AstraZeneca will Cover Co-pay for Medicare Part D

It's great to see how pharmaceutical companies are helping patients who are unable to afford their medications during these difficult economic times. We've seen many different patient assistance programs that have helped many people gain access to vital medications. AstraZeneca has made another step to help those on Medicare Part D. Here's a press release that was published today:

AstraZeneca Medicare Part D patient assistance program no longer requires co-pays

December 8, 2009 – Wilmington, DE – AstraZeneca (NYSE:AZN) announced today that patients enrolled in the company’s Medicare Part D prescription savings program will no longer pay co-pays for their medicines through the program.

Prescriptions also now will be mailed to patients’ homes or physician’s offices under the changes to the AZ&Me™ Prescription Savings program for people with Medicare Part D. The changes will take effect Jan. 1, 2010.

“These changes will better serve Medicare Part D enrollees by making it easier for them to access the medicines they need,” said Rich Fante, US President, AstraZeneca Pharmaceuticals LP. “This prescription savings program and these latest improvements reflect our ongoing commitment to patient health.”

Currently, patients enrolled in the program fill their AstraZeneca prescriptions at retail pharmacies and have a co-pay of between $15 and $25, depending on their qualifying income. The elimination of a co-pay will save approximately 30,000 patients enrolled in the program a total of $3 million each year.

Program Details

Eligible patients can enroll in the AZ&Me™ Prescription Savings program for people with Medicare Part D at any time in the calendar year, but must meet program requirements in order to start utilizing the benefit.

The AZ&Me™ Prescription Savings program for people with Medicare Part D is one of three distinct prescription savings programs in the AZ&Me Prescription Savings Program suite. Other AZ&Me Prescription Savings Programs include a plan for individuals without insurance and one for healthcare facilities.

To learn if you qualify for the AZ&Me Prescription Savings Programs, please visit www.AZandMe.com or call 1-800-AZandMe. Program specialists are available Monday through Friday between the hours of 9:00 AM and 5:00 PM EST.

Other prescription savings programs are available regardless of which medications your doctors prescribe. To find out more about the more than 475 savings programs covering 2,500 medications, please visit www.pparx.org or call 1-888-4PPA-NOW (1-888-477-2669).

To learn more, visit AstraZeneca

People want healthcare coverage but many can't afford it

President Obama spoke about the fact that most Americans want healthcare coverage, but many simply can't afford it. I think my favorite moment was when he spoke about Medicare Part D. When seniors hit the Medicare Part D doughnut hole, they "drop off a cliff."

Here are some of my questions regarding healthcare insurance reform:

• How will hardship exemptions get allocated? Will they be fully transparent about the money that funds these exemption programs?
  
• How should the government "regulate" medical practice? Will the government really be transparent about all the regulations and changes?
  
• How can we reduce the "waste" in healthcare? Perhaps we need to shift from a "defensive" medicine mindset to a cost-savings mindset.Perhaps we need to focus more on prevention.

I agree that repeat medical tests are wasteful. Whether you're repeating labs or imaging studies, this type of practice is really wasteful. Health information technology (Health IT) should help reduce this type of waste as long as all the systems talk to each other.

Role models healthcare organizations according to President Obama:

• Mayo Clinic
• Cleveland Clinic

Finally, I'd like to comment about his statement that he's followed by a doctor every minute. Sounds like some serious concierge medicine! And then he said, "it's not about me." Most people can't afford basic health insurance. The rich can afford concierge medicine. Where's the middle ground and how long will it take to get there?

Q&A with Medicare about e-prescribing incentives

Medicare can be so confusing. I'm not even talking about Part D and the donut hole (yummy, I love donuts). The e-prescribing incentives can get a bit confusing, especially if you were used to the e-prescribing quality measure that was included in the Physician Quality Reporting Initiative (PQRI) before Jan 1, 2009. To provide some clarity on this topic, let me do a bit of a "Q&A" with Medicare about the e-prescribing incentives. All this content is directly from the HHS.gov website.

Here's the first question:

"What requirements/qualifications are needed to successfully participate in the new Electronic Prescribing (e-prescribing) Incentive Program?"

Answer:

To be a successful e-prescriber for the 2009 e-prescribing Incentive Program, an eligible professional must have adopted a qualified e-prescribing system that employs standards adopted by the Secretary for Part D by virtue of the 2003 Medicare Modernization Act (MMA) and is capable of ALL of the following functions:

• Generating a complete active medication list incorporating electronic data received from applicable pharmacy drug plan(s) if available

• Selecting medications, printing prescriptions, electronically transmitting prescriptions, and conducting all alerts (defined below)

• Providing information related to lower cost, therapeutically appropriate alternatives (if any) (the availability of an e-prescribing system to receive tiered formulary information, if available, would meet this requirement for 2009)

• Providing information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan, if available

Two additional criteria must also be met for the incentive program to be a successful e-prescriber and qualify for the incentive: 1) Medicare charges for the e-prescribing measure codes (delineated in the denominator of the measure specification found here) comprise at least 10% of total Medicare Part B allowed charges; and 2) at least 50% of all Medicare Part B patient encounters (denominator-eligible cases) for the e-prescribing measure must be reported during the 2009 reporting period.

Are you ready for a second Q&A? How about this: I'll try to cover 1 key Q&A topic each day over the next few weeks.

Medicare Part D increases spending on prescription drugs

Is that what you were expecting? In a recent article in the New England Journal of Medicine (NEJM), we see that the authors conclude that "Enrollment in Medicare Part D was associated with increased spending on prescription drugs. Groups that had no or minimal drug coverage before the implementation of Part D had reductions in other medical spending that approximately offset the increased spending on drugs, but medical spending increased in the group that had more generous previous coverage."

Between December 2005 and December 2007, as compared with the increase in the no-cap group, the increase in total monthly drug spending was $41 higher among enrollees with no previous drug coverage, $27 higher among those with a previous $150 quarterly cap, and $13 higher among those with a previous $350 cap. I wonder if the government knew this was going to happen.

The article is titled, "The Effect of Medicare Part D on Drug and Medical Spending." Click here to access the abstract. The authors on this study included: Yuting Zhang, Ph.D., Julie M. Donohue, Ph.D., Judith R. Lave, Ph.D., Gerald O'Donnell, M.S., and Joseph P. Newhouse, Ph.D.

PhRMA to find $80 billion in discounts

Our country needs healthcare reform. What's the pharmaceutical companies doing about it? How are they contributing?

PhRMA members are pledging to find $80 billion in discounts. The Pharmaceutical Research and Manufacturers of America (PhRMA) represents the country’s leading pharmaceutical research and biotechnology companies. This may include reducing drug prices by 50% to seniors in the Medicare Part D “donut hole” coverage gap. The complete details of this plan are still in process and it won't be finalized until the plan is scored by the Congressional Budget Office.

At at a press conference with AARP officials, President Obama made the following statement: “The agreement by pharmaceutical companies to contribute to the health reform effort comes on the heels of the landmark pledge many health industry leaders made to me last month, when they offered to do their part to reduce health spending $2 trillion over the next decade... We are at a turning point in America's journey toward health care reform. Key sectors of the health care industry acknowledge what American families and businesses already know - that the status quo is no longer sustainable. The agreement reached today to lower prescription drug costs for seniors will be an important part of the legislation I expect to sign into law in October. And to do that we're going to have to work together to root out waste and inefficiencies that may pad the bottom line of the insurance industry, but add nothing to the health of our nation. To that end, the pharmaceutical industry has committed to reduce its draw on the health care system by $80 billion over the next 10 years as part of overall health care reform."