Minimizing part d costs for Medicare beneficiaries: “not just a drop in the bucket”
Monday, November 4, 2013
: 12:30 p.m. - 12:42 p.m.
Background: Although Medicare Part D has been largely successful in providing prescription drug coverage for Medicare beneficiaries, many continue to be burdened with unnecessary out-of-pocket (OOP) costs. Objective: This study sought to identify the frequency and impact of cost-lowering strategies used to assist Medicare beneficiaries with their Part D drug costs. Methods: Twelve outreach events were conducted in 6 different cities throughout Northern/Central California during the 2013 Medicare open enrollment period. During each event, trained student pharmacists under the supervision of licensed pharmacists assisted beneficiaries to minimize their OOP costs. Individualized assistance included: optimization of the beneficiary's Part D plan, application for the low-income subsidy (LIS) and/or pharmaceutical assistance programs (PAP), and identification of cheaper therapeutic alternatives based on the beneficiary's current prescription medications. Results: In total, 621 beneficiaries were assisted with their Part D plan, of which 412 (67.3%) were enrolled in a stand-alone prescription drug plan (PDP). Over 80% of those enrolled in a PDP could reduce costs by switching to a different PDP in the upcoming year. In aggregate, these beneficiaries could save $426,264 on their OOP costs. Nineteen non-subsidy recipients were deemed potentially LIS-eligible and had their application submitted online to Social Security on their behalf. Thirty-seven beneficiaries indicated having difficulty paying for their medication(s) and were assisted with PAP applications/discount programs. Finally, cheaper therapeutic alternatives were identified for 10 patients and prescribers accepted 90% of our recommendations. Conclusion: Targeted assistance to beneficiaries may lower their OOP costs and thereby help decrease cost-related medication non-adherence.
Administer health education strategies, interventions and programs
Provision of health care to the public
Public health or related public policy
Describe the utilization of cost-lowering strategies to assist Medicare beneficiaries with their Part D drug costs.
Evaluate the impact of adopting cost-minimization strategies to minimize Medicare beneficiaries out-of-pocket Part D drug costs.
Keyword(s): Cost Issues, Medicare
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I have created the Medicare Part D Outreach program at the School in which we have served over 2000 beneficiaries with their Part D plan since the program began 6 years ago. I have presented over 20 posters/podium presentations at national/international meetings of Medicare Part D and have several published primary research articles in the area of Medicare Part D.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.