BACKGROUND: The presence of angiotensin receptor blockers (ARBs) on the formularies of Medicare Part D prescription drug plans (PDPs) is vitally important to the health of seniors who cannot tolerate angiotensin-converting enzyme (ACE) inhibitors. OBJECTIVE: To determine whether ARBs are present on the formularies of PDPs and how the prescription cost-sharing for ARBs under Part D compares to cost-sharing before Part D. DESIGN/PARTICIPANTS: Cross-sectional analyses of March 2006 Medicare Part D formularies (n = 1,446) and of ARB utilization and cost-sharing for adults over the age of 64 included in the nationally representative Medical Expenditure Panel Survey. MAIN OUTCOME MEASURES: (1) Presence of ARBs on Part D formularies. (2) Average out-of-pocket costs for 30-day supply of ARBs before and after Part D (both in 2006 dollars). RESULTS: All PDP formularies included at least 1 ARB. Most plans covered 2 ARBs (41%) and 35% covered all 7. The average monthly copay for the most commonly used ARB, valsartan, is $28 under part D, $14 before Part D for individuals with prescription coverage, and $53 before Part D for individuals without coverage. CONCLUSIONS: Whereas ARBs are present on all Part D formularies, many seniors will pay more for these drugs under Part D. Any savings in copayments under Part D may be erased by the monthly premium and by more expensive cost-sharing when seniors reach the 'donut hole'.
BACKGROUND: The presence of angiotensin receptor blockers (ARBs) on the formularies of Medicare Part D prescription drug plans (PDPs) is vitally important to the health of seniors who cannot tolerate angiotensin-converting enzyme (ACE) inhibitors. OBJECTIVE: To determine whether ARBs are present on the formularies of PDPs and how the prescription cost-sharing for ARBs under Part D compares to cost-sharing before Part D. DESIGN/PARTICIPANTS: Cross-sectional analyses of March 2006 Medicare Part D formularies (n = 1,446) and of ARB utilization and cost-sharing for adults over the age of 64 included in the nationally representative Medical Expenditure Panel Survey. MAIN OUTCOME MEASURES: (1) Presence of ARBs on Part D formularies. (2) Average out-of-pocket costs for 30-day supply of ARBs before and after Part D (both in 2006 dollars). RESULTS: All PDP formularies included at least 1 ARB. Most plans covered 2 ARBs (41%) and 35% covered all 7. The average monthly copay for the most commonly used ARB, valsartan, is $28 under part D, $14 before Part D for individuals with prescription coverage, and $53 before Part D for individuals without coverage. CONCLUSIONS: Whereas ARBs are present on all Part D formularies, many seniors will pay more for these drugs under Part D. Any savings in copayments under Part D may be erased by the monthly premium and by more expensive cost-sharing when seniors reach the 'donut hole'.
Authors: Dana Gelb Safran; Patricia Neuman; Cathy Schoen; Michelle S Kitchman; Ira B Wilson; Barbara Cooper; Angela Li; Hong Chang; William H Rogers Journal: Health Aff (Millwood) Date: 2005 Jan-Jun Impact factor: 6.301
Authors: Anthony H Barnett; Stephen C Bain; Paul Bouter; Bengt Karlberg; Sten Madsbad; Jak Jervell; Jukka Mustonen Journal: N Engl J Med Date: 2004-10-31 Impact factor: 91.245
Authors: William H Shrank; Tuyen Hoang; Susan L Ettner; Peter A Glassman; Kavita Nair; Dee DeLapp; June Dirstine; Jerry Avorn; Steven M Asch Journal: Arch Intern Med Date: 2006-02-13