Medicare Drug Plans Pay for 12.4% of Prescriptions
Medicare prescription drug plans paid for 12.4%, or 194.3 million, of the 1.56 billion prescriptions filled in the U.S. from Jan. 1 to June 23, according to new data from IMS Health, the Boston Globe reports. In addition, the percentage of prescriptions for which beneficiaries paid cash decreased to 11.5% during the first half of the year from 12.2% in 2005, and the percentage of prescriptions for which Medicaid paid decreased to 9.1% during the first half of the year from 16.1% in 2005, IMS said.
According to IMS Health, the anticholesterol medication Lipitor had the highest sales among medications for which Medicare prescription drug plans paid during the first half of the year.
The new data from IMS Health "come as Pfizer and other drug makers report second-quarter earnings that clarify Part D's effect on prescription sales," the Globe reports. Last week, Pfizer reported that the Medicare prescription drug benefit accounted for almost half of a 7% increase in second-quarter U.S. sales of Lipitor.
Tim Anderson, an analyst at Prudential Equity Group, also said the Medicare prescription drug benefit could result in an 85% reduction in the $133 million that Pfizer would have spent this year on rebates for dual eligibles who previously received prescription drug coverage through Medicaid.
Pharmaceutical companies must pay rebates to state Medicaid programs to ensure that they receive the lowest price available to private health insurers, but companies as of this year no longer have to pay such rebates for dual eligibles because their prescription drug coverage transferred from Medicaid to Medicare.
As a result, pharmaceutical companies whose products are used by a large number of dual eligibles will receive one-time gains this year and will benefit the most from the Medicare prescription drug benefit, Anderson said.
Ken Johnson, senior vice president of communications for the Pharmaceutical Research and Manufacturers of America, said, "Medicare drug coverage has improved the lives of millions of seniors with 90% of today's Medicare beneficiaries now receiving drug coverage. That's the windfall we should be talking about" (Henderson, Boston Globe, 7/25).