1
|
Murry LT, Witry MJ, Urmie J. Medicare Part D plan-selection experience: qualitative findings from a national cross-sectional survey. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 9:100219. [PMID: 36691455 PMCID: PMC9860376 DOI: 10.1016/j.rcsop.2022.100219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023] Open
Abstract
Background A variety of services exit to assist eligible beneficiaries select Medicare Part D insurance plans; however, selecting an optimal plan remains a challenge. While patients would benefit from evaluating and switching their Medicare Part D plan on a yearly basis, few choose to do so. Objective The objective of this study was to describe the Medicare Part D plan selection experience across all US states. Methods This was a qualitative analysis using data from a cross-sectional Qualtrics panel survey administered in January 2022. Descriptive statistics were generated for demographic and patient-specific items for individuals who provided open-ended survey item responses. Open-coding and content analysis were used to analyze responses to the open-ended survey item. Results Overall, 540 responses were received, with the largest number of responses from Florida (11%, 61). A total of 101 respondents (18.7%) of survey respondents provided open-ended comments. Qualitative analysis identified four response categories: Benefit design, Plan information and selection assistance, Plan Switching, and Plan-selection experience. Conclusions Overall, participants expressed frustrations with high costs and plan restrictions. Many participants needed plan-selection assistance, with some individuals switching plans each year. Recent legislation may address difficulties related to medication costs; however, additional focus on resources and educational interventions may improve the Medicare Part D experience.
Collapse
Affiliation(s)
- Logan T. Murry
- Corresponding author at: The University of Iowa College of Pharmacy, 180 S Grand Ave, United States.
| | | | | |
Collapse
|
2
|
Crowley R, Atiq O, Hilden D. Financial Profit in Medicine: A Position Paper From the American College of Physicians. Ann Intern Med 2021; 174:1447-1449. [PMID: 34487452 DOI: 10.7326/m21-1178] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The steady growth of corporate interest and influence in the health care sector over the past few decades has created a more business-oriented health care system in the United States, helping to spur for-profit and private equity investment. Proponents say that this trend makes the health care system more efficient, encourages innovation, and provides financial stability to ensure access and improve care. Critics counter that such moves favor profit over care and erode the patient-physician relationship. American College of Physicians (ACP) underscores that physicians are permitted to earn a reasonable income as long as they are fulfilling their fiduciary responsibility to provide high-quality, appropriate care within the guardrails of medical professionalism and ethics. In this position paper, ACP considers the effect of mergers, integration, private equity investment, nonprofit hospital requirements, and conversions from nonprofit to for-profit status on patients, physicians, and the health care system.
Collapse
Affiliation(s)
- Ryan Crowley
- American College of Physicians, Washington, DC (R.C.)
| | - Omar Atiq
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (O.A.)
| | - David Hilden
- Hennepin Healthcare, Minneapolis, Minnesota (D.H.)
| | | |
Collapse
|
3
|
Korenstein D, Kaltenboeck A, Mamoor M, Chimonas S. Priceless Knowledge: Attitudes and Awareness Around Drug Pricing Among US Medical Students. MEDICAL SCIENCE EDUCATOR 2021; 31:489-494. [PMID: 34457906 PMCID: PMC8368429 DOI: 10.1007/s40670-020-01190-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/10/2020] [Indexed: 06/13/2023]
Abstract
UNLABELLED High US drug costs have garnered increasing attention, with multiple proposed reforms. While physicians are key stakeholders, medical education about drug pricing is not described, and medical students' understanding and attitudes are poorly understood. To assess students' awareness of drug pricing and its determinants, the authors conducted a cross-sectional, web-based survey of US medical students. Survey items included attitudes and knowledge around drug pricing and relevant education received (e.g., importance, quantity/quality of instruction). A composite knowledge score summed correct responses to 10 knowledge items. Descriptive statistics and t tests were used to evaluate associations. Among 815 viewers of the survey invitation, 361 visited the survey and 240 completed it (view rate 44%; participation rate 77%; completion rate 87%). Most participants were white (62%), in MD programs (82%), and female (53%). Nearly all (> 99%) said it was somewhat or very important to understand factors influencing drug pricing; over 90% were interested in learning more. Among year 3-4 students (n = 108), 59% reported receiving medical school instruction on pricing; few rated the quantity as adequate (7%) or the quality as excellent (3%) or good (8%). Among 10 knowledge questions, the median correct score was 6. Fewer than half (44%) knew that prices are uncorrelated with research/development costs. Knowledge was associated with year in school (p = 0.011) but not reported instructional quality or quantity. In sum, medical students report interest in drug pricing but inadequate instruction, and their knowledge is incomplete. Enhanced education is needed to equip future doctors to advocate effectively for patients around drug prices. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-020-01190-x.
Collapse
Affiliation(s)
- Deborah Korenstein
- Center for Health Policy & Outcomes, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, New York, NY 10017 USA
| | - Anna Kaltenboeck
- Center for Health Policy & Outcomes, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, New York, NY 10017 USA
| | - Maha Mamoor
- Center for Health Policy & Outcomes, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, New York, NY 10017 USA
| | - Susan Chimonas
- Center for Health Policy & Outcomes, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, New York, NY 10017 USA
| |
Collapse
|
4
|
Daniel H, Serchen J, Cooney TG. Policy Recommendations to Promote Prescription Drug Competition: A Position Paper From the American College of Physicians. Ann Intern Med 2020; 173:1002-1003. [PMID: 32926798 DOI: 10.7326/m19-3773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The prescription drug market in the United States relies on competition to keep prices reasonable. Although many policies have been implemented to spur competition and decrease costs for patients, these policies may be outdated and should be redesigned and updated to achieve success in the current prescription drug market. In this paper, the American College of Physicians (ACP) proposes that new policies should be implemented to prevent market manipulation, help lower-cost alternatives make it to the market faster, and ensure a robust and competitive market for generic and biosimilar drugs. The ACP believes these changes will have a meaningful effect on patients without shifting costs to other areas of the health care system.
