Erectile Dysfunction Medications To Cost Medicare $2B Over 10 Years, Congressional Budget Office Says
Erectile dysfunction medications will cost Medicare almost $2 billion over the next 10 years, according to a new cost estimate from the Congressional Budget Office released on Monday, the Washington Times reports. Earlier this year, CMS decided that the new Medicare prescription drug benefit, which begins on Jan. 1, 2006, will cover ED medications, such as Cialis, Levitra and Viagra. At the same time, CMS said that the 2003 Medicare law requires that the prescription drug benefit cover all medically necessary medications approved by FDA. Rep. Steve King (R-Iowa), who has introduced a bill (HR 712) under which the Medicare prescription drug benefit could not cover most ED medications, released the new CBO cost estimate as part of his effort.
According to CBO, ED medications will cost Medicare $1.93 billion over 10 years, including $730 million over the first five years. After 2010, the cost will increase by $20 million per year until 2015, at which time Medicare will spend $280 million annually on ED medications, according to CBO. "It's a number that's just shocking," King said, adding, "When you're looking at it starting out at $90 million a year (in fiscal year 2006) and goes up (by 2015) to $280 million -- that's not loose change. That's a huge pile of recreational drug bills." King, who has 26 co-sponsors for his bill, said that he hopes to attract additional co-sponsors before he calls for hearings on the legislation. "We've got to beat this drum and get more people to sign on," he said, adding, "If we can't pass this legislation and Medicare moves forward and funds recreational sex drugs for seniors, then what couldn't we fund with taxpayers' dollars?"
Jeff Trewhitt, a spokesperson for the Pharmaceutical Research and Manufacturers of America, declined to comment on the new CBO cost estimate but said that the group opposes the King bill. "Products that treat erectile dysfunction are part of the overall treatment of patients. Medicare and Medicaid patients should not be like second-class citizens when their diseases are treated," he said (Dinan, Washington Times, 5/17).
In related news, the Kaiser Family Foundation and the Alliance for Health Reform on Monday cosponsored a panel discussion on concerns about how beneficiaries dually eligible for Medicare and Medicaid will transition to prescription drug coverage under Medicare, CQ HealthBeat reports. Dual eligibles who currently receive prescription drug coverage under Medicaid will transition to Medicare when the prescription drug benefit begins in 2006. However, health care experts have raised concerns that some dual eligibles "could be hurt by the transition," according to CQ HealthBeat.
"The worry is that not all seven million people will make this transition smoothly," panelist Tricia Neuman, a vice president and director of the Medicare Policy Project at the Kaiser Family Foundation, said. She added, "A lot needs to be done to make sure that there aren't any gaps and make sure no one falls through the cracks." Neuman said that CMS or states will inform dual eligibles about the transition to Medicare and assign them a prescription drug plan to help with the transition. She added that Medicare beneficiaries will have the ability to change prescription drug plans to address individual medication needs. Neuman said that the Kaiser Family Foundation and CMS expect about 29 million of the 40 million Medicare beneficiaries to enroll in the prescription drug benefit by January.
Panelist William Scanlon, a senior policy adviser with Health Policy R&D, raised concern about efforts to educate Medicare beneficiaries about the prescription drug benefit. "We're talking about the entire Medicare beneficiary population," he said, adding, "It is going to be very important that the word get out to the beneficiaries so we can achieve these levels." Scanlon also cited the need for a "discussion about how we are going to finance long-term care in the future."
Panelist Linda Fishman, director of the Office of Legislation at CMS, said that the agency this year has worked to educate Medicare beneficiaries about the prescription drug benefit, adding, "Outreach is what CMS is all about" (CQ HealthBeat, 5/16).
Additional information on the Medicare drug benefit is available online.