Rx BENEFIT CAPS DO NOT LOWER HEALTH COSTS, STUDY CONFIRMS

Pharmacy Times, Volume 0, 0

Efforts by Medicare officials to cut costs byimposing benefit limits on prescription drugshave backfired, according to a new study byresearchers at Kaiser Permanente. The study,which included 200,000 Medicare beneficiariesin northern California, found that patients whoreached the limit of their drug benefitsresponded by reducing medication levels orstopping taking their prescriptions altogether.These actions increased their health costs as aresult of higher blood pressure, blood sugar,and cholesterol levels.

The research, which was reported in the New England Journal ofMedicine (June 1, 2006), compared the health of patients on MedicarePlus Choice health plans, who had a $1000 cap on prescription drugs,with the health of patients with no caps because their employers subsidizedtheir drug coverage. According to the study results, patients subjectto the caps spent 31% less on prescription drugs, but their overallmedical costs were the same because of more visits to hospitals andemergency rooms.

"The net effect was no savings," a Kaiser Permanente researcher said."One can't look at drug costs alone. You have to look at the whole healthcare picture for patients as well as society at large."