Angiotensin receptor blockers on the formularies of Medicare drug plans.
BACKGROUND
The presence of angiotensin receptor blockers (ARBs) on the formularies of Medicare Part D prescription drug plans (PDPs) is vitally important to the health of seniors who cannot tolerate angiotensin-converting enzyme (ACE) inhibitors.


OBJECTIVE
To determine whether ARBs are present on the formularies of PDPs and how the prescription cost-sharing for ARBs under Part D compares to cost-sharing before Part D.


METHODS
Cross-sectional analyses of March 2006 Medicare Part D formularies (n = 1,446) and of ARB utilization and cost-sharing for adults over the age of 64 included in the nationally representative Medical Expenditure Panel Survey.


METHODS
(1) Presence of ARBs on Part D formularies. (2) Average out-of-pocket costs for 30-day supply of ARBs before and after Part D (both in 2006 dollars).


RESULTS
All PDP formularies included at least 1 ARB. Most plans covered 2 ARBs (41%) and 35% covered all 7. The average monthly copay for the most commonly used ARB, valsartan, is $28 under part D, $14 before Part D for individuals with prescription coverage, and $53 before Part D for individuals without coverage.


CONCLUSIONS
Whereas ARBs are present on all Part D formularies, many seniors will pay more for these drugs under Part D. Any savings in copayments under Part D may be erased by the monthly premium and by more expensive cost-sharing when seniors reach the 'donut hole'.
Gellad
Walid F
WF
Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Boston, MA 02120-1613, USA.
Huskamp
Haiden A
HA
Phillips
Kathryn A
KA
Haas
Jennifer S
JS
D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000191:economics*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000191:economics; D000959:Antihypertensive Agents / Q000191:economics*; D017047:Cost Sharing; D016527:Drug Costs; D005569:Formularies as Topic; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D006278:Medicare; D014481:United States
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents