- Sixteen of 2013's 190 PDPs have a preferred pharmacy network design.
- More than 4 out of 10 seniors enrolled in one of these 16 plans.
- The Humana Walmart-Preferred Rx Plan is now the fourth-largest PDP.
- Walgreen is a preferred pharmacy in plans with 30% of total PDP enrollment.
- SmartD, the Walgreens-plus-independents plan, was a bust.
Last October, I identified the following 16 Medicare Part D prescription drug plans (PDP) with preferred network structures.
- AARP MedicareRx
- AARP MedicareRx Preferred
- AARP MedicareRx Saver Plus
- Aetna CVS/pharmacy Prescription Drug Plan
- First Health Part D Essentials
- First Health Part D Value Plus
- Humana Enhanced
- Humana Walmart-Preferred Rx Plan
- SilverScript Choice
- SilverScript Plus
- SmartD Rx Plus
- SmartD Rx Saver
- First United American - Enhanced
- First United American - Select
- United American - Enhanced
- United American - Select
Data on PDP enrollment are available from this CMS page: Medicare Advantage/Part D Contract and Enrollment Data. Note that these data reflect enrollments accepted through December 5, 2012. The final numbers may be slightly different, because the open enrollment period ended two days later (on December 7, 2012).
WINNERS AND LOSERS
There were 190 PDPs with non-zero enrollment as of December 5, 2012. Total PDP enrollment was 21.3 million people. The 16 plans with preferred pharmacy networks enrolled 9.3 million people, or 43.5% of the total. Here’s a summary of the 16 PDPs with preferred pharmacy networks:
Observations and scorecard:
- Humana-Walmart wins again. The Humana Walmart Preferred Rx Plan, which launched in October 2010, is the fourth-largest PDP, with 8.2% of total PDP enrollment. Compared to January 2012, total enrollment increased by 349,827 seniors (+25.1%).
- The Aetna-CVS plan won, too. The Aetna CVS/pharmacy Prescription Drug Plan—the only other PDP co-branded with a chain pharmacy—boosted enrollment by 103,812 (+31.3%). Note that this plan is only one-quarter the size of the Humana-Walmart plan.
- Walgreen joined the preferred bandwagon. In 2013, Walgreen wisely decided to be a preferred pharmacy in the Coventry, Humana, UnitedHealthcare, and SmartD plans. In 2013, plans with Walgreens as a preferred pharmacy account for 30.4% of total PDP enrollment, and 69.8% of preferred pharmacy network enrollment.
- Walgreen’s SmartD plan was a bust. The SmartD Rx plans attracted a mere 45,854 seniors, or 0.2% of total PDP enrollment. These plans are offered by RxAlly, a new pharmacy group that claims to have about 14,000 independent pharmacies plus Walgreens drugstores. Walgreen is the major investor behind RxAlly and SmartD.
To read more on narrow networks, see the section starting on page 115 of the new 2012–13 Economic Report on Retail, Mail, and Specialty Pharmacies.
P.S. Check out the latest edition of the Health Wonk Review for some great policy analysis.
CORRECTION: An earlier version of this article incorrectly stated the percentage of plans with Walgreen as a preferred pharmacy.
One more item: In contrast to Walgreen, CVS will have limitedReplyDelete
participation in preferred Part D networks.
In addition to the Aetna/CVS plan, CVS is also a preferred pharmacy in the two CVS-owned SilverScript plans.Combined, the three plans accounted for only 3.9% of total PDP enrollment, and 9.0%
of preferred pharmacy network enrollment.
Should anyone be shocked by this? When the average American is given a choice of paying ZERO or a few dollars for medications if they chose to go go Pharmacy A versus having a higher copay at Pharmacy B, C , D or X then the majority will want to go to the Pharmacy with the lower copay. What will be troubling for these seniors is around March, when they tire of waiting 6 hours to get those Rx's filled at Walmart and then they transfer those RX's out to another Pharmacy they will become disenchanted with the fact that they are forced to pay higher copays at a Pharmacy that offers them the service levels that they desire. Another issue is the fact that federal dollars are going into a program that pushes Seniors,via collusion between insurance companies and chain drug stores, into a particular store. This is not only anti-competitive, it's anti American and it violates some states laws that have an any willing provider statute.ReplyDelete