by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, Pharmacychecker.com | Mar 12, 2014 | Drug Prices, Healthcare Reform, Medicare Drug Plans
Last week, we reported on proposed changes to Medicare Part D that could have made it harder for millions of seniors to obtain prescribed medicine. One congressman from Pennslvania, Tim Murphy, went so far to say that suicide rates would increase as a result of the proposed changes, referring to a change that would have allowed insurers to reduce coverage for antipsychotics, immunosuppressants, and antidepressants. Other proposed changes included allowing the government to intervene in contracts between insurers and pharmacies, limiting the number of drug plans available, and also expanding access to community pharmacies.
Outcry from both sides of the aisle, as well as patient and consumer rights advocates, has resulted in the Obama administration reversing course on the changes. “We will engage in further stakeholder input before advancing some or all of the changes in these areas in future years,” wrote Marilyn Tavenner, Administrator of the Centers for Medicare and Medicaid Services.
We are glad specifically that coverage for critical medication will remain strong and that the number of drug plans will not be limited in certain areas. We know that the intention of reducing drug plans was to help make it easier to choose a plan. On the other hand, we support expanding access to community pharmacies and hope for further action on that front.
Fortunately, there are online resources that can help with this. Not all Medicare drug plans are created equal. PharmacyChecker.com runs MedicareDrugPlans.com, which you can use to compare plans and read or write reviews on those plans available in your area.
Tagged with: Marilyn Tavenner, Medicare Part D, medicaredrugplans.com, Tim Murphy
by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, Pharmacychecker.com | Mar 6, 2014 | Drug Prices, Healthcare Reform, Medicare Drug Plans
Future Changes to Medicare Part D may curtail access to affordable medication for millions of seniors enrolled in Part D prescription drug plans, according to Kaiser Health News and USA Today.
The Obama administration wants to remove three drug classes, immunosuppressants, antipsychotics, and antidepressants, from the list of specially protected drugs. What this means is that insurers would no longer be required to cover the majority of these drugs in those classes. What that means is that more patients will struggle to afford – and even skip – medications due to high out-of-pocket costs at U.S. pharmacies.
An alliance of Democrats, Republicans, drug companies, and patient advocates oppose the proposal. Rep. Tim Murphy, R-PA, who is also a psychologist, fears the worst: “If you restrict access to these drugs you restrict the treatment of mental illness,” he said. “You raise suicide rates.” Murphy’s sharp statement suggests just how important drug coverage for Medicare beneficiaries is. Over half of seniors aged 65 or older take at least five prescription drugs, and a carefully organized prescription plan may have disastrous side-effects if a drug is switched for another. Such substitution would likely occur for many patients if drugs are removed from special protection. (more…)
Tagged with: Medicare Part D, Tim Murphy
by Gabriel Levitt, President, PharmacyChecker.com and Prescription Justice | Dec 6, 2013 | Drug Prices, Healthcare Reform, Medicare Drug Plans
Your prescription drugs will never be free under Medicare Part D. The “closed” donut hole under Obamacare does not create a new coverage period under Part D during which your co-pays and co-insurance, not to mention deductibles and premiums, disappear. That’s not a reason to complain. We should shoulder costs for our healthcare, including medication, as long as they are affordable (after all, Obamacare is actually called the Affordable Care Act). So how does Obamacare strive to help you afford your prescription drugs if you’re on Medicare? First, a little history…
In the beginning, Medicare did not offer a prescription drug benefit and tens of millions of seniors paid for their medications entirely out-of-pocket. Let there be light: In 2003, Congress passed the Medicare Modernization Act, which was then signed into law by President Bush. That law gave birth to Part D – a prescription drug benefit available to Medicare enrollees. But there were holes! When Medicare Part D plans first launched in 2006, average monthly premiums were $25.93. After paying a standard deductible of $250, enrollees paid 25% of their drug costs until total drug costs (between the enrollee and insurer) reached $2,250. That’s $250 towards the deductible, $500 in cost-sharing, plus premiums of $311.16 for a total of $1,061.16 per year in out-of-pocket spending. That’s if you stayed out of the donut hole!
