A change that may affect more than 1,000,000 people on Medicare purchasing brand name rather than generic drugs is being criticized by advocates and a letter was sent to Medicare asking them to "halt the marketing of plans that require the extra charge". If that isn't done, they want the web site changed to reflect how much those enrolled in plans would pay.
via USATOday.com
More than 1 million people in the Medicare drug program next year will pay almost the full price for certain brand-name drugs when they choose them over generics — a move that advocates for patients say is not clearly spelled out by the government nor insurers.
For hundreds of targeted drugs, patients will pay a standard co-payment. They also will pay the difference in price between the brand- name medicine and the generic. The practice in Medicare mirrors similar efforts in job-based insurance.
Medicare says about 10% of insurers will use the extra charge next year.
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Jeffrey Kelman, a chief medical officer for Medicare, says enrollees have not complained about the extra fees, which don't apply to patients eligible for the low-income subsidy. Doctors can seek an exception to the charges for patients who can't take generics for medical reasons. He says Medicare is working on a "fix" for the website.
2 comments:
Even aside from the problem of not fully disclosing the extra expense that certain patients might need to incur, such a policy strikes me as discriminatory toward patients who may sometimes have a genuine *need* for brand name versions of certain medications rather than generics. It's not always a knee jerk snobbish preference for the "original" drug or a mindless prejudice against generics. Brand name and generic versions are not always automatically interchangeable.
My partner has epilepsy. Back when she was taking dilantin, we found that she *always* had more seizures (both petit mal and grand mal) on the generic version of dilantin, but these went away on the brand name version. She had a genuine *need* for brand name dilantin because the generic version just wasn't cutting it. (She's on a different set of meds now, for unrelated reasons. If there is a difference between generic and brand name for those then the distinction is not as clear. But it was very marked and unmistakable with Dilantin.) If a doctor and patient has come to a reasoned decision based on observed responses that the patient NEEDS (not just randomly prefers) the brand name version of a particular medication then they should not be automatically forced to pay more.: a patient can't help if their physiology just happens to respond to one medication but doesn't to another that is supposed to be similar (but actually isn't).
You make many good points in your comment. I'm always concerned whenever changes like this are made to the drug plans on Medicare because so many of those who most need medications may already be budgeting in a way that forces them to decide between food and medication.
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