Collapse
Affiliation(s)
- Hilary Daniel
- American College of Physicians, Washington, DC (H.D., J.S.)
| | - Josh Serchen
- American College of Physicians, Washington, DC (H.D., J.S.)
| | - Thomas G Cooney
- Oregon Health & Science University, Portland, Oregon (T.G.C.)
| | | |
Collapse
|
5
|
Hartung DM, Johnston KA, Bourdette DN, Chen R, Tseng CW. Closing the Part D Coverage Gap and Out-of-Pocket Costs for Multiple Sclerosis Drugs. Neurol Clin Pract 2020; 11:298-303. [PMID: 34484929 DOI: 10.1212/cpj.0000000000000929] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 04/24/2020] [Indexed: 11/15/2022]
Abstract
Objective To determine whether closing the Part D coverage gap (donut hole) between 2010 and 2019 lowered patients' out-of-pocket costs for disease-modifying therapies (DMTs) for multiple sclerosis (MS). Methods Using nationwide Medicare Formulary and Drug Pricing Files, we analyzed Part D drug benefit design and DMT prices in 2010, 2016, and 2019. We calculated average monthly list prices for DMTs available in each year (4 DMTs in 2010, 11 DMTs in 2016, and 14 DMTs in 2019). We projected patients' annual out-of-pocket cost for each DMT alone under a standard Part D plan in that year. We estimated potential savings attributable to closing the coverage gap between 2010 and 2019 (beneficiaries' cost sharing dropped from 100% to 25%) under 3 scenarios: no increase in price, an inflation-indexed price increase (3% annually), and the observed price increase. Results Median monthly DMT prices rose from $2,804 to $5,987 to $7,009 over the years 2010, 2016, and 2019, respectively. Median projected annual out-of-pocket costs rose from $5,916 to $6,229 to $6,618. With unchanged or inflation-indexed DMT price changes, closing the coverage gap would have reduced annual out-of-pocket costs by $2,260 (38% reduction) and $1,744 (29% reduction), respectively. Despite having the lowest monthly price, generic glatiramer acetate had among the highest out-of-pocket costs ($6,731 to $6,939 a year) in 2019. Conclusions Medicare Part D beneficiaries can pay thousands of dollars yearly out of pocket for DMTs. Closing the Part D coverage gap did not reduce out-of-pocket costs for patients because of simultaneous increases in DMT prices.
Collapse
Affiliation(s)
- Daniel M Hartung
- College of Pharmacy (DMH, KAJ), Oregon State University, Portland; Department of Neurology (DNB), Oregon Health & Science University, Portland; Pacific Health Research and Education Institute (RC, C-WT), Honolulu, HI; and Department of Family Medicine and Community Health (C-WT), University of Hawai'i John A. Burns School of Medicine, Honolulu
| | - Kirbee A Johnston
- College of Pharmacy (DMH, KAJ), Oregon State University, Portland; Department of Neurology (DNB), Oregon Health & Science University, Portland; Pacific Health Research and Education Institute (RC, C-WT), Honolulu, HI; and Department of Family Medicine and Community Health (C-WT), University of Hawai'i John A. Burns School of Medicine, Honolulu
| | - Dennis N Bourdette
- College of Pharmacy (DMH, KAJ), Oregon State University, Portland; Department of Neurology (DNB), Oregon Health & Science University, Portland; Pacific Health Research and Education Institute (RC, C-WT), Honolulu, HI; and Department of Family Medicine and Community Health (C-WT), University of Hawai'i John A. Burns School of Medicine, Honolulu
| | - Randi Chen
- College of Pharmacy (DMH, KAJ), Oregon State University, Portland; Department of Neurology (DNB), Oregon Health & Science University, Portland; Pacific Health Research and Education Institute (RC, C-WT), Honolulu, HI; and Department of Family Medicine and Community Health (C-WT), University of Hawai'i John A. Burns School of Medicine, Honolulu
| | - Chien-Wen Tseng
- College of Pharmacy (DMH, KAJ), Oregon State University, Portland; Department of Neurology (DNB), Oregon Health & Science University, Portland; Pacific Health Research and Education Institute (RC, C-WT), Honolulu, HI; and Department of Family Medicine and Community Health (C-WT), University of Hawai'i John A. Burns School of Medicine, Honolulu
| |
Collapse
|
6
|
Bornstein SS, Cooney TG. Stemming the Escalating Costs of Prescription Drugs. Ann Intern Med 2020; 172:574-575. [PMID: 32311710 DOI: 10.7326/l20-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Thomas G Cooney
- Oregon Health & Science University, Portland, Oregon (T.G.C.)
| |
Collapse
|
7
|
Jazowski SA, Dusetzina SB. Recommendations for Lowering Prescription Drug Spending in Public Programs. Ann Intern Med 2019; 171:855-856. [PMID: 31711129 DOI: 10.7326/m19-2895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Shelley A Jazowski
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and Duke University School of Medicine, Durham, North Carolina (S.A.J.)
| | - Stacie B Dusetzina
- Vanderbilt University School of Medicine and Vanderbilt-Ingram Comprehensive Cancer Center, Nashville, Tennessee (S.B.D.)
| |
Collapse
|