Thanks for writing in, and I recognize the report wasn’t perfect. For the record, I have added a Reader’s Note to the post - please see the jump page by clicking ‘Read More’ near the bottom - to explain that the post, basically, summarized the report. This was an instance where I was, for worse or better, simply posting a news item, and this once mostly relied on a Reuters dispatch, which is credited and a link is provided. Although I did provide links to the report and the committee statement as well.

I’d like to be clear that I was not ‘taking sides’ or advocating a view on the merits of Medicare Part D. As to the headline, I also address that in the Reader’s Note, but just so everyone is clear: In colloquial terms, the committee’s description conjured up the notion of a mess. However, I have added attribution now in the headline so, hopefully, it is clearer that this is the view of the committee’s Democrats, and not my own.

I hope this helps to the extent that my own view is a little better understood. I recognize that Medicare Part D has accomplished some needed goals.

Thanks, as always, for writing in.

ed at Pharmalot

There are quite a few factual errors in the report, as well. For example, the report confuses pharmacy reimbursement with beneficiary cost. I was dissappointed with your perjorative headline.

Nonetheless, I think the industry should be worried that the Democrats will use the Average Manufacturer Price (AMP) rules (now being impemented by CMS) to reign in Part D. It’s not obvious, but it would work. See my post:

http://www.drugchannels.net/2007/10/part-d-amp-trouble.html

Regards,
Adam

Thanks for the informed comments. Really appreciate it. I will start working with you on the Democrat part later :)

On an additional note…the graphic from the Dem study comparing Medicare vs. Medicaid rebates is quite misleading. By law, without any negotiation, states get a minimum of a 15.1% rebate; moreover, they also get a CPI ceiling and best price protection. Thus without any negotiation at all, the overall rebate or discount to states exceed 22%. The small remainder comes from negotiation. Thus, the negotiated rebate is actually greater in Part D than Medicaid. Another key difference is that if a state Medicaid program decides to deny access to a product if a negotiation fails, it is next to impossible for a beneficiary to get it. In Medicare, at least there is an opportunity to switch plans (remember dual eligibles can switch every month).

Of course, it’s easy to create a Medicaid level rebate in Part D; just pass a law mandating a minimum rebate of 25%. Of course, why stop there? Why not mandate a 50% rebate. Better yet, why not mandate free drugs for all?

Of course, this is but one flaw in the Waxman report. The minority report points out many others. Is Part D perfect. Not at all. However, it might be hard to find another new government program that comes in substantially under budget and has such high satisfaction rates.

I actually did post the Republican response. It’s on the jump page, which can be seen by clicking ‘read more.’ But I’ve moved it up. I should have realized it needed to be placed higher. Sorry for the confusion.

ed at Pharamlot

This was the majority report…and was specifically designed to discredit a program that has an 89% approval rating by Medicare enrollees (you’ll find that this research was released today). In addition, as a balance you should publish information from the minority report which discredits most of the analysis. I am a lifelong (well at least since I was a teen) Democrat, but I also believe that the Part D program is working relatively well.

Atlex