THE MEDICARE DRUG PLAN?GOOD AND BAD

The US Congress has now passed - and the President is certain to sign?legislation creating a prescription drug benefit for the nation's 42 million Medicare enrollees. The legislation, which takes effect in 2006, is the first major change to the massive senior citizen health program since its 1965 creation.

There is little question that prescription drugs are a frontline means of treatment for Americans. According to the National Association of Chain Drug Stores, more than 80% of patients who walk into a physician's office leave with a prescription in hand.

With US seniors being the fastest-growing population segment, it stands to reason that they have and will continue to have escalating drug care costs. Moreover, millions of American seniors have no prescription drug coverage or are having their benefits reduced or eliminated. Throw in the aging baby boom generation, and you have the makings of a potentially huge future Rx drug need.

The plan does have its complexities and questions?for patients and pharmacists. To begin benefits next year, Medicare enrollees must purchase a $30 drug discount card that supposedly will offer savings from 15% to 25% on Rx drugs (more cards for pharmacists to deal with). Where will this savings come from?the community pharmacy? How much more can community pharmacy absorb and still remain in business? When the new benefit begins in 2 years, after a $250 deductible and a monthly fee of $35, seniors will have 75% of their drug costs covered up to $2250. Then, however, there is a coverage gap up to $5100, after which the government will pay 95%.

Too often media types underscore the high price of medications. There is another side, one that is rarely discussed, and that is the long-term economic benefits of effective drug therapy. The best way to combat the overall rise in health care costs is for patients in need to be on effective drug therapy - thereby avoiding more expensive treatments (eg, surgery and inpatient hospital care).

The Medicare plan - even with all of its shortcoming - begins prescription drug benefits for America's seniors. Doubtless, it will have a significant impact on the daily practice of pharmacy.

"Change is the law of life. And those who look only to the past or present are certain to miss the future." - President John F. Kennedy