Rx benefit may hurt poor, disabled

BOSTON, Dec. 29 (UPI) -- The Medicare drug benefit could hurt poor, elderly and disabled Americans, a Harvard professor said this week.

For the so-called dually eligible -- or those enrolled in both Medicare and Medicaid -- the new Medicare drug benefit might not prove much of a benefit, argued Stephen Soumerai, professor in the department of ambulatory care and prevention at Harvard Medical School and Harvard Pilgrim Health Care, in a perspective article.

The problem stems from the fact that dually eligible beneficiaries -- which number about 7.2 million -- were given only six weeks to choose and transition to a new drug formulary, he said.

"This group of dually eligible beneficiaries are especially challenging to reach and educate about coverage changes," Soumerai said, arguing that the transition period for this group should be extended to at least one year to create a longer "crossover" period, during which beneficiaries could still get drugs through Medicaid.

Another potential pitfall is that these beneficiaries may discontinue use of essential drugs due to increased co-payments for drugs in many states, and there is also the risk that some essential medicines are now not covered, creating significant health problems in the future.

"The Center for Medicare and Medicaid Services (CMS) should commission rapid studies to examine the impact of formulary restrictions and changes in cost sharing on the use of essential medication and health outcomes," Soumerai said.