The new Medicare drug benefits: good news or bad news?

I expect that we'll see a lot of news in the next couple of days spinning the new survey from the Kaiser Family Foundation of physicians and pharmacists on the recently implemented Medicare prescription drug benefits. If I'm wrong and it doesn't catch the interest of the media, well, that's a shame, because these numbers are very interesting and potentially very important.

Here's the news release from the KFF. It starts out with a bit of a good news/bad news take:

Substantial majorities of pharmacists (86%) and physicians (71%) believe that the prescription drug law is helping people on Medicare save money on their medications, according to two new national surveys conducted by the Kaiser Family Foundation.

At the same time, pharmacists (91%) and doctors (92%) believe the law is too complicated. A majority in both professions report that Medicare beneficiaries who they see are encountering problems in getting their medications, sometimes with serious consequences.

“We have surveyed seniors many times, and now pharmacists and doctors, and the story is remarkably consistent: The benefit is providing help to millions as intended, but there are also problems, and the complexity of the law is an issue for many,” said Kaiser Family Foundation President and CEO Drew E. Altman, Ph.D.

I thought I'd look a little more closely at the bad news, because the good news - that substantial majorities of pharmacists and physicians think that people are being helped - just sounds so hopeful. Here are a few select numbers that jumped out at me (and you can look at the data yourself here and draw your own conclusions):

I'm going to focus on the pharmacists here because 84% of them say they have experience with the new Medicare drug benefits compared with only 44% of doctors who say they have experience.

• 81% of pharmacists have customers who have problems getting their meds
• 45% of pharmacists have a favorable impression of the Medicare program, compared with a full 41% who have an unfavorable impression
• 40% of pharmacists would give the program a grade of C
• 86% say their customers don't understand the benefit well
• 53% say the administrative burden is worse than that of typical insurance plans
• 91% of pharmacists say the benefit is too complicated (59% strongly agree, 32% somewhat agree)
• 62% either strongly or somewhat agree that the program benefits health plans and pharmaceutical companies too much

Still,

• 82% of pharmacists somewhat or strongly agree that the program helps save people money, particularly for low-income people.

just a couple of salient items on doctors:

• benefit
• 69% of docs reported that they are not very or at all familiar with the Medicare drug benefit formularies
  

There are a lot of questions here that beg for answers. (Another Kaiser survey of seniors themselves is available and had similar results.) I'm still hung up on the 10% of docs who had a with a serious medical consequence. To me, that sounds like a lot. How do we value it against the cost savings that pharmacists say their customers receive? That's one for the bioethicists. What about the perceived benefit to health plans and pharmaceutical companies - how does that work? Are things at least improving over time? (These data were collected between April and July of this year, too short a time frame to see real changes, though that wasn't the intent of the survey.) Finally, how will this survey's results play in Washington, now that Medicare and Medicaid administrator Mark McClellan has chosen to step down?

As always, thoughts and comments welcome...

Medicare drug benefits
pharmaceuticals
seniors