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. 2007 Aug;22(8):1172-5.
doi: 10.1007/s11606-007-0235-z. Epub 2007 May 15.

Angiotensin receptor blockers on the formularies of Medicare drug plans

Walid F Gellad  1 , Haiden A Huskamp, Kathryn A Phillips, Jennifer S Haas
Affiliations

Angiotensin receptor blockers on the formularies of Medicare drug plans

Walid F Gellad et al. J Gen Intern Med. 2007 Aug.

Abstract

Background: The presence of angiotensin receptor blockers (ARBs) on the formularies of Medicare Part D prescription drug plans (PDPs) is vitally important to the health of seniors who cannot tolerate angiotensin-converting enzyme (ACE) inhibitors.

Objective: To determine whether ARBs are present on the formularies of PDPs and how the prescription cost-sharing for ARBs under Part D compares to cost-sharing before Part D.

Design/participants: Cross-sectional analyses of March 2006 Medicare Part D formularies (n = 1,446) and of ARB utilization and cost-sharing for adults over the age of 64 included in the nationally representative Medical Expenditure Panel Survey.

Main outcome measures: (1) Presence of ARBs on Part D formularies. (2) Average out-of-pocket costs for 30-day supply of ARBs before and after Part D (both in 2006 dollars).

Results: All PDP formularies included at least 1 ARB. Most plans covered 2 ARBs (41%) and 35% covered all 7. The average monthly copay for the most commonly used ARB, valsartan, is $28 under part D, $14 before Part D for individuals with prescription coverage, and $53 before Part D for individuals without coverage.

Conclusions: Whereas ARBs are present on all Part D formularies, many seniors will pay more for these drugs under Part D. Any savings in copayments under Part D may be erased by the monthly premium and by more expensive cost-sharing when seniors reach the 'donut hole'.

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Figures

Figure 1
Figure 1
Distribution of ARBs on Part D formularies and formulary tier. Percentages indicate the proportion of Part D plans that include drug on formulary. ARBs are arranged in order of prevalence of current use among seniors. Drugs on tier 3 or above of a tiered formulary are generally less preferred brands with higher cost-sharing/copays
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References

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