Senators Seek Clarification on Effect of Medicare Prescription Drug Benefit on Patient Assistance Programs
Senate Finance Committee Chair Chuck Grassley (R-Iowa) and Sens. Max Baucus (D-Mont.), Orrin Hatch (R-Utah) and John Rockefeller (D-W.Va.) on Monday sent a letter to HHS Inspector General Daniel Levinson asking him to clarify how the Medicare prescription drug benefit will affect pharmaceutical companies' patient assistance programs, CQ HealthBeat reports. Some pharmaceutical companies have said they will end their patient assistance programs on May 15 because they are concerned that the programs could violate federal anti-kickback laws that prohibit drug makers from steering beneficiaries toward their own products.
In January, the Pharmaceutical Research and Manufacturers of America cited a guidance document from the inspector general as the reason for ending the programs. In the document, Levinson said that drug makers can lawfully provide assistance to low-income beneficiaries, in part by contributing to charities that administer the programs.
In Monday's letter, the senators ask Levinson to issue a "prompt and definitive guidance" to assure pharmaceutical companies that the patient assistance programs can continue. The letter says that without such programs, "some Medicare beneficiaries may not otherwise be able to afford their prescription drugs, even if they are enrolled in the ... drug benefit." The letter asks that the clarification be issued "as expeditiously as possible" (CQ HealthBeat, 4/17).
Los Angeles Times: The Times examines how some beneficiaries have found that Medicare drug plans' prices "are sometimes little better, and sometimes worse, than those offered at low-margin pharmacies," especially "[w]hen premiums, copayments, coverage gaps and other costs are figured in." Several small surveys have found that warehouse retailers, such as Costco, and online pharmacies, such as Drugstore.com, offer "better discounts overall" than Medicare drug plans, according to the Times. However, "[e]xperts say the program clearly can benefit chronically or catastrophically ill people who take many costly medications," the Times reports (Reitman, Los Angeles Times, 4/18).
- USA Today: USA Today examines how low-income beneficiaries and "those with few health problems" have been "the slowest to sign up" for the drug benefit. According to USA Today, beneficiaries who could qualify for a low-income subsidy "have been the hardest to enroll, often because of educational or language barriers." Healthy beneficiaries also have not enrolled in large numbers, mostly because many of them do not have high drug costs (Wolf, USA Today, 4/18).