Many Drug Discounts Listed on New Medicare Web Site Inaccurate

The new Web site allowing Medicare beneficiaries to compare discounts offered through the new prescription drug card program is "full of inaccurate, erroneous information," some card sponsors said Friday, the New York Times reports (Pear, New York Times, 5/1). Created as part of the new Medicare law, the discount cards will be available beginning Monday to all beneficiaries who do not have prescription drug coverage through Medicaid. Companies offering the cards can charge an annual enrollment fee of up to $30 and likely will offer savings on at least one drug in each of 209 categories of medicines commonly used by Medicare beneficiaries. HHS has approved a number of private companies to offer different discount cards to Medicare beneficiaries. Beneficiaries with annual incomes of less than $12,569 per year for individuals or $16,862 for couples will be eligible for a $600 annual subsidy for their prescription drug costs and will not have to pay enrollment fees. Medicare beneficiaries can use the Medicare Web site or call 1-800-MEDICARE to make card-to-card comparisons of drug discounts. According to HHS Secretary Tommy Thompson, discount cards posted so far on the Web site are offering average savings of about 17% for brand-name drugs and 30% for generic drugs (California Healthline, 4/30). Discounts will be available in June (Lueck/Martinez, Wall Street Journal, 5/3).

Just "hours" after the site was unveiled last week, some card sponsors said that inaccurate information was posted, the Times reports. Craig Fuller, president of the National Association of Chain Drug Stores, said, "In some cases, the numbers may be too low, but in many cases, the numbers are too high." He added that for the most part, the posted discount information "did not reflect all the rebates and discounts available," the Times reports. Stephen Littlejohn, vice president of Express Scripts, which is offering a discount card with NACDS, said that the Web site listed inaccurate prices for the card's discounts on arthritis drugs Vioxx and Celebrex and estrogen therapy Premarin (New York Times, 5/1). Fuller said that some discounts negotiated by card sponsors were not included in the price calculations (Wall Street Journal, 5/3). He "urged the government to take all prices off its Web site until they are corrected," according to the Washington Post (Brubaker, Washington Post, 5/1). "The site is ultimately going to be very valuable, but there are serious technical problems that need to be addressed," Fuller said (Sherman, AP/Atlanta Journal-Constitution, 5/1). Jennifer Leone, a spokesperson for pharmacy benefit manager Medco Health Solutions, said that some price information for the company's card was incorrect or missing. Laurie Meyer, spokesperson for pharmacy chain Walgreens, said, "About half our prices are inaccurate, on the high side" (New York Times, 5/1). According to the Wall Street Journal, the chain "provided incorrect pricing information to the government before the Web site went up, but it was too late to fix it" (Wall Street Journal, 5/3).

CMS held a teleconference last week with drug card sponsors to discuss the problems, the AP/Atlanta Journal-Constitution reports (AP/Atlanta Journal-Constitution, 5/1). CMS Administrator Mark McClellan said the discount information on the Web site is correct, adding the disagreement revolves around rules that require sponsors to assure that prices listed on the Web site will be charged at pharmacies (Washington Post, 5/1). HHS spokesperson Bill Pierce said the government had posted the highest drug prices that beneficiaries might encounter if they use a particular card so that the posted price is "guaranteed" and that beneficiaries can avoid a "bait and switch" scenario (Wall Street Journal, 5/3). McClellan also noted that medication prices vary based on packaging. He added, "We stand by our prices. I do believe the prices are accurate" (New York Times, 5/1).

Citing what they called a "confusing process" for enrollment, Senate Minority Leader Tom Daschle (D-S.D.) and 11 other Senate Democrats on Friday sent a letter to Thompson, asking that Medicare beneficiaries be given a 30-day "grace period" to switch cards after enrolling. Under current rules, once beneficiaries sign up for a particular card, they cannot switch cards again until next year. In response to the letter, Pierce said there is no need for a grace period because "May is an opportunity for seniors to shop. ... They've got the whole month of May to shop for benefits that start June 1, but they can sign up whenever they want" (Kemper, Los Angeles Times, 5/1). Some House Democrats last week released a report showing that prices available through the Medicare discount drug card program are about the same or higher than what beneficiaries would pay for the same 10 drugs from Internet pharmacies Drugstore.com and Costco.com (California Healthline, 4/30). House Ways and Means Committee Chair Bill Thomas (R-Calif.) said, "I don't understand the motives of people who seem to be bent on creating doubt," adding, "Would they be happy if fewer low-income seniors take advantage of the money on the table?" (CongressDaily, 4/30).

The Wall Street Journal on Monday examined how independent pharmacies could be affected by the discount card program. All pharmacies will be required to "pick up part of the cost of the card program" by splitting discounts with drug manufacturers, according to the Journal. But with "narrow markups and a greater reliance on drug sales than their chain competitors," independent pharmacies say their portion of the discount will be "more than they can bear," and it will be much harder to make a profit, the Journal reports. "I feel like we really just got the shaft in the whole deal," Donnie Calhoun, owner of Golden Springs Pharmacy in Anniston, Ala., said. He estimates that his store will lose $125 per day when the program takes effect, and customers will have to wait longer to fill their prescriptions because of added administrative duties resulting from the new program. "These are levels of payment that no independently owned business can sustain," John Rector, general counsel for the National Community Pharmacists Association, said (Adamy, Wall Street Journal, 5/3).

• The Atlanta Journal-Constitution on Monday examined the drug discount card program and how the discounts will vary by card and location. The article provides an overview of the program, a discussion of comments from critics and supporters and an explanation of how beneficiaries can learn more about the discount cards (Lipman, Atlanta Journal-Constitution, 5/3).
  
  
• CBS' "Evening News" on Sunday reported on the new Medicare Web site. The segment includes comments from Elinor Ginzler, manager of AARP's Independent Living/Long-Term Care Initiative (Chen, "Evening News," CBS, 5/2). The complete segment is available online in RealPlayer.
  
  
• C-SPAN's "Washington Journal" on Monday included an interview with Congressional Quarterly Capitol Hill Bureau Chief Mary Agnes Carey about the Medicare drug discount cards ("Washington Journal," C-SPAN, 5/3). The complete segment will be available online in RealPlayer and Windows Media after the broadcast.
  
  
• Roll Call on Monday looked at how the "political battle" over prescription drugs is heating up as both Democratic and Republican lawmakers seek to educate beneficiaries about the discount drug card program. House and Senate Republicans are holding dozens of workshops across the United States, and the National Republican Congressional Committee is booking lawmakers into radio programs in targeted districts to try to "sell" the program, according to Roll Call. Meanwhile, Democratic lawmakers are holding town hall meetings in a number of states, and House Minority Leader Nancy Pelosi (D-Calif.) and Rep. Rahm Emanuel (D-Ill.) are holding press conferences in Washington, D.C., and Illinois, respectively, to address the program (Cillizza/Pershing, Roll Call, 5/3).