Drug rebate confusing seniors
Isle residents who are 65 or older may benefit from both the Hawaii Rx Plus law and the Medicare Part D Prescription Drug Program, state officials say.
Consumer advocates told House and Senate Health Committee members at an informational briefing yesterday that people are confused by the programs.
"They do not know whether or not to sign up for Medicare Part D if they are already enrolled in Rx Plus," said Bruce McCullough, member of the Policy Advisory Board for Elder Affairs. "They do not understand that belonging to one does not prohibit belonging to the other."
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Rx America operates a toll-free customer service number, 877-667-1892, that Hawaii residents can access at any time.
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McCullough said a delay by the Department of Human Services in negotiating rebates with drug manufacturers for the Rx program as the law allows "have created an unintentional consequence: Grassroots advocacy organizations, which have promised second rounds of rebates, have lost credibility when these rebates were not realized."
Human Services officials said drug companies won't give the rebates unless brand-name prescriptions are used.
And use of generic prescriptions in Hawaii runs from 72 to 74 percent, said Cyndi Bryant, director of account services for Rx America in Salt Lake City under a state contract to manage the Rx Program. "You are performing better than other clients (states)," she said.
The Rx law, which began in July 2004, provides free membership to uninsured and underinsured residents with income below 350 percent of the federal poverty level so they can get discounts on prescription drugs. There are no age restrictions for Rx Plus, unlike the Medicare Part D Prescription Drug Program, which is for seniors.
"Seniors should get our (Rx) card and Part D," said Human Services Director Lillian Koller.
Medicare clients with a Part D prescription drug plan pay deductibles, co-payments and reach a certain point -- the so-called "doughnut hole" -- where they can't get coverage until drug use hits a catastrophic level, she said. Those with an Rx Plus card can use it when they reach the "doughnut hole" and for drugs excluded from Part D, she said.
"They should empty their pocket and lay out all (prescription drug ) cards for the pharmacist, who will give them the best price," Koller said.
The cost of prescription drugs in the Rx Program is reduced through discounts voluntarily provided by pharmacists, said Tracy Okubo, Koller's administrative assistant.
She said 149,460 people were enrolled as of July 28 and 143 pharmacies were participating out of 186. About 1,200 to 1,900 members a month are using the cards, she said.
The average dollar savings for Hawaii Rx Plus clients as of June 30 was $139,791 on generic drugs and $56,510 on brand-name drugs, for a total savings of $196,302, she said.
Koller said, however, that enrollment has dropped off since the Medicare Part D Program began in January.
Rebates won't work because of the high generic drug use, she said, but changes could be made to help increase discounts for the program.
Bryant said most of Rx America's clients use its preferred drug list to take advantage of its high value purchasing power.