Washington Matters

Will Automatic Enrollment Save the Medicare Drug Card?

From Drug Benefit Trends®

Posted 08/24/2004

By Daniel B. Moskowitz

The response of seniors to the Medicare-endorsed private prescription drug discount cards so far has been less than enthusiastic. When the card program went into operation June 1, just under 2.9 million seniors had cards in hand—far below the 7.3 million that the Bush Administration had suggested would be enrolled.

"It's been a very slow uptake," said Tim Dickman, chief executive officer, Prime Therapeutics. AARP, for example, sent out 26,000 enrollment kits to members and had only 400 sign-ups by June 1. With dozens of cards to choose from, "people are still very confused," explained Eileen Doherty, executive director of the Colorado Gerontological Society. "A lot of people come away with, 'It's not worth my time and energy to do this.'"

There's even less support for the discount cards than the raw numbers suggest. Only about 500,000 of the 2.9 million actually signed up for a card. The rest were issued cards automatically by the Medicare managed care plans in which they were already enrolled.

The Bush Administration seems to have abandoned its 7.3 million cardholder projection. Mark McClellan, head of the Centers for Medicare & Medicaid Services (CMS), now talks in terms of "hundreds of thousands" more enrollees. To reach that goal, CMS is looking to follow the lead of private Medicare HMOs and rely on automatic enrollment to boost the numbers. In a June 8 testimony, McClellan told the Senate Finance Committee that he expects to get 400,000 more cardholders through automatic enrollment of seniors already participating in state drug-purchasing assistance programs in Maine, Massachusetts, Connecticut, New York, New Jersey, Pennsylvania, and Michigan.

HHS Secretary Tommy Thompson insisted that the program already is "successful" because every cardholder has a chance to save money on prescriptions that he or she did not have before. CMS reported on June 7 that an analysis of the card prices of 5 drugs (enalapril, furosemide, metformin, lisinopril, and warfarin) in Albuquerque, NM, and Little Rock, Ark, showed that if seniors used the cards and opted for generic forms of their medications, they could reap savings of as much as 92% off the list price of brand-name drugs.

More Medicare beneficiaries are expected to ask for cards now that the program is fully operational. A Walgreens spokesman observed that "there is a momentum building," noting that enrollment in the chain's card plan surged in the final days of May.

Daniel B. Moskowitz, Washington, DC-based Journalist

Drug Benefit Trends 16(7):355, 2004.
© 2004 Cliggott Publishing, Division of CMP Healthcare Media

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