Study: Coverage Varies Widely Under Medicare Drug Benefit Plans
Fewer than half of prescription drugs are widely covered among 72 Medicare prescription drug plans in California, according to a study published Tuesday in the Journal of the American Medical Association, the Oakland Tribune reports.
Moreover, the study found that physicians are having more difficulty prescribing medications to Medicare beneficiaries because of the variations among Part D plans and insurers.
The study included stand-alone drug plans, as well as Medicare Advantage plans with a drug benefit. Widely covered drugs were defined as being affordable and available, with a copayment of $35 or less per prescription.
According to researchers, out of the 45% of drugs that were widely covered, 94% of treatments were generic (Vesely, Oakland Tribune, 6/20). Researchers concluded that although the majority of widely used drugs were generic, physicians should not assume they will be covered when writing a prescription, noting that 10% of generic drugs are not covered.
R. Adams Dudley, one of the authors of the study, proposed resolving the problem using technology, such as a Web site that would provide current, easy-to-find drug coverage information. Dudley is affiliated with UC-San Francisco.
Dudley said, "Fundamentally, this is not a coverage problem. It's an information problem."
Aaron Hase, CMS spokesperson, said he is not aware of an effort to provide an online tool for physicians to access drug information. Hase added, "Obviously, we want to minimize the burden on the physician. It's in everyone's best interest" (Colliver, San Francisco Chronicle, 6/21).