Letter Of The Year

by all counts, this one's the winner.

After two months and thousands of prescriptions having been filled under the Medicare Part D plans, pharmacists have yet to see one truly discounted prescription offered to a senior citizen.

When I say a truly discounted prescription, I mean the final price that the senior citizen is charged against the program’s $2,250 maximum allowance.

Every single prescription that we are filling is at 100 percent of the drug manufacturers’ cost to any pharmacy. The total prescription price that is being charged to that maximum benefit is not discounted to the senior citizen in any way.

For the past two years, there were discounted manufacturer programs that took $100 prescriptions and had patients pay only a fraction of that price. The manufacturer, through the program, rebated money back to cover the total cost.

I am sure that rebated money is still flowing back to all the insurance companies that have a Medicare D drug program. But it appears that any and all of those millions of dollars of rebate money are stopping at the insurance company.

With every dollar that is coming off the $2,250 cap in benefits, the share that is coming from the insurance plan is 0 percent. They may be receiving that same $20, $30, $50 or $100 rebate, but they are charging against the senior citizens’ benefits at 100 percent.

There is no transparency as to how much money is being rebated back to private insurance companies through these programs, and that is an outrage.

We are seeing patients pay full price for prescriptions that we know, based on the previous manufacturer discount programs, cost the insurance company only a fraction of that amount. Seniors may be seeing lower prescription prices, but that is all coming out of reduced profit margins that the insurance plan allows the pharmacy.

We have seen manufacturers raise the wholesale cost of drugs 5 to 8 percent since Jan. 1. The drug companies are winners because they continue to raise prices to cover the amount of rebate they are giving.

The insurance company wins because they have all those new premium payers and this new huge pool of rebate money.

The senior citizen pays an additional premium to get the crumbs that are left over. If the plan is to buy the drugs for less money, then the plan’s clients — seniors — should be getting that reduced price.

Somebody needs to start asking why they are not, and just where all
this rebate money is going.

— Mark Richards, Richards Pharmacy, Des Moines.

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