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Medtipster Sees Growth In Generic Drug Switches With Co-pay Waivers

December 14, 2010 By: Nadia Category: Free Prescriptions, HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Medtipster Client Data: August 1, 2009 – November 30, 2010

Medtipster.com, working with it’s employer sponsored benefit plan members, found that offering a waiver of generic drug co-payments led to more switches to generics from their brand equivalents and that plan members were more likely to remain on their generic drugs after the switch was made.

The waiver program resulted in savings of about $500,000. to the sponsor and about $750,000. to the plan members during the observation period.

To improve generic dispensing rates, Medtipster offered plan members using brand medications in 40 therapeutic classes up to two co-pay waivers if they switched to a preferred generic drug. Information about the waiver was mailed to plan members, alerting them that all they needed to do was switch within six months of receiving the communication.

Members who took advantage of the waivers early in the six-month period were able to use it twice, while members who acted later in the window were only able to use the waiver once.

The recently enacted health care reform law has a provision in it that will allow Medicare Part D plan sponsors, beginning with the 2011 plan year, to reduce or waive the first co-pay for a generic drug when a plan member switches from its corresponding brand product.

Medtipster examined how many of the plan members remained on the generic drug after receiving one or two co-pay waivers. Findings among the top four therapeutic classes (HMG CoA reductase inhibitors, antihypertensive combinations, proton pump inhibitors and beta blockers cardio-selective) showed that plan members who took advantage of two co-pay waivers had higher generic dispensing rates in the fill immediately after the waivers and had higher sustained GDRs during the months after the generic dispensing conversion program began compared to those only using one waiver.

For example, 94.9 percent of members using beta blockers filled the next prescription with a generic following the use of two waivers, compared to 59.5 percent who used only one waiver. Members who used two waivers had a sustained generic dispensation rate of 89.5 percent, compared to 58.5 percent who only used one waiver.

The drug that showed the highest difference in sustained GDR between the use of two waivers and one waiver was AstraZeneca’s high blood pressure medication Toprol XL (metaprolol succinate), which had sustained GDR of 91.5 percent for members using two waivers, compared to 62.5 percent for members who used only one waiver.

Of the top 10, the drug that had the lowest difference was AstraZeneca’s cholesterol lowering drug Crestor (rosuvastatin), which had a sustained GDR of 82.7 percent for members using two waivers versus 78.1 percent for members who used one waiver.

More than 3M seniors may have to switch drug plans

August 25, 2010 By: Nadia Category: HealthCare, Medtipster, Prescription News

www.Medtipster.com Source: The Associated Press – By Ricardo Alonso-Zaldivar – 8.25.2010

A plan by Medicare to try to make it simpler for consumers to pick drug coverage could force 3 million seniors to switch plans next year whether they like it or not, says an independent analysis.

That risks undercutting President Barack Obama’s promise that people can keep their health plans if they like them.

And it could be an unwelcome surprise for many seniors who hadn’t intended to make a change during Medicare’s open enrollment season this fall.

The analysis by Avalere Health, a leading private research firm, estimated that more than 3 million beneficiaries will see their prescription plan eliminated as part of a new effort by Medicare to winnow down duplicative coverage and offer consumers more meaningful choices.

Seniors would not lose coverage, but they could see changes in their premiums and copayments.

Medicare officials dismissed the Avalere estimate without offering their own number. “Anybody who is producing that kind of analysis is simply guessing,” said Jonathan Blum, deputy administrator for Medicare.

But Bonnie Washington, a senior analyst with Avalere, said the company’s analysis used Medicare’s specifications.

For example, Medicare has already notified insurers they will no longer be able to offer more than one “basic” drug plan in any given location. Several major prescription plans, including CVS-Caremark and AARP, offered two basic options throughout the country this year, Washington said. Eliminating that particular form of duplication among the top plans would force 2.75 million beneficiaries to find new coverage, according to Avalere’s estimate.

When other changes are taken into account, as many as 3.7 million Medicare recipients may have to switch, the analysis concluded. That amounts to about 20 percent of the 17.5 million enrolled in stand-alone drug plans.

Avalere serves industry and government clients with in-depth research on Medicare and Medicaid. The company’s president was a health care budget analyst in the Clinton White House.

Former Medicare administrator Leslie Norwalk said the change might make things easier for people signing up for Medicare but harder for those already in the program.

“If you’re in a plan that you like and you have to change it, it will be disruptive,” said Norwalk, acting administrator under President George W. Bush. “It depends on how (Medicare) handles it to try to make it as seamless as possible.”

Reducing the number of Medicare drug plans has long been a goal for consumer advocates. This year, nearly 1,600 plans offered a dizzying range of options, many of which were not significantly different.

But Medicare is going ahead with the consolidation in a hard-fought election year. Republicans have barraged seniors with charges that Obama and the Democrats raided the program to expand coverage for younger generations under the health care overhaul. Obama’s promise that people can keep health plans they like was made in the context of that broader debate, but the president has repeatedly assured seniors their Medicare benefits are safe.

“Some opponents of the (health care) law may say that this is taking away choices, but we have heard from our members for years that the (drug coverage) options can be confusing,” said Nora Super, AARP’s top health care lobbyist. The seniors lobby supports the change. AARP’s public policy branch is separate from its business side, which sponsors Medicare and other insurance plans.

