P&T
Our
Other
Journal
MediMedia Managed Markets
Managed Care

 

ARB costs run high in Medicare Part D

MANAGED CARE August 2007. © MediMedia USA
The Formulary Files

ARB costs run high in Medicare Part D

MANAGED CARE August 2007. ©MediMedia USA













Researchers at Brigham and Women's Hospital, in a cross-sectional analysis of 1,446 Medicare Part D formularies to determine the presence and utilization of angiotensin receptor blockers (ARBs), found that people who have been in a Medicare supplement plan will pay more for these drugs when they join a Part D plan.

Also, any savings from lower copayments under Part D may be offset by the monthly premium and by more expensive cost-sharing when beneficiaries reach the "doughnut hole."

Depending on how broadly a formulary defines the class of renin-angiotensin-aldosterone system inhibitors, of which ARBs and angiotensin-converting enzyme (ACE) inhibitors are a part, formularies could contain two ACE inhibitors and no ARBs. This could be detrimental to patients who cannot tolerate ACE inhibitors.

"The ARBs valsartan and losartan are the most commonly found ARBs on formularies, which will limit therapeutic substitution," says Walid F. Gellad, MD, lead author of the study. "Nonetheless, there will be some patients who will have to switch ARBs when they join Part D," says Gellad.

Under Part D, the average prescription cost-sharing for each of the ARBs ranges from $28 to $47. Average copayments were more than twice as high for the Part D plans, compared to commercial copayments. About one-half of patients who take ARBs will be affected by the doughnut hole and there will be no generic ARBs until at least 2009, when the patent on losartan (Cozaar) expires.

Paying more under Part D

People who paid the whole cost of their ARB prescriptions before Part D may pay less on average if they join a Medicare Part D prescription drug plan, but those who had supplemental coverage and paid between $11.76 and $15.58 for a 30-day supply would pay substantially more under Part D.

Source: Gellad, WF, et al. Angiotensin receptor blockers on the formularies of Medicare drug plans. J Gen Intern Med. 2007 Aug;22(8):1172–5

Meetings

Pharmaceutical Pricing and Contracting Conference Philadelphia, PA September 22–23, 2014
Private Health Insurance Exchanges Conference Washington, D.C. October 7–8, 2014
National Healthcare Facility Management Summit Palm Beach, FL October 16–17, 2014
National Healthcare CFO Summit Las Vegas, NV October 19–21, 2014
National Healthcare CXO Summit Las Vegas, NV October 19–21, 2014
Innovative Member Engagement Operations For Health Plans Las Vegas, NV October 20–21, 2014
4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014