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PDPs see increases in cost-sharing amounts

MANAGED CARE August 2009. © MediMedia USA
The Formulary Files

PDPs see increases in cost-sharing amounts

MANAGED CARE August 2009. ©MediMedia USA













Cost-sharing amounts can vary considerably among Medicare Part D plans for commonly used brand-name drugs without generic equivalents. In general, Part D plans charged more than employer plans did in 2008 for preferred and nonpreferred brand drugs, but somewhat less for generics.

Today, more than 26 million people are enrolled in Medicare drug plans, including 17.5 million in stand-alone prescription drug plans and 9 million in Medicare Advantage drug plans.

The most recent “Medicare Part D 2009 Data Spotlight” from the Henry J. Kaiser Family Foundation presents monthly cost-sharing amounts for the top 10 brand-name drugs in national plans.

A beneficiary with Alzheimer’s disease could pay as little as $22 for a monthly supply of Aricept under one of the 44 national and near-national Part D plans in 2009, but as much as $88 per month under another plan. Cost sharing for Advair Diskus, for asthma and chronic obstructive pulmonary disease, ranges from $22 and $68 in national PDPs when on formulary, but as much as $289 for an enrollee in a national PDP that does not cover the drug (an uncovered drug in the graph) — 13 times the lowest cost-sharing amount.

Monthly cost sharing for top 10 drugs

Source: Georgetown/NORC analysis of data from CMS for the Kaiser Family Foundation