Compliance among Pharmacies in California with a Prescription-Drug Discount Program for Medicare Beneficiaries

Lewis, Joy H.; Schonlau, Matthias; Muñoz, Jorge A.; Asch, Steven M.; Rosen, Mayde R.; Yang, Hannah; Escarce, José J.
March 2002
New England Journal of Medicine;3/14/2002, Vol. 346 Issue 11, p830
Academic Journal
Background: Several states have developed prescription-drug discount programs for Medicare beneficiaries. In California, Senate Bill 393, enacted in 1999, requires pharmacies participating in the state Medicaid program (Medi-Cal) to charge customers who present a Medicare card amounts based on Medi-Cal rates. Because Medicare beneficiaries may not be accustomed to presenting their Medicare cards at pharmacies, we assessed the compliance of pharmacies with Senate Bill 393. Methods: Fifteen Medicare beneficiaries who received special training and acted as “standardized patients” visited a random sample of pharmacies in the San Francisco Bay area and Los Angeles County in April and May 2001. According to a script, they asked for the prices of three commonly prescribed drugs: rofecoxib, sertraline, and atorvastatin. The script enabled us to determine whether and when, during their interactions with pharmacists or salespeople, the discounts specified in Senate Bill 393 were offered. Pharmacies at which the appropriate discounts were offered were considered compliant. Results: The patients completed visits to 494 pharmacies. Seventy-five percent of the pharmacies complied with the prescription-drug discount program; at only 45 percent, however, was the discount offered before it was specifically requested. The discount was offered at 91 percent of pharmacies that were part of a chain, as compared with 58 percent of independent pharmacies (P<0.001). Compliance was higher in the San Francisco Bay area than in Los Angeles County (84 percent vs. 72 percent, P=0.004) and was higher in high-income than low-income neighborhoods (81 percent vs. 69 percent, P=0.002). A Medicare beneficiary taking all three drugs would have saved an average of $55.70 per month as compared with retail prices (a savings of 20 percent). Conclusions: Discounts required under California's prescription-drug discount program for Medicare beneficiaries offer substantial savings. Many patients, however, especially those who use independent pharmacies or who live in low-income neighborhoods, may not receive the discounts. (N Engl J Med 2002;346:830-5.)


Related Articles

  • Prescription drugs considered.  // State Government News;May2001, Vol. 44 Issue 5, p9 

    Focuses on the initiatives of several states across the United States to lower the cost of prescription drugs. Information on an Ohio bill that would provide discount for senior citizens; Lawsuit filed against drug companies in Texas for Medicare fraud based on prices charge.

  • Slow Card Uptake. Vastag, Brian // JAMA: Journal of the American Medical Association;7/14/2004, Vol. 292 Issue 2, p163 

    Reports on the implementation of a Medicare drug discount card program. Number of seniors enrolled automatically; Eligibility for the cards; Campaign of the Department of Health and Human Services and Access to Benefits Coalition to enroll seniors; Reaction of lawmakers to the disappointing...

  • MCOs sign up seniors for discount cards. Wechsler, Jill // Managed Healthcare Executive;Jul2004, Vol. 14 Issue 7, p10 

    Reports on the enrollment of Medicare beneficiaries for Medicare drug discount cards program in the U.S. Rate of price increase for medical services; Reduction in drug retail prices with the Medicare cards; Establishment of a reasonable pharmacy benefit for seniors.

  • PRICING PRESCRIPTION DRUGS.  // State Legislatures;Mar2005, Vol. 31 Issue 3, p7 

    Presents information on several prescription drug discount programs in the U.S. Requirements for the Rx Outreach patient assistance program developed by Express Scripts Specialty Distribution Services; Companies participating in the Together Rx Access program; Other plans that target senior...

  • DEALING WITH Rx CARDS. Vaczek, David // SN: Supermarket News;12/6/2004, Vol. 52 Issue 49, p35 

    Reports on the challenges posed by prescription discount cards on supermarket pharmacies and their Medicare customers in the U.S. Implications of the discount cards on pharmacy service; Introduction by in-store pharmacies of their own discount cards in order to help Medicare customers and...

  • Medicare cards gaining ground, say sponsors. Frederick, James // Drug Store News;11/22/2004, Vol. 26 Issue 16, p21 

    Focuses on the popularity of the Medicare-endorsed prescription discount cards. Estimated number of Medicare recipients who have signed up for the discount card; Concept behind the Medicare prescription discount card; Benefits associated with the Medicare cards.

  • Medco ready for senior discount cards. Garza, Xazmin // Las Vegas Business Press;4/5/2004, Vol. 21 Issue 13, p1 

    Reports on Centers for Medicare and Medicaid Services' (CMS) announcement of sponsors for its senior drug discount cards in Las Vegas, Nevada. Criticism against the objective of CMS; Estimated number of health industry companies eligible for discount cards; Benefits of the discount card...

  • Debating the merits of drug discount card program.  // Medical Marketing & Media;Jul2004, Vol. 39 Issue 7, p8 

    Focuses on the launch of the new Medicare drug cards that offer eligible seniors discounts on prescriptions in the U.S. Number of senior citizens enrolled in the program; Implications associated with the program; Criticisms made against the drug discount card program.

  • Illinois reforms transit system to save money.  // American City & County Exclusive Insight;2/16/2011, p1 

    The article reports on the reform in the transit system in Illinois in 2012 to save money. It states that Illinois Governor Pat Quinn has signed a new law that provides elderly residents a 50% discount on state transit, which is expected to save over $30 million. It says that Quinn also signed...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics