Texans often struggle to follow the medication regimens their doctors have prescribed.
A recent study ranked San Antonio, Dallas and Houston among the bottom 10 cities in America for prescription adherence.
That’s a scary reality, as failure to follow a prescription plan often results in more hospitalizations, health scares and deaths — adding as much as $300 billion to the nation’s annual healthcare bill.
The Medicare prescription drug program, Part D, has proven extraordinarily effective in addressing the problem of non-adherence, helping 1.5 million Texas seniors and those in the disability community access the drugs they need.
Unfortunately, some lawmakers want to tinker with Part D, imposing virtual price controls that would fundamentally alter the competitive structure that has made the program a runaway success.
As U.S. Rep. Michael Burgess, R-Lewisville, has pointed out, Part D has succeeded primarily because of “its competitive, free-market structure.”
Insurers participating in the program compete for enrollees’ business, resulting in high-quality offerings at an affordable cost.
Texas Part D beneficiaries can choose from 28 drug coverage plans.
From 2006 to 2007 — the first year of Part D — beneficiaries saved an average of $300 in yearly out-of-pocket costs.
Nationwide, about 90 percent of Part D beneficiaries say they are satisfied with the program.
New estimates indicate that Part D premium costs will remain steady through 2016, averaging $32.50 a month nationwide. Part D premiums have been relatively stable since 2011.
In addition, a study examining the first two years of the program found that yearly non-drug medical spending decreased by $1,200 per beneficiary for those who had limited or no prior coverage.
Despite Part D’s success in helping Texans afford their prescriptions, some lawmakers contend that Medicare spends too much on drugs.
Only 11 percent of Medicare’s budget is dedicated to the drug benefit, and this benefit has cost far less than originally expected.
Some in Washington want to interfere with the program — essentially imposing price controls across Medicare Part D.
Pharmaceutical companies invest an average of $2.6 billion on each new medication and devote about a decade to the necessary research and development to bring a new medicine to market.
Only a tiny fraction of drugs makes it to the human clinical trial stage, while even fewer receive federal approval. And among that elite minority, only one in three ever recovers its investment.
Government interference in Part D will negatively affect medical innovation, resulting in fewer groundbreaking cures for future generations of Medicare beneficiaries.
The Department of Veterans Affairs is an example of such government interference, as it restricts access to medications to derive artificially low prices. Veterans have access to fewer drugs than Part D beneficiaries.
On average, more than 95 percent of the top 200 Part D drugs are covered by the two highest-enrollment Part D plans, while only 81 percent of those drugs are on the VA formulary.
For the sake of senior citizens, the disability community and the economy alike, Texans need to send Congress a simple message when it comes to Medicare Part D: Don’t mess with success.
Rita Littlefield is a longtime Texas patient advocate and a founding member of the Texas Renal Coalition.