Rx comparisons may lead seniors to doctors' doors

Medicare Web site gives patients a way to look for lower-cost drug alternatives.

By David Glendinning — Posted Oct. 4, 2004

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A new price-comparison tool will prompt many Medicare drug discount cardholders to question their doctors about their prescriptions, federal officials predicted.

Launched Sept. 15 on Medicare's drug card Web site, the mechanism permits seniors not only to determine which card will offer them the lowest prices but also whether there is a less-expensive option, based on national averages, within the class of drug that they need. Commonly used blood-pressure medications, statins, ACE inhibitors, allergy drugs and arthritis medications make up the types of prescriptions for which patients can receive alternative quotes.

The discovery that a competing brand-name drug or generic substitute is significantly less costly will likely convince some beneficiaries to ask their physicians about the appropriateness of a switch, Health and Human Services Secretary Tommy Thompson said at a briefing.

"Nobody compares prices better than our seniors," he remarked.

A beneficiary who is on Zocor (simvastatin) to manage cholesterol, for instance, could save $300 to $400 a year on average by switching to Altoprev (lovastatin-extended release) or one of three other alternatives, according to information on the Web site. The data are also available by calling 800-MEDICARE.

Centers for Medicare & Medicaid Services Administrator Mark McClellan, MD, PhD, nevertheless stressed that a patient cannot move to a different medication without first receiving a new prescription from his or her doctor. HHS designed the Web site to be a price comparison tool for both physicians and consumers, he said, not to replace treatment decisions that must be made by both parties nor to drive beneficiaries toward a particular set of drugs.

The eight classes of drugs for which the department chose to provide lower-cost alternatives were determined through a rigorous medical review, Dr. McClellan said. Possible monthly updates to the drug list will be based on the same clinical considerations that guided the initial rollout of the comparison tool.

American Medical Association Chair J. James Rohack, MD, offered the group's support for the HHS initiative. "We appreciate the involvement of physicians in the drug comparison review process. The list of prescription medication options provides an estimate that can help patients evaluate potential cost savings and also assist physicians in choosing the best medication for their patients."

Thompson predicted that average market prices would drop once Medicare patients start gravitating toward less-expensive drugs. He suggested that the comparison tool "will do more to drive down drug prices than anything else."

Dr. McClellan noted that the medication classes on the list account for roughly one-fourth of total drug spending by seniors.

Although the cost information provided by the government is Medicare card-specific, physicians also might expect to see non-Medicare patients requesting lower-cost treatment options after accessing the online data, which are available to anyone.

"There's going to be a tremendous consumer pushback," Thompson predicted. He added that some brand-name drugmakers "would rather we didn't do it."

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On the shopping list

Medicare's drug card Web site and 800-MEDICARE now allow beneficiaries to search for lower-cost alternatives within the following classes of medications:

  • ACE inhibitors
  • Angiotensin receptor blockers
  • ARB/diuretic combinations
  • Antihistamines (nonsedating or low-sedating)
  • Antihistamines (nonsedating or low-sedating) plus decongestants
  • HMG-CoA reductase inhibitors (statins)
  • Nonsteroidal anti-inflammatory COX-2 inhibitors
  • Proton pump inhibitors

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External links

Centers for Medicare & Medicaid Services information on the Medicare drug discount card program (link)

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