Many California Medicare Beneficiaries Do Not Receive State-Mandated Discounts on Rx Drugs, Study Finds
Many California Medicare beneficiaries do not receive state-mandated discounts on prescription drugs, according to a study in today's New England Journal of Medicine, the San Francisco Chronicle reports. A 1999 state law (SB 393), which is set to expire this year, requires pharmacies that participate in Medi-Cal to charge seniors who present Medicare cards the same discounted rate for prescription drugs as Medi-Cal beneficiaries receive (Colliver, San Francisco Chronicle, 3/14). In the study, titled "Compliance Among Pharmacies in California with a Prescription Drug Discount Program for Medicare Beneficiaries" and commissioned by the California HealthCare Foundation, researchers from Rand Health studied 494 pharmacies in Los Angeles County and the San Francisco Bay area to determine compliance with the law. Researchers sent 15 Medicare beneficiaries with "special[ized] training" to the pharmacies between April and May 2001 to determine when the pharmacies would offer the Medicare discount -- when the Medicare beneficiaries asked about prices, when they asked about a "senior discount," when they asked about a "Medicare discount" or never. The study found that 75% of the pharmacies complied with the law, but only 45% offered the discount to Medicare beneficiaries "before it was specifically requested." In addition, the study found differences in compliance with the law based on pharmacy classification, region and neighborhood income level. Ninety-one percent of chain drugstores complied with the law, compared to 58% of independent pharmacies; 84% of San Francisco Bay pharmacies complied with the law, compared to 72% Los Angeles County drugstores; and 81% of pharmacies located in higher-income neighborhoods complied with the law, compared to 69% of drugstores in lower-income neighborhoods.
In the study, the Medicare beneficiaries asked pharmacies about the prices of three prescription drugs -- the arthritis drug Vioxx, the antidepressant Zoloft and the cholesterol treatment Lipitor. The study found that Medicare beneficiaries taking the three medications would have saved an average of $55.70 per month, 20% less than the retail price, with the discount provided under the law. According to the study, "Discounts required under California's prescription drug discount program for Medicare beneficiaries offer substantial savings. Many patients, however, especially those who use independent pharmacies or live in low-income neighborhoods, may not receive the discounts" (Lewis et al., NEJM, 3/14). Joy Lewis, lead author of the study, said, "The people who could most benefit from this, people with low incomes, are the ones who are not getting the discount because they are located in lower-income neighborhoods" (Carrero, Los Angeles Times, 3/14). The study recommended that the state develop a system to ensure that pharmacies comply with the law and establish programs to educate Medicare beneficiaries about the state-mandated discount. However, Carlo Michelotti, CEO of the California Pharmacists Association, said that the rate of compliance with the law among state pharmacies "pleased" the group. "When you get 75% complying, that's a pretty great thing" he said, adding, "Would I like to see 100%? Of course" (Bandler, Wall Street Journal, 3/14). Sen. Jackie Speier (D-Hillsborough), who sponsored the 1999 law, has proposed a bill that would extend the prescription drug discount program and would require pharmacies to post information about the discount (Los Angeles Times, 3/14).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.