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Poll: Seniors content with preferred network plans
May 20th, 2013
WASHINGTON – Seniors in Medicare Part D drug benefit plans with preferred pharmacy networks are satisfied with them, according to a survey released by Pharmaceutical Care Management Association (PCMA).
A leading community pharmacy trade group, however, questioned the poll's findings and said that public officials recently have expressed concerns about preferred networks.
PCMA, a pharmacy benefit manager (PBM) industry trade group, said Monday that 85% of seniors polled by Hart Research Associates said they're satisfied with their Part D preferred network plan, citing lower costs, convenient pharmacy access and other benefits.
More than 40% of Part D seniors, or 9.5 million people, are currently enrolled in plans with preferred networks, according to PCMA.
Eighty percent of seniors said they would be disappointed if their preferred network plan is eliminated. They indicated that the cost of premiums (50%) and co-payments (48%) are the most important considerations for in selecting their preferred pharmacy plan.
Seniors reported that they are very satisfied with the convenience of pharmacies (81%), the number of pharmacies in their network (74%) and the prescription drugs available through their plan (75%). Less than half (47%) were very satisfied with their plan's cost of premiums, though 31% indicated they were fairly satisfied.
The survey revealed that increased cost is the most common reason that seniors would be disappointed if their preferred network plan was eliminated. PCMA noted that cost is the top factor for seniors regardless of income, age, number of medications and distance from their drug store.
"Seniors like the lower costs, pharmacy choices and overall value of plans with preferred pharmacy networks," PCMA president and chief executive officer Mark Merritt said in a statement. "Furthermore, 80% of those in preferred pharmacy plans — which translates to over 7 million seniors — would be very upset if their plan was no longer available in the future."
Only 8% of seniors polled listed the number of pharmacies in the network as an important consideration, PCMA noted.
"Our survey results clearly show that seniors see Medicare Part D preferred networks as a win-win because they offer good value without sacrificing access to convenient pharmacies," stated Geoffrey Garin, president of Hart Research Associates.
In response to the PCMA/Hart survey, the National Community Pharmacists Association on Monday said officials with Medicare and MedPAC, 16 senators and more than 30 House members have raised questions about patient pharmacy access and costs with Medicare preferred pharmacy plans.
"First, in rural areas, seniors in these plans may have to travel 20 miles or more to obtain their prescription drugs. Independent community pharmacists in these areas report that patients are repeatedly dealing with this barrier to obtaining their medications," explained NCPA CEO B. Douglas Hoey.
"Perhaps reflecting this problem, more than 1 million seniors are either very dissatisfied or somewhat dissatisfied with their preferred pharmacy Medicare drug plan," he said, citing the PCMA/Hart survey's finding that 11% of seniors expressed dissatisfaction with their preferred network plan.
"Second, Medicare and taxpayers may not realize any overall savings from these prescription drug plans (or PDPs). As Medicare said in its proposed 2014 call letter, 'We have begun to scrutinize Part D drug costs in PDPs with preferred networks, and comparing these to costs in the non-preferred networks, as well as to costs in PDPs without preferred networks," Hoey stated. "We are concerned because our initial results suggest that aggregate unit costs weighted by utilization (for the top 25 brand and top 25 generic drugs) may be higher in preferred networks than in nonpreferred networks in some plans. Combined with lower cost sharing, we believe these higher unit costs may violate the requirement not to increase payments to such plans.' "
Hoey also pointed to an NCPA analysis finding that that preferred pharmacy plans may actually be more expensive for the Part D program and consumers. The study found that in a comparison of four common medications, using Medicare's Plan Finder website, the full cost of 90-day supplies was more at the preferred network pharmacy than at the nonpreferred pharmacy 75% of the time.
NCPA, too, said preferred pharmacy drug plans often exclude independent pharmacies from offering patients the plan's lowest advertised co-payments.
"There is an easy solution to address the concerns of more than 1 million seniors with preferred pharmacy drug plans. Allow any legitimate pharmacy willing to accept plan terms and conditions, including reimbursement, to participate," Hoey stated. "Medicare officials have already recommended this change. In its final 'call letter' for 2014, the agency said it believes that the best way to encourage price competition and to lower costs is to allow any willing pharmacy to participate in preferred networks."