Enter the dark days of the “donut hole,” which, in 2006, meant 100% out-of-pocket spending between $2,250 and $5,100 – Ouch! Above $5,100 – an amount called, for good reason, “catastrophic costs” –enrollees only paid 5% of their drug costs. Part D maintained these basic components, except with rising costs in the form of higher premiums and deductibles, and a larger “donut hole,” until the passage of the Patient Protection and Affordable Care Act in 2010 – enter Obamacare (hope and change?).
(more…)
Tagged with: donut hole, Medicare Part D, Obamacare
by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, Pharmacychecker.com | Oct 2, 2013 | Drug Importation, Healthcare Reform, Online Pharmacies, Politics
This past Monday, we reported that average savings from international online pharmacies are now 87% on popular brand name meds, up from 85% a year ago. As Americans gain access to health insurance through state exchanges under Obamacare, which kicked off yesterday, will there still be a need for the international online pharmacy option?
Yes.
It may come as a surprise, but international online pharmacies benefit people with insurance, not just the uninsured. If a plan does not cover a drug, or has a high deductible or co-pay, ordering from abroad may help those on that particular plan. Fortunately, new health plans will help millions of Americans afford needed medication at neighborhood pharmacies, but some will continue to fall through the cracks.
Twenty-one percent of Americans with prescription benefits skipped filling a prescription in 2012 because of high prices, according to the Commonwealth Fund. Therefore, unless drug prices unexpectedly come down in America, we can predict that millions of Americans will still struggle with high drug prices in the U.S., and that many of them will seek relief from international online pharmacies.
There are other reasons that Americans can’t count on Obamacare to improve their access to affordable medication, especially in 2014. Due to a delay in implementing Obamacare’s spending cap of $6,350 a year, insurance plans that use more than one benefits administrator will not be subject to the cap next year. Instead, they will apply the cap to each benefit separately. Thus, Americans choosing an insurance plan that works with an independent pharmacy benefit manager may see one cap for doctor and hospital visits of $6,350 and another cap of $6,350 for medication! See our blog post “Obamacare Out-of-Pocket Cost Delays A Bad Prescription for Consumers” for more information on this topic.
Last but not least, the new plans may leave you with huge out-of-pocket drug costs if you take expensive medications. A report in the New York Times shows that plans in some states will require patients to pay as much as 50% of a drug’s cost. Depending on the medication, 50% of a drug’s price can be prohibitive for many Americans. The Times article mentions the drug Tecfidera, which costs $4,000 a month; many Americans will struggle to make the initial payments of $2,000 or more before their out-of-pocket limit is reached.
We believe that over time Obamacare will succeed in helping millions of Americans afford medical care, including prescription medication. But the road ahead is a long one and we can’t let tens of millions continue to go without medication in the years to come. Fortunately, the lifeline of safe personal drug importation through verified international online pharmacies is available. If you choose to order from abroad, make sure you only order form a credentialed, verified pharmacy, such as those listed on PharmacyChecker.com.
We will continue to monitor and report on how Obamacare affects drug prices and access by Americans to prescription medication.
