P&T
Our
Other
Journal
MediMedia Managed Markets
Managed Care

 

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

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