Medicare officials seek to boost use of discount drug cards

The temporary discount drug cards created under the new Medicare law can save senior citizens as much as 18 percent off retail prices on brand-name drugs, and 65 percent off national average prices for generic drugs, boasts Mark McClellan, Medicare's administrator. Moreover, if seniors switch some of their brand-name drugs to generics, the savings can be as great as 92 percent off retail prices. The cards cost $30 a year at most, and some are free.

So, if the card is such a no-brainer, then why aren't seniors pushing their way to the front of the line? Why the slow uptake?

At the end of July, two months after the cards took effect, 4 million Medicare beneficiaries had a card, out of 33 million eligible people. And only 1.7 million had signed up on their own, while the other 58 percent had been enrolled automatically by their Medicare HMOs. About 1 million people were getting the $600 federal subsidy available to low-income beneficiaries, even though 7.2 million were eligible because their incomes fell below cutoff levels ($12,569 for individuals and $16,862 for couples). Even though such eye-opening savings are available, finding the best card is difficult, and many angry seniors refuse to try the system out.

If Medicare can't get seniors to sign up now for a temporary discount card, some health care analysts are asking, what will be the response when Medicare launches its more complicated, permanent drug benefit in 2006?

McClellan disputes that the start of the discount card program has been sluggish. He says that enrollment is picking up and that it's been speedier than for other new government programs in recent years, such as the state-level Children's Health Insurance Plan. Still, even proponents of the cards acknowledge that there's a long way to go and that emotions are running high because of the partisan fight over the legislation. While some Medicare beneficiaries are rejoicing at the discovery of big savings, other seniors are cursing Washington for enacting what they see as a skimpy benefit and are refusing the discount cards outright.

Wayne Richards, a 78-year-old Dayton, Ohio, resident, fits the "elated" category. Last year, he paid $1,548 for eight prescription drugs on an income of $5,000. This year, with a discount card, he's likely to pay less than $100. "This is terrific," Richards said in an interview. "I got Lipitor for nothing. I near-about flipped."

Baltimore resident Ellie Tickner, however, doesn't share Richards's enthusiasm. The irate senior says she has no idea whether a discount card would save her money and isn't going to find out. "I was tempted to call up, but then I saw a big article in the paper that the cards are not what they're supposed to be," she roared in a recent telephone interview, before slamming down the phone in fury.

"People feel the legislation was a rip-off by the drug companies, and most of their anger is directed at the failure to do something truly meaningful about skyrocketing prices," said Ron Pollack, executive director of the consumer group Families USA, which wants the government to use its power to force down drug prices.

Then there's the disagreement over savings. Medicare officials are praising the discounts, but Rep. Henry Waxman, D-Calif., says there's no reason to celebrate. "Seniors are confused, frustrated, and angry about the cards, and with reason. They're not saving seniors significant amounts of money," he said in an interview. The discounted prices are "up and down each week like a yo-yo. Medicare's Web site is riddled with errors. It's no wonder seniors are overwhelmingly rejecting these cards."

A study commissioned by the Henry J. Kaiser Family Foundation concludes that the cards can make a difference in spending for many people. The study compared discount-card prices against a combined Maryland retail price of $758 for a month's supply of 10 commonly used drugs. Kaiser found that seven discount cards resulted in combined prices ranging from $574 to $611. Mail order cost even less, ranging from $517 to $555.