Minimizing out-of-pocket prescription drug costs for Medicare beneficiaries: not just a drop in the bucket
Journal of the American Pharmacists Association
Objective: To identify the frequency of uptake and financial impact of four cost-minimization strategies used to assist Medicare beneficiaries in lowering their out-of-pocket (OOP) costs.
Design: Cost-savings analysis.
Setting: Twelve outreach events were conducted in six different cities throughout Northern and Central California during the 2013 Medicare open enrollment period.
Participants: Noninstitutionalized Medicare beneficiaries from various socioeconomic backgrounds, including those receiving Medicaid.
Main outcome measures: Potential OOP cost savings for the upcoming year.
Results: In total, 621 beneficiaries were assisted. Part D plan optimization was performed for 535 beneficiaries; the findings indicated that 435 (81%) could save money (average: $1,334) by switching plans in the upcoming year. The results also demonstrated that 28 beneficiaries could save money (mean: $1,274) through a patient assistance program. In total, 16 beneficiaries had self-reported income and/or assets that were low enough to qualify for additional governmental assistance through the low-income subsidy. Finally, less costly therapeutic alternatives were identified for 7 beneficiaries and prescribers accepted recommendations for change in 6 (85%) such cases. In total, beneficiaries could realize more than $770,000 in potential OOP savings from the performed interventions.
Conclusion: Targeted assistance to beneficiaries through a variety of cost-lowering strategies can help significantly reduce OOP costs and thus may also result in lower cost-related medication nonadherence and improved beneficiary outcomes.
Patel, R. A.,
Galal, S. M.,
Woelfel, J. A.,
Carr-Lopez, S. M.,
Minimizing out-of-pocket prescription drug costs for Medicare beneficiaries: not just a drop in the bucket.
Journal of the American Pharmacists Association, 54(6), 604–609.