keep those seniors on their regimens and reduce the self-rationing and substitution behavior that could hurt the manufacturers long-term.  This will become even more important as large numbers of baby boomers on branded medicines transition to Medicare Part D plans in the next few years.  We’ll be posting more details soon. 

 ~ Jim Yocum, DestinationRx