Pricing and Reimbursement Series Medicare Part D's progress so far

Introduction

The roll-out of Part D in January 2006 represented a significant leap forward, since it provided coverage for outpatient drugs for Medicare patients for the first time. A high number of both patients and insurance providers are now involved in the program, as a result of strong patient enrollment.

Scope of this report

Overview of Part D enrollment, plus an analysis of how it has impacted the healthcare insurance market, and the branded and generic drug environment

Analysis of how Part D plans have changed from 2006 to 2007

Analysis of problems faced by Part D since its roll-out, and the identification of possible improvement areas going forward

Identification of how key issues such as the dual eligible patient population and drug sourcing in the donut hole are shaping Part D evolution

Research and analysis highlights

Uptake into Part D has been strong, and despite the size and complexity of the program, patient satisfaction has been relatively high. The program faced a number of teething problems during roll-out, which have largely been resolved (e.g. IT issues); however, there are still a number of issues that haven't been remedied.

A significant factor to impact Part D is the way that plan providers have handled patients covered by both Medicare and Medicaid. Providing these 'dual eligibles' with adequate coverage has been a significant challenge, particularly during the roll-out of the program.

The choice facing Part D beneficiaries about where to source drugs when they enter the gap in coverage in Part D programs (termed the donut hole) is also impacting plan providers and patients, since patient choice in this situation has a significant impact on market dynamics.

Key reasons to read this report

Gain a clear understanding of how Part D has evolved since its roll-out in January 2006

Understand the problems that Part D has faced, together with identifying areas for improvement

Gain insight into the key issues that are shaping Part D currently and in the future

Published: 30 March 2007

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