Pharmacists lag on Medicare Rx awareness

Even though the law was adopted two years ago, many pharmacists are just now waking up to the fact that there's a Medicare prescription drug benefit heading straight for their pharmacy counters, according to the president of the American Pharmacists Association.

In his duties as APhA president and as president of Lutz Pharmacy in Altoona, Iowa, Gene Lutz has met with a fair number of fellow pharmacists. And he's concerned that "an awful lot of pharmacists haven't paid much attention" to Medicare Part D, he told Drug Topics editors during a recent sit-down at APhA's Washington, D.C., headquarters. The meeting was held to discuss American Pharmacists Month and the start of Medicare Rx plan marketing, both scheduled for this month. He said that after attending one of the Medicare Rx drug benefit educational sessions sponsored by the National Community Pharmacists Association, he sensed that the seminar was the first time some of his fellow attendees had investigated the drug benefit.

"That was a month ago, so they really don't know what's happening," said Lutz. "I guess pharmacists are suddenly realizing that this is really going to happen. I think that three out of four patients are going to ask their pharmacist about it. Based on our experience with the Medicare drug discount cards, we spent an incredible amount of time explaining them to people. Our suspicion is that most people are going to come to the pharmacy."

"Unlike pharmacists, physicians will choose not to be informed," said Lutz. "They'll say, 'Ask your pharmacist,' or they'll foist it off on the nurse or office personnel, who will say 'Go ask your pharmacist.' They do that all the time with formularies, which will be exacerbated by this program. My fear is that pharmacists will get so frustrated and get so many requests, they'll say they won't deal with it at all. That's not good for the program, but it's probably going to happen, especially where you have high-script volume already."

Ready or not, Medicare Part D is going to bring chaos to the pharmacy counter during January, which is traditionally hectic anyway with patients switching insurance plans, said APhA executive VP-CEO John Gans, Pharm.D. There will also be significant changes in how and where seniors buy their medications and that means pharmacies will be seeing a lot more consumers who won't be hunting for bargains so much, he added.

Any discussion of Medicare inevitably leads to a look at the medication therapy management (MTM) services mandated for beneficiaries with multiple diseases and multiple drugs. But the early indications are that drug plans are slow to develop MTM services and are doing only what's required by the law, according to Lutz.

"Most in the profession are working their tails off to make sure that we get something that's a real benefit for patients and that pharmacists can get reimbursed for," said Lutz. "Pharmacy needs to move in that direction. This is a great opportunity, the first time any major program recognizes that pharmacists can be responsible for this kind of care. I think most pharmacists involved are excited about it and a little bit worried about how it might all play out."

Even if Medicare drug plans don't enlist pharmacists to provide MTM, they should still offer those services to other beneficiaries on a fee basis, said Susan Winckler, R.Ph., APhA VP-policy and communications. "Beneficiaries may end up with a drug plan that doesn't allow them to get MTM services locally, so pharmacists should provide those services on a cash basis," she added.