HHS enhances Medicare drug card program to help seniors

Sep 15 2004

Health and Human Services Secretary Tommy G. Thompson today announced new measures to help seniors get the lowest price possible for their medicines by allowing them -- for the first time -- to compare prices for similar drugs used to treat common diseases such as high cholesterol or blood pressure.

Secretary Thompson said the enhancements to the Medicare-endorsed drug discount program give seniors another tool to save even more money on their prescription drugs and will create more incentives for drug companies to lower their prices as they compete for consumers.

"We are creating greater competition among drug companies and making the price of prescription drugs more transparent - giving seniors more power to compare prices and choose the lowest-cost medicine that's right for them," Secretary Thompson said. "It's another example of President Bush taking decisive action to drive down health care costs for Americans."

The "Lower Cost Rx Comparison Tool" -- accessible at www.Medicare.gov or by calling 1-800-MEDICARE -- will help consumers compare lower-cost prescription drugs by category (cholesterol lowering drugs, blood pressure medicines, allergy medications, etc.) that are similar to the drugs they currently take and are used to treat the same conditions.

Secretary Thompson called for the new transparency to be added to the Medicare discount drug Web site so that seniors would have an even clearer picture of drug costs so they can make more informed choices about their medicines in consultation with their doctors.

"Many widely-used drugs for common health problems often have similar effects, but rarely do consumers have good information on how their prices compare," said Centers for Medicare & Medicaid Administrator Mark B. McClellan, M.D., Ph.D. "Only physicians can decide what drug is best for their patient. We want to help patients and their physicians find the least costly way to get the health benefits that prescription drugs can provide -- including an informed discussion about whether a less expensive, similar drug is right for them."

Dr. McClellan noted that this new assistance is part of a set of further enhancements in the opportunities to get drug savings through the Medicare drug card program. "Recent independent studies have confirmed that drug cards provide real savings, often over 20 percent on brand-name drugs alone, and now there are even more ways to save. It's all accessible just by calling 1-800-MEDICARE anytime or going to medicare.gov on the Internet," he said.

Medicare beneficiaries interested in using the new comparison tool can simply go to the "prescription drug and other assistance program" section of www.medicare.gov and enter the medications they are currently taking. A customized report will be generated for each of their medications, including less expensive versions of the same drug and brand name and/ or generic versions of similar but less expensive drugs that are available to treat the same condition.

For example, Zocor, a top-selling medication used for treating high cholesterol costs an average of $89.38 per month for the 20 mg. tablets. Using the new comparison tools, a beneficiary will find several lower cost options, including another brand name drug, Altoprev, that costs $57.19 per month for the 40 mg. tablets, an annual savings of $386.32. (It is important to note that different drugs may have different dosing requirements -- which is one reason why this new tool is intended to help doctors and patients make decisions that are informed by cost savings as well as benefits, not to replace those decisions.)

Medicare beneficiaries can take the information they get from the Lower Cost Rx Comparison Tool and discuss it with their doctors. Beneficiaries using the comparison tool will also learn that drugs in a class or category (such as statins, ACE inhibitors, proton pump inhibitors, etc.) to treat similar conditions but may have different side effects. This information should also be discussed with the doctor.

"The new Medicare benefits are saving seniors money on their drugs," Secretary Thompson said. "We are going to remain aggressive in using the new law and new technology to further drive down costs for seniors. We're helping seniors become more informed consumers so they can get the best price and service to meet their needs."

A rigorous medical review process was used to develop the new lower-cost comparison tool. Physicians and pharmacists review all medical content on a monthly basis to ensure the information is up to date. Prices quoted on the site are updated weekly. The comparison tool includes drugs in classes for which substitutions between different drugs should present the lowest number of clinical challenges to patients and providers.

The classes include:

• For lowering blood pressure: ACE Inhibitors, Angiotensin Receptor blockers (ARBs), and Angiotensin Receptor Blockers (ARBs)/Diuretic Combinations,
• For treating the symptoms of allergies: Low and Non Sedating Antihistamines/Decongestant Combinations, and Low and Non Sedating Antihistamines, for treating the symptoms of allergies;
• For lowering cholesterol: HMG-CoA Reductase Inhibitors or "statins"
• For treatment of pain and inflammation: NSAID Cox II inhibitors
• For treatment of stomach irritation and ulcers: Proton Pump Inhibitors.

The tool includes a total 52 drugs, representing about a quarter of all Medicare drug spending.

The Price Compare services available at 1-800-MEDICARE and www.medicare.gov now also include specific information about the breadth of drugs covered by each drug card, to provide more help to beneficiaries who are interested in whether a card would provide discounts on other drugs that they might need in the future. All cards provide discounts on all of the top 100 drugs used by seniors that can be included in the drug card program (benzodiazepines are excluded).

All cards also provide discounts on more than 60 percent of all drug products marketed in the United States that can be included in the drug card program, and 73 percent (48 out of 66) of the national cards provide discounts on more than 80 percent of drug products. This coverage compares favorably to "open formulary" commercial prescription drug plans.

Other enhancements to the Price Compare features of the drug card program include:

• Letting beneficiaries know that they may be able to qualify for the Medicare replacement drug demonstration program, which can provide substantial help with potentially lifesaving self-administered medicines for beneficiaries with diseases that can also be treated by physician-administered drugs covered under Medicare Part B;
• Providing a beneficiary's annual savings by drug card after a beneficiary provides their current drug costs;
• Providing new features that allow beneficiaries to focus their choices only on a particular pharmacy, as well as on only certain drug card sponsors that are available at the beneficiary's preferred pharmacy.