Few Apply for Medicare Drug Coverage 

By MARK SHERMAN, Associated Press Writer 

WASHINGTON - Far from the expected deluge, relatively few patients 
with cancer and other serious illnesses have applied for generous 
early Medicare prescription drug coverage. 

 

The Bush administration was planning a lottery to determine who 
would get the 50,000 slots included in last year's Medicare 
prescription drug law. Instead, just 6,364 people have applied for 
the head start on drug insurance for costly cancer medicines taken 
orally and self-injectable drugs for multiple sclerosis, rheumatoid 
arthritis and other diseases. 


The Medicare Web site now advises: "There are still many enrollment 
slots available!" 


Patient advocates and physicians blame the low enrollment on several 
problems: The government scared off some people by using the term 
lottery and hasn't publicized the program enough. In addition, it 
came up with an intimidating application for people with 
debilitating, life-threatening illnesses. 


Complaints about complexity also have been raised regarding the 
Medicare discount drug card program, where enrollment also has 
fallen short of expectations. 


The experience so far is a cautionary tale for the new full-blown 
Medicare prescription drug benefit scheduled to begin in 2006. 
Advocates, health-care analysts and even government officials expect 
that will be even harder to sort out. 


"Maybe all of us were overly optimistic about how eager the consumer 
would be to get into the program," said Nancy Davenport-Ennis, chief 
executive of the not-for-profit Patient Advocate Foundation, which 
says it has helped obtain early coverage for 324 people. 


The administration had expected tens of thousands of people like 81-
year-old Helen Curtis to step forward when it unveiled the new 
program in June. While many cancer drugs administered in doctors' 
offices already are covered under Medicare, costly newer oral 
medicines and most drugs for other illnesses are not. 


Curtis had been spending $560 for each shot of Abbott Laboratories' 
Humira that she injects herself with every two weeks to relieve 
symptoms of rheumatoid arthritis � a cost that would reach
$14,560 
for a full year. 


Since her coverage began Sept. 1, Curtis said she will pay $1,200 
for the medicine for the rest of the year, amounting to less than 
$150 per injection. 


Unusual for someone her age, Curtis is an avid computer user and 
read about the program online. "I told my doctor about it and even 
took extra forms for other patients," she said in a telephone 
interview from her home in Scarsdale, N.Y. 


"The sad thing is, people didn't know about it," she said. 


Dr. Mark McClellan, administrator of the federal Centers for 
Medicare and Medicaid Services, said his agency is increasing 
efforts to publicize the program among physicians and organizations 
dedicated to the affected diseases. 


"Some beneficiaries have gotten misinformation because they think 
the program might not provide much of a benefit or they might not 
have much chance of getting in," McClellan said. "That's absolutely 
not correct." 


The perception was at least partly created by McClellan's boss, 
Health and Human Services (news - web sites) Secretary Tommy 
Thompson. When he announced the program in June, Thompson said more 
than a half-million people without prescription drug coverage would 
be eligible. 


"There'll be a lottery to be chosen as one of 50,000 lucky 
individuals," Thompson said then. 


Medicare was planning two lotteries, the first in August to fill 
5,000 slots. Instead, virtually all the 3,700 applicants were 
enrolled in the program. Officials set a second application deadline 
of Sept. 30. 

   



McClellan now says Medicare will continue to accept applications 
beyond the end of the month. Medicare also has dropped all mention 
of a lottery, which some critics found distasteful when talking 
about serious illness. 

That change probably was a good thing, said Davenport-Ennis, the 
patient advocate. 

"Speaking as a two-time cancer survivor, if you're battling an 
illness you know can take your life and already conserving all of 
your emotional reserves to battle the disease, you may be dissuaded 
just by the word lottery," she said. 

Bob Hall, chief lobbyist for the National Coalition for Cancer 
Survivorship, said the application form was too complex, although 
several groups offer help filling it out. "You think about the 
Medicare population and that population might not be one that 
gravitates towards a 12-page application," Hall said. 

Still, advocates said they have been surprised by the lack of 
participation, given the number of people they presume to be 
eligible. 

But Dr. David Johnson, a Nashville, Tenn., cancer specialist and 
president of the American Society of Clinical Oncology (news - web 
sites), said even the most generous benefit is of little value to 
people who don't know about it. 

"This is something that hasn't been widely publicized," he said. "I 
didn't know about this thing until our policy people raised it with 
me." 

___ 

On the Net: 

Centers for Medicare and Medicaid Services: http://www.cms.hhs.gov 

Patient Advocate Foundation: http://www.patientadvocate.org 




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