PhRMA study finds success in Medicare Part D

Washington -- Seniors who did not have prescription drug coverage before enrolling in Medicare's drug benefit filled nearly twice as many prescriptions and cut their out-of-pocket costs nearly in half after signing up, according to a new report sponsored by drug manufacturers.

The study compared drug use and spending in the year before the benefit with use and spending in the benefit's first year among tens of thousands of seniors who had no drug coverage before Part D began. Beneficiaries in this group filled an average of 1.7 prescriptions per month in 2005. The figure jumped to 3.3 prescriptions per month after the benefit launched in 2006, found the analysis, commissioned by the Pharmaceutical Research and Manufacturers of America.

Even with the increased use, average out-of-pocket drug spending by the seniors declined by an average of 45% over that same time period.

The data show that Medicare Part D is working the way that Congress intended, said Richard Smith, PhRMA's senior vice president of policy. "It's offering seniors better access to care and to more affordable care."

Seniors with certain medical conditions seem to have benefited the most from the improved access to drugs. Beneficiaries who took medications for such conditions as diabetes, hypertension, and neurological and psychological disorders significantly increased the number of prescriptions they filled. Low-income Part D enrollees who received additional financial support from Medicare appeared to improve their medication adherence the most.

The PhRMA study, which used prescription data from the health care information firm Verispan, did not attempt to measure if patient health status improved as a result of beneficiaries filling their prescriptions more diligently. But independent research has shown that improved medication adherence leads to better health outcomes, the group noted.

"Better access to medicines is a key to improving health care, and it offers the opportunity to avoid hospitalizations, emergency room visits and nursing homes," Smith said.

Calling for more

But health care consumer organizations continue to criticize drug manufacturers and Medicare officials for not doing enough to keep medication prices low. Families USA, for instance, has released numerous studies showing that the Dept. of Veterans Affairs can obtain many of the same drugs as Medicare at substantially lower costs to both the government and beneficiaries.

Many patient advocacy organizations, AARP and the American Medical Association have pushed for legislation that would allow the government to negotiate lower drug prices directly with manufacturers. That effort has stalled on Capitol Hill in the face of opposition from PhRMA, the Bush administration and Medicare's drug benefit managers.

Some organizations said drug access problems still exist despite Part D. The Medicare Rights Center, for example, is calling on the administration to revise its off-label rules, which the group says are keeping needed medications out of beneficiaries' hands. Medicare permits coverage of drugs for off-label use only if the prescribed use is supported by one of three medical compendia that the government follows.