Making Sense Out of the Medicare Prescription Drug Plans
Since the plan for prescription drug coverage for our Medicare patients was announced, we have been confronted with the need to address many questions raised by our patients and their families. Clearly, we are aware that many patients may not be able to easily afford medications we prescribe, and our hope is that these new drug plans will ensure better access to medication. Low-income Medicare beneficiaries may be particularly in need of the new benefit; we should be able to direct our patients appropriately.
For the past year, AGS has been participating in a broad-based coalition led by the National Council on the Aging (NCOA) that has sought to help low-income Medicare beneficiaries enroll in the prescription drug discount card program. The Access to Benefits Coalition (ABC) is a public-private partnership comprised of nearly 100 organizations, including the Alzheimer’s Association, AARP, and NCOA. The AGS recently received a grant to help extend the reach of the coalition’s work. On the website www.accesstobenefits.org the coalition recently launched BenefitsCheckUpRx™, a new service aimed at helping low-income Medicare beneficiaries navigate the prescription drug plans available from more than 260 government and private programs. A fast, free, confidential service for older persons and their family caregivers earning $19,000 or less for an individual or $25,000 or less for a couple per year, the service gives information on Medicare, state, and pharmaceutical company programs.
The ABC’s objective is to help as many eligible persons as possible learn about and sign up for the best available combination of public and private prescription savings programs to help them lower the cost of their medications. With a feature called the Medicare Card Finder, Medicare beneficiaries or their health care professionals can locate the most suitable cards and enroll online. We urge AGS members to share this information with interested patients, families, and caregivers. For more information on the ABC program, visit www.accesstobenefits.org. The AGS continues to be focused, as its members are, on medication prescribing and the implementation of the new Medicare prescription drug plans. We know that we all must work toward minimizing potential harmful drug-disease or drug-drug interactions. An Agency for Healthcare Research and Quality (AHRQ) study published in the Journal of the American Geriatrics Society (February 2005) found in reviewing data linked to more than 157,517 older adults enrolled in HMOs that potentially inappropriate medication is still commonly prescribed despite more than a decade of research and other efforts focused on this issue.
According to the researchers, in 2000-2001 more than 28% of older adults received one or more of 33 medications deemed potentially inappropriate by medical experts, while approximately 5% received at least one of 11 drugs that had been classified as inappropriate for all older adults. In addition, older patients were prescribed at least one medication that could have caused a harmful drug-disease interaction in nearly 3% of outpatient visits. This demonstrates the need for system-wide improvements, such as implementation of e-prescribing, further education about drug interactions, and improved coordination among all providers. Look for an upcoming column to address one way to potentially improve medication management of our older patients—collaboration with clinical pharmacists.