Price sta­bil­ity

No hike ex­pected in Medi­care drug plan av­er­ages

Modern Healthcare - - The Week In Healthcare - Jessica Zig­mond

Medi­care ben­e­fi­cia­ries won’t see an in­crease in the av­er­age price of Medi­care pre­scrip­tion drug pre­mi­ums next year, HHS of­fi­cials said last week. In 2012, the av­er­age Medi­care pre­scrip­tion drug plan pre­mium will be about $30, com­pared with an av­er­age pre­mium of $30.76 in 2011, ac­cord­ing to HHS. CMS Ad­min­is­tra­tor Dr. Don­ald Ber­wick said in a con­fer­ence call with re­porters that the av­er­age pre­mium is about 44% lower than what had been es­ti­mated in 2003.

The news was part of a larger an­nounce­ment from HHS about the num­ber of Medi­care ben­e­fi­cia­ries who are tak­ing ad­van­tage of drug dis­counts and free preven­tive ser­vices be­cause of last year’s Pa­tient Pro­tec­tion and Affordable Care Act. Ac­cord­ing to HHS, about 17 mil­lion Amer­i­cans, or roughly 51% of those with orig­i­nal Medi­care, have re­ceived preven­tive ser­vices at no cost from Jan­uary through July. Mean­while, about 900,000 Amer­i­cans who reached the dough­nut hole—a term to de­scribe the Medi­care part D cov­er­age gap— have re­ceived a 50% dis­count on their pre­scrip­tion drugs from Jan­uary through June of this year.

In that same call, HHS Sec­re­tary Kath­leen Se­be­lius said nearly one in four se­niors have re­ported skip­ping doses, cut­ting pills in half or not fill­ing pre­scrip­tions be­cause of cost. That’s why, she said, the Affordable Care Act “took ac­tion” last year by pro­vid­ing about 4 mil­lion ben­e­fi­cia­ries in the dough­nut hole with re­bate checks of $250 and this year of­fer­ing a 50% dis­count on pre­scrip­tion drugs. “And the Affordable Care Act will fill in the dough­nut hole un­til that gap is closed by 2020,” Se­be­lius said.

Ber­wick and Cheri Rice, di­rec­tor of CMS’ Medi­care Pay­ment Plan Group, said competition among Medi­care Part D plans,

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