Disabled Patients Skew Medicare Rx Benefit Design

If policy makers crafting a Medicare pharmacy benefit are worried about heavy prescription spending by seniors, they should take a closer look at medication use by the five million disabled beneficiaries in the program of 40 million patients. Medicare provides healthcare coverage for individuals under 65 who are totally and permanently disabled. Many qualify for Medicaid pharmacy benefits, but their low incomes make paying for prescription medicines particularly burdensome, according to a report on "Medicare's Disabled Beneficiaries: The Forgotten Population in the Debate Over Drug Benefits" from the Commonwealth Fund and the Henry J. Kaiser Family Foundation. That population fills more prescriptions and spends more on medicines each year than the elderly. (See "The Other Medicare Patients.")

The Other Medicare Patients

Moreover, the report points out, disabled Medicare beneficiaries use a different mix of pharmaceuticals than seniors do. Most notable is the heavy use of psychotherapeutics and analgesics -both low on the list of drugs commonly used by Medicare patients. (See "One Program, Two Lists.")

One Program, Two Lists