OVERVIEW OF MEDICARE PART D IN 2012 AND TRENDS OVER TIME Juliette - - PowerPoint PPT Presentation

OVERVIEW OF MEDICARE PART D IN 2012 AND TRENDS OVER TIME

Juliette Cubanski, Ph.D.

Associate Director, Program on Medicare Policy The Henry J. Kaiser Family Foundation June 6, 2012

Prescription Drug Coverage Among Medicare Beneficiaries in 2012

Part D non‐LIS enrollees 21.7 million Part D LIS enrollees 11.0 million Employer subsidy 4.5 million All other 13.5 million

Exhibit 1

SOURCE: 2012 Medicare Trustees report. NOTE: LIS is low‐income subsidy. Total Part D and Medicare enrollment based on 2012 intermediate estimates.

Total Medicare Enrollment in 2012 = 50.7 million Total Part D Enrollment (excluding employer subsidy) = 32.7 million

26% 43% 22% 9%

SOURCE: Kaiser Family Foundation analysis of Centers for Medicare & Medicaid Services PDP landscape file, 2012. NOTE: Excludes Medicare Advantage Drug Plans.

25‐29 drug plans (8 states) 30 drug plans (17 states) 31‐32 drug plans (8 states and DC) 33‐36 drug plans (17 states)

Number of Medicare Part D Stand‐Alone Prescription Drug Plans (PDPs), by Region, 2012

Exhibit 2

31 30 33 29 30 30 28 30 30 30 25 25 33 30 34 30 30 30 32 33 29 33 29 30

OR, WA

33

IA, MN, MT, NE, ND, SD, WY

33

ID, UT

31

IN, KY

30

CT, MA, RI, VT

31

DE, DC, MD

36

PA, WV

32

AL, TN

30

NJ

28

ME, NH

33

National Average: 31 drug plans

Weighted Average Monthly Premiums for Medicare Part D Stand‐Alone PDPs, 2006‐2012

Exhibit 3

SOURCE: Georgetown/NORC analysis of data from CMS for the Kaiser Family Foundation. NOTE: Average premiums are weighted by enrollment in each year (Feb for 2012). Excludes plans in the territories.

$25.93 $27.39 $29.89 $35.09 $37.25 $38.29 $37.89 $0 $5 $10 $15 $20 $25 $30 $35 $40 2006 2007 2008 2009 2010 2011 2012

2006‐2012: 46% increase

2011‐2012: 1% decrease

Premiums in Medicare Part D Stand‐Alone PDPs with Highest 2012 Enrollment, 2006‐2012

Name of PDP in 2012

2012 Enrollment (of 17.5 million) Weighted Average Monthly Premium1 % Change Number

(in millions)

% of Total 2006 2011 2012 2011‐ 2012 2006‐ 2012

AARP MedicareRx Preferred

4.0 23.0% $26.31 $34.72 $39.85 +15% +51%

CCRx Basic

1.8 10.4% $30.94 $29.71 $30.74 +3% ‐1%

Humana Walmart‐ Preferred2

1.4 8.0% ‐‐ $14.80 $15.10 +2% ‐‐

Humana PDP Enhanced

1.4 7.9% $14.73 $43.74 $39.58 ‐9% +169%

CVS Caremark Value

1.3 7.6% $28.32 $30.54 $30.27 ‐1% +7%

SOURCE: Georgetown/NORC analysis of CMS 2006‐2012 PDP Landscape Files for the Kaiser Family Foundation. NOTES: 1Average premiums are weighted by enrollment in each region for each year. 2Humana Walmart‐Preferred PDP was not offered before 2011.

Exhibit 4

Costs in Medicare Part D Stand‐Alone PDPs with Highest 2012 Enrollment in 20037 Zip Code (DC)

Name of PDP Monthly premium Deductible Lipitor Actonel TOTAL ANNUAL COST Tier Cost Tier Cost AARP MedicareRx Preferred

$37.50 $0 3 $43 3 $43

$1,482

CCRx Basic

$32.80 $320 1 $2 Not covered 100% ($145.14) $2,475

Humana Walmart‐ Preferred2

$15.10 $320 3 20% ($43.75) 4 35% ($50.41) $1,509

Humana PDP Enhanced

$43.80 $0 2 $40 3 $74 $1,894

CVS Caremark Value

$33.30 $320 1 $9.50 Not covered 100% ($145.14) $2,556

SOURCE: Kaiser Family Foundation analysis of data from Medicare Plan Finder.

Exhibit 5

Costs for Top Brands in Stand‐Alone PDPs with Highest 2012 Enrollment in 20037 Zip Code (DC)

$43.00 $43.00 $43.00 $43.00 $43.00 $95.00 $43.00 $43.00 $43.00 $95.00 $145.14 $69.80 $60.21 $24.13 $31.64 $59.78 $2.00 $47.16 $95.83 $109.93 $50.41 $104.76 $90.37 $36.21 $44.41 $46.73 $43.75 $220.41 $80.98 $85.93

Actonel Actos Advair Diskus Diovan Lantus Lexapro Lipitor Nexium Plavix Seroquel AARP Preferred CCRx Basic Humana Walmart

SOURCE: Kaiser Family Foundation analysis of data from Medicare Plan Finder.

Exhibit 6

(not covered) (not covered)

Cost Sharing for Medicare Part D Stand‐Alone PDPs, 2006 and 2011

SOURCE: Georgetown/NORC analysis of data from CMS for MedPAC and the Kaiser Family Foundation. NOTES: Part D cost‐sharing amounts are medians. Analysis excludes generic/brand plans, plans with coinsurance for regular tiers, and plans with flat copayments for specialty tiers.

Exhibit 7 $5 $28 $55 $7 $42 $78 Generic Preferred brand Non‐preferred brand

2006 2011

25% 30% Specialty

33 31 34 34 10 25 25 27 3 23 34 4 34 2006 2007 2008 2009 2010 2011 2012

Number of Low‐Income Subsidy “Benchmark” Plans Offered by Two Major Part D Sponsors, 2006‐2012

SOURCE: Georgetown/NORC analysis of CMS PDP landscape files, 2006‐2012, for the Kaiser Family Foundation. NOTES: Counts include combined offerings of merged organizations.

UnitedHealth Humana

Number of PDP regions (out of 34):

Exhibit 8

1,990,000 LIS enrollees in 2011 831,000 LIS enrollees in 2011