Tagged with: Commonwealth Fund, New York Times, Obamacare, out-of-pocket costs
by PharmacyChecker.com | Sep 30, 2013 | Drug Prices, Healthcare Reform, Online Pharmacies, Politics
Insured Americans, including those on Medicare, too often find that the brand name drugs they are prescribed are not covered by their plans. That population of underinsured Americans may increase under Obamacare. Fortunately, they will find that drug prices offered by international online pharmacies are often 87% lower than their local pharmacies. These prices seem too good to be true, so you might be asking how this is possible. It’s simple: governments in other countries negotiate with drug companies to keep drug prices affordable. Licensed pharmacies in those countries operate online and by mail-order to serve Americans seeking medications sold here at a much lower price. Here are the savings on popular drugs:
Prices for a 3-month supply of top-selling brand name medications*
| Drug |
Local Pharmacy Price |
International Online Pharmacy Price |
International Online Savings |
Annual Dollar Savings |
| Abilify 10 mg+ |
$2,582.97 |
$331.20 |
87.18% |
$9,007.08 |
| Advair Diskus 250-50 mcg |
$1,061.97 |
$108.00 |
89.83% |
$3,815.88 |
| Celebrex 200 mg |
$692.97 |
$104.00 |
84.99% |
$2,355.88 |
| Crestor 20 mg+ |
$713.97 |
$74.00 |
89.64% |
$2,559.88 |
| Cymbalta 60 mg+ |
$878.97 |
$90.00 |
89.76% |
$3,155.88 |
| Diovan 160 mg+ |
$475.99 |
$62.10 |
86.95% |
$1,655.56 |
| Januvia 100 mg+ |
$1,026.00 |
$131.40+ |
87.19% |
$3,578.40 |
| Namenda 10 mg++ |
$1,049.97 |
$210.60 |
79.94% |
$3,357.48 |
| Nexium 40 mg+ |
$878.97 |
$67.50 |
92.32% |
$3,245.88 |
| Spiriva Handihaler 18 mcg |
$1,115.97 |
$132.15 |
88.16% |
$3,935.28 |
| Average |
$1,047.78 |
$131.10 |
87.60% |
$3,666.72 |
*Sources: Local pharmacy — Rite Aid in New York City; International online pharmacies – lowest prices found on www.PharmacyChecker.com from verified websites. +price calculated from 84 pills. ++price calculated from 100 pills.
Obamacare will help tens of millions of Americans afford prescriptions at the local pharmacy next year, and even more so into the future. However, with 21% of insured Americans going without medication due to high drug prices, we’re proud to offer useful information to help people afford the medication they are prescribed to stay healthy, get better, and live longer.
Tagged with: Obamacare, under-insured
by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, Pharmacychecker.com | Aug 22, 2013 | Advocacy, Drug Prices, Healthcare Reform
Americans with high out-of-pocket healthcare costs will be disappointed with a new Affordable Care Act (Obamacare) delay announced by the Obama administration. The delay allows insurers and employers using more than one benefits administrator to wait one extra year – until 2015 – before being required to limit out-of-pocket costs to a maximum of $6,350 for an individual or $12,700 for a family, as mandated by the law. Instead, they will be permitted to maintain separate out-of-pocket limits for various benefits. For example, a patient may have a $6,350 cap for doctor visits and another $6,350 cap for prescription drugs.
Except that there may actually be no cap at all for prescription drug plans. Plans currently without out-of-pocket caps will not be subject to mandatory ones in 2014.
The only reason for the delay mentioned in a recent New York Times article is a technological problem. Many companies use different administrators for different benefits, and their computer systems are currently unable to combine all costs from different programs for a given patient. As the New York Times says, “In many cases, the companies have separate computer systems that cannot communicate with one another.” Companies need more time to upgrade their software to accommodate this.
Obamacare was passed in 2010, and the mandatory out-of-pocket limits were slated to go into effect in 2014, giving companies four years to figure out how to get their computers to talk to each other.
This does not seem like a legitimate reason to delay prescription drug spending caps. Fifty million adults did not fill a prescription last year due to cost; access to affordable medicine is a big problem in the United States, and failure to implement out-of-pocket spending limits will likely keep prescriptions unfilled.
Fortunately, safe international pharmacies offer low prices to Americans. As of last November, prices for brand name medication were 85% less expensive from them when compared to U.S. pharmacies. If you choose to order medication from abroad, make sure the pharmacy is a PharmacyChecker.com verified online pharmacy.
