Reactions are mixed to Medicare drug plan
Pharmacists and doctors say not all beneficiaries equal

Pharmacists and physicians view Medicare's prescription drug benefit as a mixed bag for beneficiaries, according to a national survey released Thursday.

Most of the pharmacists and doctors interviewed for the Kaiser Family Foundation survey said the new program helps elderly and disabled Medicare patients save money. At the same time though, more than 80 percent of pharmacists reported that some customers have had troubles getting medications.

Nearly half of the pharmacists reported customers had to leave stores without their prescriptions because they couldn't afford their share of costs. About 10 percent of doctors said patients suffered health complications because of problems getting their medications under Medicare.

"There's general satisfaction and a general sense the law is producing a benefit for most people. But a significant minority of people are experiencing problems," said Drew Altman, chief executive officer of the Kaiser Family Foundation, a health research group in Menlo Park.

Altman said the foundation wanted to survey people on the front lines, who have seen results of the of the drug benefit plan that began Jan. 1.

The program, administered by private companies, has provided coverage to millions of Medicare beneficiaries who did not have insurance to help pay for medications.

The drug program has been fraught with problems and computer glitches, especially in its early weeks. Medicare has resolved most major computer problems and many other difficulties. But consumer and senior advocates still criticize the program for its complexity and for significant gaps in coverage.

The foundation conducted the survey of 802 pharmacists and 834 doctors between April and July, after many of the startup problems had diminished, but before many seniors started hitting the most significant coverage gap -- the infamous "doughnut hole." Beneficiaries must pay cash for their drugs after total drug spending reaches $2,250. Coverage kicks in again when drug expenses exceed $5,100.

Eighty-six percent of pharmacists and 71 percent of doctors said the benefit is helping people save money. But pharmacists reported frequent and serious problems with the program, known as Medicare Part D.

"If there's any trouble anywhere along the line related to the administration of the Part D benefit, where it hits the fan, it's at the pharmacy," said Michael Negrete, vice president of professional affairs for the California Pharmacists Association.

Pharmacists spend considerable time advising customers about the benefit, Negrete said. According to the survey, 85 percent of pharmacists and 57 percent of doctors said they have "a lot" or "some" responsibility to help their patients understand the program.

Many physicians reported they didn't fully understand which drugs individual plans cover. About 69 percent of the physicians surveyed said they are not very familiar with the plans' formularies, which are the lists of covered medications, and 59 percent said they never or rarely check formularies before prescribing a drug to Medicare patients.

More than 90 percent of both physicians and pharmacists said the Medicare drug benefit law is too complicated.

The Kaiser Family Foundation is also studying patient opinions about the Medicare drug benefit. In the latest patient survey, conducted in early June, more than 8 in 10 seniors said they were satisfied with the program, while 2 in 10 said they had encountered a major problem.

The survey of physicians and pharmacists about the Medicare drug benefit can be found at www.kff.org.

Drug benefit

-- 86 percent of pharmacists and 71 percent of physicians believe the benefit is helping Medicare beneficiaries save money.

-- 53 percent of pharmacists and 27 percent of doctors report the program has resulted in "a lot" of administrative burdens.

-- 91 percent of pharmacists and 92 percent of physicians say the Medicare drug law is too complicated.

Source: Kaiser Family Foundation.

Source SFGate.com