PharmacyChecker Blog

Helping Americans Get The Truth About Prescription Drug Savings
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Future Changes to Medicare Part D may curtail access to affordable medication for millions of seniors enrolled in Part D prescription drug plans, according to Kaiser Health News and USA Today.

The Obama administration wants to remove three drug classes, immunosuppressants, antipsychotics, and antidepressants, from the list of specially protected drugs. What this means is that insurers would no longer be required to cover the majority of these drugs in those classes. What that means is that more  patients will struggle to afford – and even skip – medications due to high out-of-pocket costs at U.S. pharmacies.

An alliance of Democrats, Republicans, drug companies, and patient advocates oppose the proposal. Rep. Tim Murphy, R-PA, who is also a psychologist, fears the worst: “If you restrict access to these drugs you restrict the treatment of mental illness,” he said. “You raise suicide rates.” Murphy’s sharp statement suggests just how important drug coverage for Medicare beneficiaries is. Over half of seniors aged 65 or older take at least five prescription drugs, and a carefully organized prescription plan may have disastrous side-effects if a drug is switched for another. Such substitution would likely occur for many patients if drugs are removed from special protection.

One other proposed change to Medicare Part D is limiting the number of plans offered by insurers to one enhanced and one basic plan per service area. Some seniors’ groups are welcoming the change, noting that with less choice it is easier to choose a health plan. Critics say that the measure would reduce competition, and therefore raise prices. I checked out the plans available in Indiana and found 28 plans altogether. Five companies had more than 2 plans available. If the measure went into effect, that would leave 23 plans. The difference between choosing between 28 and 23 plans is not significant. A reduction this small is also unlikely to significantly impact prices, but it certainly limits choice.

I’m happy to hear lawmakers so outraged by the prospect of high drug prices, noting that they have severe adverse health consequences. Hopefully, moving forward, any outcome from these changes is beneficial for seniors. I’ll be checking.

UPDATE: These proposed changes have been scrapped, read more in our Part II.

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