Abstract
BackgroundMedicare beneficiaries without prescription drug coverage consistently fill fewer prescriptions than beneficiaries with some form of drug coverage due to cost. ESRD patients, who are disproportionately poor and typically use multiple oral medications, would likely benefit substantially from any form of prescription drug coverage. Because most hemodialysis patients are Medicare-eligible, they as well as their providers would be expected to be well informed of changes in Medicare prescription drug coverage. By examining the level of understanding and use of the temporary Medicare Prescription Drug Discount Card Program in the hemodialysis population, we can gain a better understanding of the potential long-term utilization for Medicare Part D.MethodsWe surveyed English-speaking adult hemodialysis patients with Medicare coverage from two urban hemodialysis centers affiliated with the University of California San Francisco (UCSF) during July and August 2005 (n = 70). We also surveyed University- and community-based nephrologists and non-physician dialysis health care professionals over the same time frame (n = 70).ResultsFifty-nine percent of patients received prescription drug coverage through Medi-Cal, 20% through another insurance program, and 21% had no prescription drug coverage. Forty percent of patients with no prescription drug coverage reported "sometimes" or "rarely" being able to obtain medications vs. 22% of patients with some form of drug coverage. None of the patients surveyed actually had a Medicare-approved prescription drug card, and of those who intended to apply, only 10% reported knowing how to do so. Only 11% health care professionals knew the eligibility requirements of the drug discount cards.ConclusionDespite a significant need, hemodialysis patients and providers were poorly educated about the Medicare Prescription Drug Discount Cards. This has broad implications for the dissemination of information about Medicare Part D.
Highlights
Medicare beneficiaries without prescription drug coverage consistently fill fewer prescriptions than beneficiaries with some form of drug coverage due to cost
We surveyed hemodialysis patients from two urban hemodialysis centers affiliated with the University of California San Francisco (UCSF) during July and August 2005
We asked for information on current medical insurance coverage, prescription drug coverage, ability to pay for medications and the use of Medicare-approved Prescription Drug Discount Cards
Summary
Medicare beneficiaries without prescription drug coverage consistently fill fewer prescriptions than beneficiaries with some form of drug coverage due to cost. By examining the level of understanding and use of the temporary Medicare Prescription Drug Discount Card Program in the hemodialysis population, we can gain a better understanding of the potential long-term utilization for Medicare Part D. Medicare beneficiaries without prescription drug coverage have considerable difficulty filling prescriptions due to costs. Medicare beneficiaries without drug coverage filled one-third fewer prescriptions in 2002 than beneficiaries with some form of drug coverage – a difference that (page number not for citation purposes). The Medicare Prescription Drug Discount Card and Transitional Assistance Program were intended as temporary measures to provide immediate assistance in lowering prescription drug costs for persons in need. The law made Medicare-approved Prescription Drug Discount Cards available to Medicare beneficiaries as of May 2004, in place until Medicare Part D prescription drug coverage began on January 1, 2006 [2]
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