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

Exhibit 1 Prescription Drug Coverage Among Medicare Beneficiaries in 2012 Part D non ‐ LIS enrollees 21.7 million 43% All other 13.5 million 26% 9% 22% Employer Part D LIS subsidy enrollees 4.5 million 11.0 million Total Medicare Enrollment in 2012 = 50.7 million Total Part D Enrollment (excluding employer subsidy) = 32.7 million SOURCE: 2012 Medicare Trustees report. NOTE: LIS is low ‐ income subsidy. Total Part D and Medicare enrollment based on 2012 intermediate estimates.

Exhibit 2 Number of Medicare Part D Stand ‐ Alone Prescription Drug Plans (PDPs), by Region, 2012 National Average: 31 drug plans 28 ME, NH 30 30 OR, WA 33 CT, MA, 29 29 RI, VT IA, MN, MT, NE, ND, 34 SD, WY 30 33 36 NJ 33 ID, UT PA, WV 29 33 31 31 30 28 DE, DC, MD 33 31 30 IN, KY 30 32 32 30 30 30 30 AL, TN 30 30 30 33 25 33 25 25 ‐ 29 drug plans (8 states) 30 drug plans (17 states) SOURCE: Kaiser Family Foundation analysis of Centers for Medicare & 31 ‐ 32 drug plans (8 states and DC) Medicaid Services PDP landscape file, 2012. 33 ‐ 36 drug plans (17 states) NOTE: Excludes Medicare Advantage Drug Plans.

Exhibit 3 Weighted Average Monthly Premiums for Medicare Part D Stand ‐ Alone PDPs, 2006 ‐ 2012 $38.29 $37.89 $40 $37.25 $35.09 $35 2011 ‐ 2012: 1% decrease $29.89 $30 $27.39 $25.93 $25 $20 2006 ‐ 2012: 46% increase $15 $10 $5 $0 2006 2007 2008 2009 2010 2011 2012 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.

Exhibit 4 Premiums in Medicare Part D Stand ‐ Alone PDPs with Highest 2012 Enrollment, 2006 ‐ 2012 2012 Enrollment Weighted Average % Change Monthly Premium 1 (of 17.5 million) % of 2011 ‐ 2006 ‐ Number 2006 2011 2012 (in millions) Total 2012 2012 Name of PDP in 2012 AARP MedicareRx 4.0 23.0% $26.31 $34.72 $39.85 +15% +51% Preferred CCRx Basic 1.8 10.4% $30.94 $29.71 $30.74 +3% ‐ 1% Humana Walmart ‐ 1.4 8.0% ‐‐ $14.80 $15.10 +2% ‐‐ Preferred 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: 1 Average premiums are weighted by enrollment in each region for each year. 2 Humana Walmart ‐ Preferred PDP was not offered before 2011.

Exhibit 5 Costs in Medicare Part D Stand ‐ Alone PDPs with Highest 2012 Enrollment in 20037 Zip Code (DC) TOTAL Lipitor Actonel Monthly Deductible ANNUAL premium Tier Cost Tier Cost Name of PDP COST AARP $1,482 MedicareRx $37.50 $0 3 $43 3 $43 Preferred Not 100% CCRx Basic $32.80 $320 1 $2 $2,475 covered ($145.14) Humana 20% 35% Walmart ‐ $15.10 $320 3 4 $1,509 ($43.75) ($50.41) Preferred 2 Humana PDP $43.80 $0 2 $40 3 $74 $1,894 Enhanced CVS Caremark Not 100% $33.30 $320 1 $9.50 $2,556 Value covered ($145.14) SOURCE: Kaiser Family Foundation analysis of data from Medicare Plan Finder.

Exhibit 6 Costs for Top Brands in Stand ‐ Alone PDPs with Highest 2012 Enrollment in 20037 Zip Code (DC) AARP Preferred CCRx Basic Humana Walmart $43.00 Actonel $145.14 $50.41 (not covered) $43.00 Actos $69.80 $104.76 $43.00 Advair Diskus $60.21 $90.37 $43.00 Diovan $24.13 $36.21 $43.00 Lantus $31.64 $44.41 $95.00 Lexapro $59.78 $46.73 $43.00 Lipitor $2.00 $43.75 $43.00 Nexium $47.16 $220.41 (not covered) $43.00 Plavix $95.83 $80.98 $95.00 Seroquel $109.93 $85.93 SOURCE: Kaiser Family Foundation analysis of data from Medicare Plan Finder.

Exhibit 7 Cost Sharing for Medicare Part D Stand ‐ Alone PDPs, 2006 and 2011 2006 2011 $78 $55 $42 30% $28 25% $7 $5 Generic Preferred brand Non ‐ preferred Specialty brand 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 8 Number of Low ‐ Income Subsidy “Benchmark” Plans Offered by Two Major Part D Sponsors, 2006 ‐ 2012 Number of PDP 2006 2007 2008 2009 2010 2011 2012 regions (out of 34): 34 34 34 34 33 31 27 25 25 23 10 4 3 0 UnitedHealth Humana 1,990,000 LIS enrollees in 2011 831,000 LIS enrollees in 2011 SOURCE: Georgetown/NORC analysis of CMS PDP landscape files, 2006 ‐ 2012, for the Kaiser Family Foundation. NOTES: Counts include combined offerings of merged organizations.