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Saturday, March 10, 2012

Cash Cow Grows for Pharmaceutical Companies - More OTC: Less for Medicare D

http://oneturkeyrun.blogspot.com/2006/02/cash-cow-medicare-part-d-benefit-and.html (comment from reader Joe in Bangor ME at end sent via email*)

In February 2006, I posted a blog about how over the counter sales (OTC) of pharmaceuticals, for drugs that are now available only by prescription, will undermine the intention of the Medicare D benefit:  "Part D Medicare Prescription Drug Plan is a stand-alone drug plan that adds prescription drug coverage to Original Medicare, some Medicare Cost Plans...." posted on the Medicare.com website.


But, Medicare D does not pay for over the counter (OTC) pharmaceuticals.  Meanwhile, the pharmaceutical companies receive monthly reimbursement from Medicare for providing coverage, while a growing number of once prescription medications are going "OTC".  


Of course, consumers, especially Medicare beneficiaries, have come to rely on Medicare D, especially the Managed Care "Medicare Advantage" plans, that roll the "D" premiums into their beneficiaries' coverage.


Reuters News reports the US Food and Drug Administration (FDA) is considering deregulating some diabetes and cholesterol lowering drugs so they can be purchased OTC. Medicare D won't pay when the drugs are OTC.
http://www.reuters.com/article/2012/03/08/us-fda-drugs-otc-idUSBRE8270TG20120308

Of course, some consumers will benefit from more OTC pharmaceuticals. Nonetheless, Medicare beneficiaries who are diabetics may actually pay hidden costs, because their benefit won't cover some of their commonly taken medications, the ones now covered in their plans. In other words, pharmaceuticals could be accused of "double dipping", by receiving premiums for drug coverage while pushing more commonly covered medications off of the benefit.  Either way, or both ways, Big Pharmas get money.

So, my point is: When Republicans obsessively chant about Medicare fraud, they must turn to Big Pharma contributors to ask how much money each company receives from the Medicare D benefit and how much of it they actually pay for beneficiaries' drug coverage.

It's extraordinarily difficult, maybe impossible, to roll back the Medicare D benefit; but, tracking the program's revenues, and expenses makes  for sound fiscal and public policy sense.

*Joe from Bangor writes in response: 
A Cash Cow and how!!!
Time to turn off the milk machine Apparently politics and "milk" do mix! Otherwise this travesty would have been ended long ago!
Brilliant article! Bravo!!    Joe Jr.









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