Medicare official Blum said the agency is working with insurers to keep disruptions to a minimum. For example, seniors could be automatically reassigned to a comparable plan offered by their insurance company. Premiums may not necessarily be any higher, Medicare officials said.

“We are not reducing the number of (insurers). We are not reducing the number of quality plans,” said Blum, adding that having fewer, more distinct choices will benefit seniors. “That puts beneficiaries in a stronger, rather than weaker position.”

Besides eliminating duplicative basic coverage, insurers that offer more than one enhanced coverage plan will have to show they are clearly different.

Medicare is expected to release its list of drug plans for 2011 late next month. Instead of 40 or more choices in each state, seniors may have around 30 plans to pick from.

Copyright © 2010 The Associated Press. All rights reserved.

Generic Drug Prices Drop, Brand Prices Continue Rising

May 25, 2010 By: Nadia Category: HealthCare, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: FDAnews.com – Washington Drug Letter, 5.25.2010

AARP: Generic Drug Prices Drop, Brand Prices Continue Rising

The prices of brand-name prescription drugs most often used by Medicare beneficiaries increased nearly 10 percent over the 12-month period ending in March, an AARP report says.

While generic drug prices fell during the April 2009 to March 2010 period, the average price of top brand drugs used by Medicare beneficiaries rose 9.7 percent, continuing an upward trend in annual drug price increases, according to the AARP Public Policy Institute Rx Watchdog Report released last week.

Prices of generic drugs most widely used by Medicare beneficiaries dropped 9.7 percent while prices for widely used specialty drugs rose by 9.2 percent.
“These trends resulted in an average annual rate of increase of 5.3 percent for manufacturer drug prices during the 12 months ending with the first quarter of 2010 despite an extremely low rate of general inflation for all consumer goods and services,” the report says.

Drug companies raised the price of about two-thirds (90 of 144) of specialty drugs studied in the one-year period. Two of the 144 specialty drugs had a drop in price, and both were generics. For an individual taking one specialty medication, the average annual increase in cost of therapy rose by $2,760 during the study period.

AARP’s analysis echoes that of pharmacy benefit managerExpress Scripts’ 2009 Drug Trend Report, released last month. Prices of drugs in the most popular therapeutic classes increased 9.1 percent in 2009, according to that report.

PhRMA, however, said the AARP report is misleading and based on incomplete information. The report fails to take into account discounts and rebates generally negotiated between drug manufacturers and payers, which can significantly lower the cost of brand-name medicines, ultimately benefiting patients, Senior Vice President Ken Johnson said.

“Also, the report’s conclusions ignore the reality that prescription medicines represent a small and decreasing share of growth in overall health care costs in the United States,” Johnson said. “Not only is the current rate of growth for prescription medicines historically low, but the recent decline in drug spending growth has contributed to the lowest rate of total health care growth in almost 50 years.”

Prices Rising For Brand-Name Drugs In Coverage Gap

March 18, 2010 By: Nadia Category: Medicine Advice, Medtipster, Prescription News, Prescription Savings

Medtipster Source:  The Henry J. Kaiser Family Foundation – www.kff.org
Medicare Part D 2010 Data Spotlight: Prices for Brand-Name Drugs in the Coverage Gap
This analysis finds prices for some commonly used brand-name drugs rising in 2010 for beneficiaries who reach the coverage gap (or “doughnut hole”), with increases since 2006 far exceeding the growth in inflation.

The Part D benefit’s coverage gap generally requires enrollees to pay the full cost of their drugs after their total drug spending exceeds their initial coverage limit ($2,830 in 2010) until they reach the threshold for receiving catastrophic coverage ($6,440 in 2010).  In 2007, an estimated 3.4 million Part D enrollees reached the coverage gap.

Using data posted on the government’s Medicare.gov website, the analysis looks at prices for commonly used brand-name drugs without a generic substitute for enrollees in stand-alone prescription drug plans.  The prices reflect the amount that enrollees would pay for a 30-day supply after they reach the coverage gap and before catastrophic coverage begins.  

The spotlight is one in a series analyzing key aspects of the Medicare Part D drug plans that will be available to beneficiaries in 2010. These spotlights were prepared by a team of researchers at Georgetown University, NORC and the Kaiser Family Foundation.

Find generic equivalants and alternatives for commonly used brand-name drugs at www.medtipster.com.

Medicare Part D – Donut Hole

June 02, 2009 By: PharmaSueAnn Category: Medtipster, Prescription Savings

I used to love those small sweet bites at least until July 2007 came around and my parents were in the donut hole. My parents called – when I arrived a pile of EOBS (explanation of benefits) were given to me. They were in the DONUT HOLE and what was I going to do about it, wanting to be a teenager again and respond “Not My Problem”, it was my problem because I chose the Medicare Part D provider. Ok, so it was my problem. My parents had a fighting chance their daughter was PharmaSue we just did not know that then. I worked with their physician to change medications to drugs on the Four Dollar type lists and they have not been in the donut hole since.

Since I cannot come to each of your homes and work with your doctors personally and I certainly do not want you to be one of the many millions of Medicare Part D beneficiaries that go without medication – I became involved with medtipster so that we can bring this information to you too! Tell your family and friends it is for all of us.

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