title: Medicare-approved drug discount cards and renal transplant patients: how much can these cards reduce prescription costs?
abstract: BACKGROUND
  Post-transplant prescription medications are expensive, often costing over 12,000 dollars annually. Many solid-organ transplant patients have Medicare coverage and patients enrolled in Medicare-approved drug discount card (MADDC) programs may be able to receive prescription medications at a reduced price. However, many transplant healthcare practitioners are unaware of the utility of MADDCs. The purpose of this study was to determine whether enrolling renal transplant patients (RTPs) into a MADDC produces significant savings in prescription costs.
  
  
  METHODS
  Two Medicare RTPs, with prescription medication profiles representative of an RTP within 3 months post-transplant and an RTP greater than 5 yr post-transplant, were randomly selected from the Medication Access Program's database. Cost benefit analyses were from the patients' perspective and were performed using the: (i) prescription cost from the Medicare website of MADDCs that listed the greatest and least prescription costs compared with the retail cash price of the same prescription without using the MADDCs; and (ii) MADDCs' annual enrollment fee. The potential cost difference of using MADDCs and not using MADDCs to purchase the prescription medications were calculated.
  
  
  RESULTS
  RTPs' monthly out-of-pocket cost for prescription medications ranged from 162 dollars to 340 dollars, and MADDCs offered discounts of 20-37% from retail prices; thus outweighing the MADDC enrollment cost.
  
  
  CONCLUSIONS
  MADDCs, when selected and used appropriately, can reduce prescription medication cost for RTPs. Card selection is of great importance as discount rates vary greatly among cards, and only under restricted circumstances is a patient allowed to switch to another card. It is imperative that practitioners are aware of these programs and utilize cost-effective prescribing practices.
authors.affiliation: University of Georgia College of Pharmacy, Augusta, GA 30912, USA. mchishol@mail.mcg.edu
authors.forename: Marie A
authors.initials: MA
authors.lastname: Chisholm
authors.forename: Josh
authors.initials: J
authors.lastname: Marshall
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Smith
authors.forename: Charlene J
authors.initials: CJ
authors.lastname: Garrett
authors.forename: Jeanie C
authors.initials: JC
authors.lastname: Turner
mesh_terms: D017046:Cost Savings / Q000191:economics; D003362:Cost-Benefit Analysis; D011307:Drug Prescriptions; D005260:Female; D005380:Financing, Government / Q000191:economics; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D016030:Kidney Transplantation / Q000191:economics*; D008297:Male; D006278:Medicare / Q000191:economics*; D011306:Prescription Fees; D014481:United States