Medicare Prescription Drug Premiums will not increase but Pharma free to raise prices again

More taking advantage of Preventive Care provisions including annual Wellness Check-up

Washington, DC, August 4, 2011 – Medicare average prescription drug premiums will not increase in 2012, but the latest statement from the Department of Health and Human Services makes no mention of limiting the amount of price increases that might be enacted by pharmaceutical manufacturers.

A recent Harvard University study estimates that even with HHS data that indicates that 17 million people with Medicare have received free preventive services this year while 900,000 Medicare beneficiaries who hit the prescription drug donut hole have received a 50 percent discount on their prescription drugs but one in ten elderly on Part D still cannot afford their prescription medicines.

“The Affordable Care Act continues to improve the value of the drug coverage people with Medicare will receive next year.  Out-of- pocket costs will be lower thanks to discounts on brand name prescription drugs and increasing generic coverage for people in the donut hole,” said Donald M. Berwick, M.D., CMS Administrator. 

“Beneficiaries should still carefully compare their current plan’s coverage and quality with what is being offered in 2012 when that information becomes available in the fall.”

Under the Affordable Care Act, people with Original Medicare can receive recommended preventive benefits and a new annual wellness visit without paying an additional penny out of pocket.  In addition, the Affordable Care Act is closing the prescription drug donut hole by providing increasing discounts on covered drugs in the donut hole.  In 2011, the number of people with Medicare benefiting from these improvements is growing:

•           From Jan. 1, 2011 to July 2011 there were 17, 336,421 people, or 51.5 percent, with Original Medicare who received one or more free preventive services.

•           During the same time period, 1,061,780 Americans with Original Medicare have taken advantage of Medicare’s new Annual Wellness Visit, up from 780,000 in mid-June.

•           Through the end of June, 899,000 Americans with Medicare have benefited from the 50 percent discount on covered brand name drugs in the Medicare Part D donut hole -- an increase of over 420,000 individuals in the month of June alone.

•           The dollar amount of these out-of-pocket savings on drug costs for Medicare beneficiaries has risen to $461 million saved through June 2011 -- up from $260 million through May 2011, meaning beneficiaries in the donut hole saved over $200 million in the month of June alone.

HHS also announced that the cost of the average Medicare prescription drug plan premium in 2012 will be about $30. The average premium in 2011 is $30.76.  The announcement was based on bids submitted by Part D plans for the 2012 plan year.

The national and regional premium data in today’s announcement can be found at:  http://www.cms.gov/MedicareAdvtgSpecRateStats/RSD/list.asp.

For state-by-state information on the number of Medicare beneficiaries who have seen lower out-of-pocket costs in the donut hole, please visit http://www.cms.gov/newmedia/03_partd.asp.

For state-by-state information on utilization of free preventive services and the annual wellness visit, please visit http://www.cms.gov/newmedia/02_preventive.asp.

In June, Medicare launched Share the News, Share the Health, a campaign to raise awareness about the importance of prevention for people with Medicare and their health care providers.  As part of the campaign, television and radio public service announcements are airing nationwide and regional events are being held around the country this summer to make sure Medicare beneficiaries know that these services are available to them.  CMS has reached out to doctors through a “Prevention Advisory,” and other health care provider-directed materials on Medscape, a respected website for continuing medical education.  

“The Share the News, Share the Health campaign is helping make sure that all Americans are aware of the preventive services in Medicare that are provided at no cost to beneficiaries, if obtained from qualified and participating health care professionals, thanks to the Affordable Care Act,” said CMS Administrator Donald M. Berwick, M.D.  “It is critical that Americans know about these important services that can improve health and prevent chronic diseases.”

For more information on Medicare’s Share the News. Share the Health prevention campaign, go to http://www.medicare.gov/share-the-health/ or call 1-800-MEDICARE.