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Drug
Companies Programs May Be Better Than Medicare
By Amy Norton, Reuters
October 18, 2005
The new Medicare drug benefit will soon be a reality, but a study published 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.
10/18/05 10:27
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