In 1965, the Medicare program was introduced, and today it covers 41 million Americans. It serves all eligible beneficiaries without regard to income or medical history. It plays a central role in the US health care system.
Last year the first major addition to Medicare was passed with the enactment of the Medicare Prescription Drug, Improvement and Modernization Act. Although controversial, the new provisions could have a major impact on pharmacy practice. The major provisions of the law go into effect on January 1, 2006, with the availability of Part D, a prescription drug benefit, but the transition program becomes effective in the spring of 2004 with the availability of a drug discount card and a transitional assistance program.
According to the New York Times (February 6, 2004), 106 health industry companies have applied to sponsor a card. Both the National Association of Chain Drug Stores, in cooperation with Express Scripts Inc, and the National Community Pharmacists Association, in cooperation with MemberHealth Inc and Computer Sciences Corp, are included in this number.
The architects of the Medicare drug program are using the transitional program to offer beneficiaries discounts on prescription drugs with expected savings of 10% to 25%. A major concern to the community pharmacist is, where will this discount come from, the pharmacist or the manufacturer, or both? Additionally, this program will provide $600 per year that low-income beneficiaries can apply toward prescription drug costs.
The coverage area for any card must be at least a state. A beneficiary may have to choose between 30 or 40 different cards. Can you imagine the potential for confusion? A beneficiary is allowed only 1 card, so the decision is critical.
Community pharmacists may find themselves fielding a lot of questions from patients on which card to choose. Your national pharmacy organizations will be doing their best to educate their members, and pharmacist employers will find themselves also trying to educate their employees. Pharmacy Times will do its best to keep you informed too.
The next few months will be very exciting, as patients are enrolled in this drug benefit. Will a future generation of pharmacists be able to look back to 2004 and see that the Medicare Part D benefit was the beginning of growth and improvement in pharmacy practice? I hope so.