More Part D shenanigans
I've talked about the Part D donut hole extensively. I've also talked about how the media is feeding on a frenzy of sob stories involving individuals who hit the doughnut hole earlier than they expected, through their own poor planning. These stories mostly revolve around someone taking an expensive medication (cancer meds, etc.) who burned through their benefit faster than they thought they would. These are the same people who were in love with the program earlier this year when it started saving them boatloads of money. Ironically, they're the same people who will love the program again in January.
For their sake and mine, I hope these people opt to change their Part D coverage to something without a doughnut hole in November — the beginning of the window where people can switch Part D PBMs. There's another prominent sob story in the media today:
David Madison, 67, of Lakewood, Colo., was diagnosed with pancreatic cancer in May and fell into the coverage gap this month. One prescription eats up 20% of his $34,000 annual income. "I really don't know where the money's going to come from," he told a Democratic Senate panel last week.
Allow me to quote myself from the first time I wrote about this (link above):
most importantly, there were and are plans which do not have a doughnut hole. A pharmacist cannot help it if someone didn’t pick a plan that would suit their needs better. At some point, it must be the patient’s responsibility to take care of themselves.
If patients had used the Part D comparison tool, they wouldn't be having these problems now. (And yes I realize that not everyone is technology- and Internet-proficient, but outreach programs existed months before Part D went into effect that would have beneficiaries pick the most suitable plan. For free.)
These media and partisan shenanigans are turning a non-issue into an issue. It's estimated that most people will hit the doughnut hole six weeks before Congressional elections.
Drugwonks has some different commentary on the article as well:
Two observations: First, where was the money coming from before BEFORE Medicare part D? I mean, if people are in such bad shape before the drug benefit, are they actually doing worse with it?
[...]
The question is, should we impose price controls on drug companies because people are too dumb to avoid the donut hole?
The media fails to point out that fact, as do the Dems for political reasons: they want to impose a VA style drug plan on seniors. It should be noted that Tarceva is not on the VA drug formulary. Neither is Erbitux. Nor is Avastin which is used in combo with either two. Too bad USA Today didn’t talk about the black hole of no medicines a VA style plan would create.
By way of clarification, Tarceva is probably the medication referred to in the USA Today article that Mr. Madison is taking that eats up 20% of his income.
Maybe I sound cold and unsympathetic. It's because I am. I sympathize that medications do, indeed, cost a lot of money. But when it comes to Part D, I know the trouble we went through in my pharmacy alone to explain and educate the senior public to get them on a plan that works the best for them. For many people, the simplest plan was the best. But for a select minority, they needed upper-tier plans to take care of their needs, but many in this group instead opted for something simple because they didn't have to think about it. It's incredibly frustrating for someone on the other side of the fence who knew better all along and tried to guide these people in the right direction, then the media comes along and completely skewers any hope of fair-and-balanced reporting because of the misconception that fair-and-balanced doesn't sell. (Truth is, it does. The MSM just hasn't figured that out, yet.)
[tags]Medicine, pharmacy, medicare, Medicare part D, Part D, politics, bad journalism, journalism[/tags]
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[...] The first sentence there is the reason that Medicare Part D will largely fund itself — by allowing seniors greater access to medications, the government will actually be saving money because prevention is inherently less expensive than treatment. It costs more to hospitalize someone — where they get their meds for free — than it does to pay for preventative medications. A lot more. (Even when drug therapy involves brand-name drugs and expensive, targeted cancer therapies.) [...]
Pingback by Two Texas ERs to turn away non-emergency patients :: OnThePharm — August 1, 2006 @ 5:54 pm
[...] This article has been sitting in my browser for a couple of days now. With all the nonsense in the mainstream media, it's nice to see an article that's not inflammatory and tells the other side of the story. Most senior citizens who signed up for Medicare's new prescription drug coverage say they are happy with their plans, but some report that they are not saving money and many say the overall program could be better designed, two new independent studies show. [...]
Pingback by Overall, seniors are satisfied with their Part D coverage :: OnThePharm — August 4, 2006 @ 1:03 pm
While I sympathize with your predicament, diabetes mellitus is one of the listed adverse effects of Zyprexa. The question is whether the benefits outweighed the consequences, and whether you were notified of these side effects by your psychiatrist.
These things happen. Unfortunately they happened to you.
But your comment does not belong on this entry, and as such is spam, and this is why I have taken your URLs out. You might consider moving on. The odds of a court decision in your favor are pretty slim. I'd prefer to get on with the business of living rather than dwelling on the past and things that cannot be helped. Particularly when a similar class action lawsuit has already been settled by Lilly.
I'll ask you once, now, not to post any more comments on my blogs. You spammed another of my blogs with your zyprexa victims stuff, and you're doing it again — I don't appreciate it. If your comments don't contribute to the actual conversation at hand from now on, your comments will be deleted.
Comment by RJS — August 6, 2006 @ 4:08 pm