Keeping you updated on the latest Medicare and Part D news

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Negative Perceptions of Generic Drugs

In Why the Bad Rap on Generic Drugs?, Katie Thomas explores reasons for negative patient and prescriber attitudes towards generic drugs. 

The BBC recently reported on FDA efforts to increase quality controls in India to counter perceptions that generic drugs are of lower quality than their brand counterparts. India currently produces nearly 40% of generic drugs used in the US, and this share is expected to grow.



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FDA Supports New Regulation of Narcotic Painkillers

The FDA recommended today several measures that change access to commonly used narcotic painkillers, including reducing the number of refills per prescription and reclassifying painkillers with hydrocodone as “Schedule II” drugs. 

The FDA had previously rejected recommendations for tighter controls on narcotic painkillers, citing potential hardships and costs for patients. The DEA has long advocated controls to reduce prescription drug abuse, especially as painkiller overdose deaths are reaching all time highs.


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Geographic Variations in Medication Use Among Part D Beneficiaries

The most recent report from the Dartmouth Institute for Health Policy analyzed 2010 prescription data from Medicare Part D, and discovered significant geographic disparities in the use of high-risk medication and key treatments. For example,

Seniors who live in Alexandria, La., were more than three times as likely as those in Rochester, Minn., to receive those potentially harmful drugs, which include muscle relaxants and anxiety relievers that can cause excessive sedation, falls and other problems in older adults.

On the flip side, far more seniors who survived a heart attack were filling prescriptions for cholesterol-lowering statin drugs in Ogden, Utah, than in Abilene, Texas — 91 percent compared to just 44 percent, the study found. That’s even though statins are proven to reduce those patients’ risk of another heart attack.


Researchers also found that patients in regions with higher Part D spending were not more likely to receive the most effective medications. According to the study, the general health of a region’s Medicare population accounts for less than a third of the geographic variation found. Lead researcher Dr. Jeffrey Munson believes that prescriber adherence to best medication practices would greatly reduce these disparities.


Dartmouth Atlas Report

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California Governor Jerry Brown Vetoes Biosimilar Drugs Bill

On October 12th, Governor Brown returned a biosimilar drugs bill without his signature (see earlier post for more details about the vetoed bill).

The bill would have allowed the substitution of biologics with biosimilars that were deemed interchangeable by the FDA, and required physician notification of any substitutions. As the FDA has not yet determined the criteria for labeling a biosimilar and biologic drug interchangeable, Governor Brown felt that it was premature to require prescriber notification. Those against the bill felt that prescriber notification would cast doubt on the safety and effectiveness of biosimilar drugs.


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“Paying Till It Hurts” series on US Health Care Costs

Elisabeth Rosenthal, a correspondent for The New York Times, spent a year investigating the high cost of health care. Her findings can be read in the series “Paying Till It Hurts.” The most recent installment focuses on the growing cost of asthma and reasons for the lack of affordable asthma treatment.

One of the major issues is the lack of generic substitutions for asthma treatment. Rosenthal writes,

“sprays, creams, patches, gels and combination medicines are more difficult to copy exactly to make a generic that meets Food and Drug Administration standards. Each time a molecule is put in a new inhaler or combined with another medicine, the amount delivered into the lungs or through the skin may change, even though that often has an imperceptible effect on patients.

“Drug companies can switch devices and use different combinations, and it becomes quite difficult to demonstrate equivalence,” Dr. Norman said, adding that inhaler makers have exploited such barriers to increase sales of medicines long after the scientific novelty has passed.”

The Soaring Cost of a Simple Breath

To listen to the author’s NPR interview and access the earlier three installments of “Paying Till It Hurts,” click here.

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2014 Medicare Part D Offerings- Helpful Infographics and Analysis

From the Kaiser Family Foundation:

“Medicare Part D continues to be a marketplace with an array of competing plans offered at a wide range of premiums and benefit designs.

  • In 2014, Medicare beneficiaries will have a choice of 35 stand-alone PDPs, on average, up by four from 2013.  The average premium (weighted by enrollment) is expected to increase by 5 percent across all PDPs from 2013 to 2014 unless many new or current enrollees select lower-priced plans.  As in prior years, the average monthly premium for 2014 masks a significant amount of variation across plans.  Enrollees in two of the most popular PDPs will experience 50-percent premium increases if they stay in the same plans in 2014, while enrollees in three other popular PDPs will see lower premiums.
  • Beneficiaries receiving Low-Income Subsidies (LIS) will have access to a modestly higher number of plans for no monthly premium in 2014 compared to 2013, but some plans have lost their so-called “benchmark” status for 2014, which will require enrollees to switch plans to maintain the full value of their subsidies.
  • The majority of plans offered in 2014 will offer no gap coverage beyond that which is required by the Affordable Care Act (ACA) of 2010, which phases out the coverage gap by 2020.  Under current law, for 2014, manufacturer prices for brand-name drugs purchased in the gap will be discounted by 50 percent (with plans paying 2.5 percent and enrollees paying the other 47.5 percent), and plans will pay 28 percent of the cost for generic drugs in the gap (with enrollees paying 72 percent).
  • Notable trends for 2014 include a growing share of PDPs using preferred pharmacy networks and adopting more formulary cost-sharing tiers.  For example, a majority of PDPs now use preferred pharmacy networks where cost sharing is lower when enrollees use preferred pharmacies and higher outside the preferred network.  In 2006, few PDPs used this type of pharmacy network.”

Medicare Part D: A First Look at Plan Offerings in 2014- Kaiser Family Foundation

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Maine Becomes First State to Allow Prescription Drug Imports

Starting today, Maine residents can directly purchase prescription drugs from foreign pharmacies. The law aims to cut prescription drug costs for employers and residents. In Portland, several companies on the Canadian border have already set up drug plans with foreign pharmacies, saving $3.2 million on employee drugs between 2004 and 2012. Drug manufacturers have opposed on the grounds of patient safety and the lack of FDA oversight.