Prices Offered Through Medicare Prescription Drug Discount Cards Fluctuate on CMS Web Site

Medicare beneficiaries searching the new Web site designed to help them choose a prescription drug discount card are finding that prices are changing "from week to week," making it difficult to determine which cards offer the best savings, the Wall Street Journal reports (Lueck, Wall Street Journal, 5/19). The discount card program, created as part of the new Medicare law, is available to Medicare beneficiaries who do not have prescription drug coverage through Medicaid. Discount card sponsors can charge an annual enrollment fee of as much as $30 and likely will offer savings on at least one medication in each of 209 classes of treatments commonly used by Medicare beneficiaries. Medicare beneficiaries with annual incomes of less than $12,372 for individuals or $16,608 for couples will qualify for a $600 annual subsidy for their prescription drug costs and will not have to pay enrollment fees. Beneficiaries can use the Medicare Web site or call 1-800-MEDICARE to make card-to-card comparisons of prescription drug discounts. According to HHS Secretary Tommy Thompson, the discount cards provide average savings of about 10% to 17% for brand-name medications and 30% to 60% for generic treatments. Enrollment in the program began this month, and the cards take effect in June (Kaiser Daily Health Policy Report, 5/18).

Fluctuations
According to CMS Administrator Mark McClellan, "many thousands" of people have already signed up for the cards, and interest continues to be high, with the Web site receiving more than seven million hits last week. However, many beneficiaries who visited the Web site have noticed ongoing price fluctuations. For example, a beneficiary in Des Moines, Iowa, examining the prices available through United Healthcare's U Share Prescription Discount Card last week would have found that a one-month supply of cholesterol drug Lipitor, arthritis medication Celebrex and the antidepressant Prozac would have cost a total of $231.17. This week, the total for a one-month supply of the medications was $220.73, a discrepancy that a UHC spokesperson attributes to technical changes and bargaining with drug makers for better prices. Other drug card sponsors say the price changes can present an inaccurate picture of savings. For example, the PBM Plus Senior Care Card available to seniors in Washington, D.C., listed a $221 price for a one month supply of Lipitor, Celebrex and Prozac last week, compared with a $223 price this week. PBM Plus officials said the discrepancy exists despite the fact that they sent the same price data to Medicare both weeks. Medicare officials say the Web site was changed to reflect a narrower geographic area.

Prices Should Stabilize
Price changes are "the result of a variety of factors," including efforts to fix early errors that led to incorrect pricing, the Journal reports. In addition, prices have changed as more pharmacies offering new prices and fees have signed up to accept the discount cards, and as card sponsors bargain with pharmaceutical companies and pharmacies for additional savings. Medicare officials note that although some drug prices have risen in the last several weeks, overall savings increased by about 12% last week from the previous week. Bonnie Burns of California Health Advocates, a senior advocacy group, said the discount fluctuations are "a little distressing because people are going to be locked in to those choices" for the rest of the year. But Medicare officials say they expect price fluctuations to slow in the coming weeks and suggested that some beneficiaries might want to see if prices stabilize before enrolling in a card. Medicare also is planning to make improvements to the Web site in the coming weeks, including adding a feature allowing beneficiaries to view cheaper options for the brand-name drugs they take (Wall Street Journal, 5/19). Join "Ask the Experts" as kaisernetwork.org's Editor-in-Chief and Kaiser Family Foundation Vice President Larry Levitt talks with Michael McMullan of CMS; Patricia Nemore with the Center for Medicare Advocacy; and Julie James with Health Policy Alternatives, about implementation of discount drug cards. The live webcast will begin at 2 p.m. ET on Tuesday, May 25. Call toll-free at 1-888-KAISER8 (524-7378) during the scheduled showtime or submit your questions to ask@kaisernetwork.org before and during the discussion.